Health Care myths around the world

Last year, Washington Post correspondent, TR Reid, created an amazing documentary entitled "Sick Around the World."  So good, I've made it required viewing for my Public Policy class ever since.  He's got a new book on the matter, too, that I am really looking forward to reading.  I don't expect many of you to watch the video or read the book, but fortunately for you, he's summed up some of the best points into a nice little essay in a recent essay for the Post in which he takes on 5 health care myths. My favorite parts:

3. Foreign health-care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free
enterprise — private-sector, for-profit health insurance — is
naturally the most cost-effective way to pay for health care. But in
fact, all the other payment systems are more efficient than ours.

U.S. health insurance companies have the highest administrative
costs in the world; they spend roughly 20 cents of every dollar for
nonmedical costs, such as paperwork, reviewing claims and marketing.
France's health insurance industry, in contrast, covers everybody and
spends about 4 percent on administration. Canada's universal insurance
system, run by government bureaucrats, spends 6 percent on
administration. In Taiwan, a leaner version of the Canadian model has
administrative costs of 1.5 percent; one year, this figure ballooned to
2 percent, and the opposition parties savaged the government for
wasting money.

The world champion at controlling medical costs is
Japan, even though its aging population is a profligate consumer of
medical care. On average, the Japanese go to the doctor 15 times a
year, three times the U.S. rate. They have twice as many MRI scans and
X-rays. Quality is high; life expectancy and recovery rates for major
diseases are better than in the United States. And yet Japan spends
about $3,400 per person annually on health care; the United States
spends more than $7,000.

And the conclusion:

All the other developed countries have settled on one model for
health-care delivery and finance; we've blended them all into a costly,
confusing bureaucratic mess.

Which, in turn, punctures the most persistent myth of all: that
America has "the finest health care" in the world. We don't. In terms
of results, almost all advanced countries have better national health
statistics than the United States does. In terms of finance, we force
700,000 Americans into bankruptcy each year because of medical bills.
In France, the number of medical bankruptcies is zero. Britain: zero.
Japan: zero. Germany: zero.

Given our remarkable medical assets — the best-educated doctors and
nurses, the most advanced hospitals, world-class research — the United
States could be, and should be, the best in the world. To get there,
though, we have to be willing to learn some lessons about health-care
administration from the other industrialized democracies.

To understand the reality of health care around the world, rather than the myths, is to understand that we need dramatic reform that gives more of a role to the government (either through providing insurance or much more regulation of the insurance market).  Period.  To believe otherwise is to willingly ignore and deny the overwhelming evidence to the contrary.  Do yourself a favor and read all 5 myths, and if you have the time, I promise you will not regret watching the documentary. 


About Steve Greene
Professor of Political Science at NC State

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