5 Myths About Health Care Around the World

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Isabella Hime

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[SIZE=+2]5 Myths About Health Care Around the World[/SIZE]
[SIZE=-1] By T.R. Reid
Sunday, August 23, 2009

As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:

1. It's all socialized medicine out there.
Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.
In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.

2. Overseas, care is rationed through limited choices or long lines.
Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.
In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.
Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.
As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"

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.

4. Cost controls stifle innovation.
False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.
Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

5. Health insurance has to be cruel.
Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.
Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.
The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.
This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. 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.
T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," to be published Monday.

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Discuss this nao!
sucks to be you guys.

i pay $150AUD for a psychiatrist thing right, but this joint called Medicare pays about $100 to me in cash when i bring em the recipt.

medicare = Medicare is Australia's publicly-funded universal health care system, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all resident citizens and permanent residents except for those on Norfolk Island. Residents with a Medicare card can receive subsidised treatment from medical practitioners who have been issued a Medicare provider number, and fully subsidised treatment in public hospitals.
No, the Indian Health Service is the planet's purest form of government run and paid healthcare. And it's located in the United States. It's free to all enrolled tribal members. It is also the perfect example of 'you get what you pay for' - meaning it sucks. Big time.

Sure we're small, extremely isolated areas that doctors really don't want to come to... which means we often get new docs that just like to experiment or really don't know jack, or we get the old ones who don't give a fuck anymore and are only waiting for retirement, OR we get the doctors that have been fired everwhere else. The government then hires them and ships them to our area. If enough complaints are filed against the particular doctor, they're just shipped to another reservation to repeat the process.

We're an extremely small percentage of the population, like .03%. You would think that maybe, perhaps, BY PURE CHANCE EVEN that we would get at least average health care. Hell naw.

I had a family member be given the wrong medication ON PURPOSE to "see what would happen". When she went into anaphylactic shock and her vitals started plummeting, the doctor just walked away. When the rest of her family pleaded with the doctor to do something, he just laughed. When she flatlined and they pleaded again, he threatened to call the police.

He wasn't fined. Didn't lose his license. Wasn't even fired. Eventually after SO MANY people began to complain....he was TRANSFERED. To another reservation.

This wasn't even that long ago either. I was little when it happened, so that was probably in the 90s. Ever since this 'health care reform' discussion has come up, pretty much everyone here has gotten rowdy. We're trying to bring the word to the front, but when your state's own govenor won't even show up, well...you begin to have doubts. But hell if that's going to stop us >=(

This is why I get so riled up when people talk about government-run/sponsored healthcare. It just means that it's going to turn into one giant IHS. The only way we're able to escape it is to make the trek to a private doc and pay out of pocket. Just remember man, you get what you pay for.
I am one of the many uninsured ones.. I think a crappy health care system is better than none at all..
The main reason I liked the Clinton Adminstration is that his crew made "preexisting condition" illegal but that was quickly overturned when the Bush Administraion came into office. The fundamental problem is that Insurance Companies are more into wealth than helping. Probably the best thing about going to a state run college is that as long as I'm a student I have access to a "Swiss" styled system.
I have a feeling getting insurance for a hemophiliac might be hard.. the cost is around 100-200k a year just for my meds.. they might pull the preexisting condition thing on me!
Here's some real healthcare reform:

1) Eliminate Medicare and Medicaid.

2) The government covers all legal citizens for preventive and primary healthcare. Examples: Annual physicals and PAP/gynecological exams, well-child check ups, seeing a family practice physician or pediatrician for ambulatory care.

3) The government WILL NOT cover elective or surgical procedures. Examples: Seeing a specialist, skin grafting, Botox, any operation requiring an OR.

4) Citizens can get coverage from medical cards. Medical cards are like debit cards. You pay a premium monthly, but the company takes a smaller percentage off for their own ends compared to private insurers. The rest is deposited into an account. Unlike with private insurers, you will pay the FULL PRICE (instead of a fraction) for any surgery, procedure, or consultation, BUT you will be able to draw from all the resources within your account. Essentially, this model of insurance behooves you to go to the higher-end doctors only when absolutely necessary, thus lowering the strain on healthcare and lowering healthcare costs.
Razilins idea might work.. but what if your medical costs are 100-200,000 dollars a year? Be impossible to pay off that way..
Do you know WHY you're medical costs are 6 figures long? Its because we have a broken insurance system in which a single US dollar won't go very far--instead of 80 cents of the dollar going to healthcare and 20 going to the insurers, its reversed. Because of that, you have to pay more in order to get the money you need to cover the costs.

An alternative system will, theoretically, increase the percentage of the dollar going into healthcare, thus lowering that 100-200 grand annual to 70-80 grand where its supposed to be.
>=( Screw you, no one is taking away my skin grafts and cybernetic implants!
get rid of american medicare if you want, but stay away from aussie medicare!
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