The bottom line in health care

healthIn my previous post on Single-payer health care: Why not?, I talked about our family’s experiences with health care in France, UK, Ireland, Italy, China, Australia, and other places in comparison to that in the US. This included health care for children and the elderly, and both minor (blood donation, physicals, skin growth removal) and major (broken hip, eye infection) procedures.

Thinking a bit more about this I realized that there were four essential facts that emerged from this wide variety of experiences. In every industrialized country except the US,

  1. Equitable: Everyone has the right to health care.
  2. Effective: People live longer, healthier lives.
  3. Economical: They spend less on health care, as much as 50% less.
  4. Efficient: There is much less bureaucracy, fewer forms, less running around, less waiting.

dollarI might add a fifth point, too: The scare stories that we hear (“you have to wait forever!” “you can’t choose your doctor!”) are simply false, or they index issues that are the same or worse in the US. The information we get about health care promotes profit, not health.

There are many issues–changing demographics, new technologies, new medical knowledge, changing standards, globalization, and more–which affect health care. But the fundamental difference in the current US situation is that health care is driven by the bottom line. Insurance companies, pharmaceutical companies, media corporations, hospitals and clinics, doctors and other health care professionals, and all others involved in health care operate in a system in which rewards bear little relation to the overall quality of care or efficient use of resources.

One can debate each of the points above, but the evidence from OECD, UN, WHO, WTO, and other international organizations is overwhelming in support of them. Other systems offer health care that is more equitable, more effective, more economical, and more efficient.

So, why is single-payer, or national health care not even worth discussing? Why does the Obama plan dismiss it? Why does even public broadcasting ignore it?

5 thoughts on “The bottom line in health care

  1. Pingback: The health care plan we can’t discuss « Chip’s journey

  2. Pingback: Opening the door to single-payer health care « Chip’s journey

  3. Thanks, Ann.

    When my mother broke her hip in Ireland, we insisted on a private room, instead of the six-patient ward she’d been assigned. But by the time one became available she’d grown to like the other women in the ward, and enjoyed all the activity and companionship. So, she turned down it down!

    That tells me (1) some things we think are essential may not be so, or even desirable, and (2) a national system can easily offer those extras for a fee.

    No system is perfect, but I don’t see any evidence that a for-profit system offers as much on any of the four essential points.


  4. Very good points, and very sharp questions, Chip. My in-laws are from Italy, and they receive top-notch (free) care. Their doctor even makes house calls. Imagine that!

    It is not a perfect system: red-tape is a problem, but no more than it is here, and when I have visited my in-laws in the hospital, they have been in rooms with four patients. Personally, I would like more privacy than that, but I think we could envision a system where you could pay a little more out-of-pocket for more privacy.

    This is all to say, I agree that Americans are fed horror stories of “socialized” medicine abroad, when we could find just as many horror stories from within our current system. And in my experience, the general public has already made up its mind about how terrible European and Canadian medicine is, and they’re not interested in being disabused of their convictions.


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