[Vision2020] Examples Debunk Health Care Myths

[Tom Hansen]

Courtesy of today's (March 7, 2010) Spokesman-Review and Trudy Rubin.

--------------------------------------------------

Examples debunk health care myths
Trudy Rubin, The Spokesman-Review

One of the most bewildering aspects of the current health care debate is
the failure to learn key lessons from health systems abroad.

Conservative talk show hosts decry the alleged evils of “socialized
medicine” in countries with universal health coverage; they warn grimly of
rationed health care. Yet there’s nary a peep from Rush Limbaugh or Glenn
Beck – let alone Congress – about countries such as Germany, France,
Switzerland, or Japan, where coverage is universal, affordable, and top
quality, and patients see private doctors with little or no waiting.

And, oh yes, their health costs are a fraction of our bloated numbers: The
French spend 10 percent of GDP on health care, the Germans 11 percent, and
they cover every citizen. We spend a whopping 17 percent and leave tens of
millions of Americans uninsured.

If you want a very readable short course how European systems really work,
take a look at “The Healing of America: A Global Quest for Better,
Cheaper, and Fairer Health Care,” by T.R. Reid, a former Washington Post
foreign correspondent. You might also watch a fascinating 2008 “Frontline”
series, available online, in which Reid was an adviser: “Sick Around the
World: Can the U.S. Learn Anything From the Rest of the World About How to
Run a Health Care System?”

So far, the answer seems to be “No,” not because there aren’t valuable
lessons, but because politicians won’t relinquish their myths about
European health systems. Reid takes up that task.

Myth No. 1, he says, is that foreign systems with universal coverage are
all “socialized medicine.” In countries such as France, Germany,
Switzerland and Japan, the coverage is universal while doctors and
insurers are private. Individuals get their insurance through their
workplace, sharing the premium with their employer as we do – and the
government picks up the premium if they lose their job.

Myth No. 2, “long waits and rationed care,” is another whopper. “In many
developed countries,” Reid writes, “people have quicker access to care and
more choice than Americans do.” In France, Germany and Japan, you can pick
any provider or hospital in the country. Care is speedy and high quality,
and no one is turned down.

Myth No. 3 really grabs my attention: the delusion that countries with
universal care “are wasteful systems run by bloated bureaucracies.” In
fact, the opposite is true.

America’s for-profit health insurance companies have the highest
administrative costs of any developed country. Twenty percent or more of
every premium dollar goes to nonmedical costs: paperwork, marketing,
profits, etc. In developed countries with universal coverage, such as
France and Germany, the administrative costs average about 5 percent.
That’s because every developed country but ours has decided health
insurance should be a nonprofit operation. (We once thought that, too,
until private insurance companies began buying up nonprofit health
insurers like Blue Cross and Blue Shield and converting them into
profit-makers.) In France and Germany, health insurance is sold by private
insurers, who can only charge fixed rates in the nonprofit health field
but can sell other forms of insurance for a profit.

These countries also hold down costs by making coverage mandatory and by
using a unified set of rules and payment schedules for all hospitals and
doctors. This does not mean a single-payer system or a government-run
health system. But it does sharply cut health costs by eliminating the
mishmash of records and charges used by our myriad insurance firms, who
use all kinds of gimmicks to shift their costs. A unified system makes it
possible for France and Germany to use digital records; every insured
person has a smart card that includes all his or her health information,
further cutting the number of bureaucrats. U.S. companies oppose such
efficiencies, Reid says, “because they spend money on proprietary systems
and no one wants to get together on a common system.” Can we afford this
stubbornness?

For those who think we could never make the switch to such systems, take
note that Switzerland shifted from private health insurers to nonprofits
in 1994. None of these European plans have to be adopted wholesale.

Yet there’s no sign we’re even examining them for useful lessons. Some
U.S. senators on the Finance Committee bought Reid’s book, but have you
heard anyone talk about European health systems? Of course not. It’s
easier to embrace our myths and pretend Americans know best about managing
health care. But that’s the biggest myth of them all.

--------------------------------------------------

Seeya round town, Moscow.

Tom Hansen
Moscow, Idaho

"The Pessimist complains about the wind, the Optimist expects it to change
and the Realist adjusts his sails."

- Unknown