Universal Health Care...pros and cons.?
the only way it will ever work to help all people is if it's universal. they way insurance companies do it is they only give insurance to people they don't think will cost them money. so sick people can't get it (unless their job has a plan that covers everyone). so you have to make them give insurance to sick people. they won't do it unless you make them. but you also have to make everyone buy it. if you don't, then people will buy a car instead or whatever and then still get treatment when they get sick. but it's better to treat them while they're healthy and prevent illnesses. and if you don't make everyone buy it, then it costs more for the people who do. there's no free lunch and someone always has to pay for everything. it's fairer to have everyone pay equally. plus it brings the cost down for everyone if the insurance companies can't play their games that are only for their benefit. (by the way, despite the extremely deceptive ad that obama is running, hillary's plan does NOT require people to buy insurance "even if they can't afford it." if they can't afford it, her plan has subsidies to reduce or eliminate the cost.)
What are some of the primary drivers of health care cost?
My top 4 picks - random order:Lack of pricing transparency. Lot's of work underway to change this - but Mary Meeker did a financial analysis of USA, Inc earlier this year. Her chart highlights how consumer "out-of-pocket" healthcare expenses went from 47% in 1960 to 12% in 2009. Her chart (below) was meant to highlight the growth of Medicare/Medicaid - but I found the out-of-pocket percentages to be noteworthy as well. When the patient/consumer doesn't know or understand pricing - it has a corrosive effect on the system overall.Obesity epidemic. The CDC has a great time-lapse version of this chart - which shows how the country (state-by-state) has added weight. The time lapse version is compelling to watch - online here: http://1.usa.gov/p1d1LQ The health effects of this are numerous - well known - and largely preventable.Volume versus value payment model. The US healthcare system has evolved to one which rewards volume over value. As a single example - imaging scans per thousand insured patients went from 85 in 1999 to 234 in 2007. There are more MRI machines in Pittsburgh than Canada ( http://healthcare-economist.com/... ), and doctors are four-times more likely to order a scan if they own the imaging equipment than ones who don't. Providers will argue that "defensive medicine" (to avoid litigation) is to blame. Shannon Bronlee's book - Overtreated - also highlights the role of patients in this equation.Inefficient and/or fraudulent administration. Billing errors, Medicare fraud (estimated at about $50B/yr), paper-claims processing, paper health records, Rx errors - all add up.Much of this was also summarized by PWC in their 2008 landmark study called: The Price of Excess. They estimated that $1.2T - or about 50% of all healthcare spending - is wasted. They had three similar categories: Behavioral, Clinical and Operational. That study is downloadable online here: http://bitly.com/hmFymb
How would you fix health care in the US?
I'm speaking from an outsiders point of view, so I may not know everything about US health-care but I've seen Michael Moore's Sicko and I lived in Sarasota FL for a while so I know a bit. I think that the problem is that corporations that supply health care in the USA are more bothered by revenue than they are by the health of their customers. That's understandable, as they're a business. But making money out of the declining health of others is just about the most unethical form of business imaginable, so obviously a change is needed. The one thing that I suggest is the same thing as so many other companies around the world already use. A National Health Service. Here in the UK, all surgical treatment is free, as is most pharmaceutical health care. Some prescription drugs over here are sold at a fixed price, but these are easily cheap and affordable. The one problem that we do experience here (a problem which is often exaggerated hugely in the US, is waiting lists. Obviously free care means that everyone in the country is as entitled to a certain operation or procedure if they need it, than anyone else. But this problem can be countered if you pay to seek private health care elsewhere. Overall a national health policy is a huge advantage over here and one which is often taken for granted. Sure, it takes a bit out in taxes, but the benefits make it worth while eventually.
Which Country has the best Health Care System?
Great Britain and Canada both provide universal single payer systems. Everyone has care that they pay for through taxes. There are NO uninsured patients. And cost is not really an issue. These systems also have downsides, disease survival rates, waiting times, shortages of medicine and medical technology, and quality of care and doctors all are major problems in both of these systems. In France, Germany, and many other developed nations they have universal multipayer health care. Basically these systems have a large portion of Health Care costs covered by the government, they also have government insurance available to everyone, while also having a small private insurance market. These countries also have ups and downs. Quality and disease survival rates are not as big of issues, but they are still issues. Shortages also plague these systems Finally, the US (my country) has a private Health Care system, with a good amount of government regulation and a robust safety net (which has gotten bigger due to the recent passage of "Obamacare". The US system undoubtedly has the best doctors, highest quality, shortest waiting times, best disease survival rates, most innovative medicine companies, and the best availability of medical technology. However, our system is VERY expensive. We have 46 million uninsured. We also have people who struggle to pay for medical care becuase they get dropped... So, which one is best?