The paradox of US healthcare (Article from Al Jazzera)

[dtotire]

The paradox of US healthcare
By Andrew Kennis

http://english.aljazeera.net/focus/2009/10/2009103164332709367.html

snip>
In the meantime, the US continues to be the country with the highest proportion of uninsured people in the developed world. It also has the distinction of spending a greater portion of its total economic output on healthcare than any other developed country - just over 17 per cent of its gross domestic product (GDP) last year.

On average, the US spends twice as much as other developed countries on healthcare.

But even though US citizens pay more for healthcare, they get less of it, resulting in a lowly 37th place ranking among healthcare systems in the world, according to a study by the World Health Organization based on quality and fairness.

In terms of the infant mortality rate, a common marker for the overall state of healthcare systems, the US was outranked by all of the following countries according to the CIA's World Factbook: Sweden (3rd), Japan (4th), France (7th), Norway (10th), Germany (14th), Israel (17th), Denmark (21st), United Kingdom (31st), Canada (35th), Taiwan (39th), Italy (41st) and even a few underdeveloped countries, including Cuba (43rd).

How can this paradox of the US spending the most and getting the least for its healthcare occur in the country with the world's largest economic output?

Claudia Schaufan, an Argentine physician and professor of comparative health policies at the University of California in Santa Cruz, explains that the common characteristics of healthcare systems in the developed world have to do with the universality of coverage and the lack of for-profit entities.

The key behind each of these systems is that they all outperform the US in terms of their infant mortality rates, administrative costs, the extent of population with coverage and the proportion of GDP spent on healthcare.

Furthermore, there are no documented instances of citizens going bankrupt because of medical care in these systems while, conversely, some studies have shown as many as 700,000 Americans suffer that fate annually.

'Making a buck


One grouping of healthcare systems can be described as socially insured and multi-payer (Germany, Switzerland, Japan, Israel, Belgium and Austria), another as socially insured and single-payer (Taiwan and Canada), and a third as nationally insured and delivered (United Kingdom, Spain, all of Scandinavia, Italy and Iceland).

Socially insured and multi-payer systems feature health insurance delivered by non-profit insurers. Those who are unemployed or cannot afford to pay for the insurance, receive governmental assistance so that universal coverage is achieved.

Certain multi-payer countries have a wide choice of insurance programmes, as is the case in Germany. When you choose a private, non-profit insurer - Germany has 240 of them - the government pays a portion of the costs based on your income.

Developed countries with one national insurer that is funded publicly - often described as single-payer - have a healthcare system that is delivered by either private (as is the case in Canada) or publicly-run institutions (as is the case in all of Scandinavia).

While these systems differ in their specific characteristics, the similarities are more important, according to Schaufan.

"Everyone has health insurance and there is no significant for-profit aspect in any part of the medical sector ... nobody in these systems 'makes a buck' at the expense of the health of patients," she says.

Learning from others

Taiwan, which spends three times less than the US on healthcare, developed its current healthcare system in the mid-1990s, when the majority of citizens were uninsured and policymakers collectively decided the health system needed to be radically overhauled. However, the Taiwanese looked to other countries to forge their own system.
Asked what the proposed US reforms show in terms of learning from other examples, Naoki Ikegami, a leading Japanese healthcare economics professor, says simply: "Not much, because there has to be a willingness to learn and if anything, US leaders have isolated themselves from learning about other healthcare systems."

Professor Ikegami's co-author on numerous scholarly publications, John Campbell, an American-born political science professor, says: "The reforms being proposed in the US simply do not fix or get at the heart of the problem, which is price containment and unsustainable healthcare costs.

"The US would stand to gain a lot from going to a single-payer system, where costs could easily be contained and controlled."


more:
http://english.aljazeera.net/focus/2009/10/2009103164332709367.html

[nightrain]

1. knr. Thanks for posting. good synposis of where the US is and what we aren't doing...

[depakid]

2. Impressive piece- and all the more so because it comes from Al Jazzera

[yurbud]

3. did you see the film CONTROL ROOM?

It's a doc about Al Jazeera, and it's pretty clear that their goal is to be the Arabic BBC, which it does a decent job of, which is probably why they are so reviled in the US press. It's hard to spread propaganda when you've got a reasonable source from the region contradicting your bullshit.

[dtotire]

4. Never Saw The Film

Sounds pretty good. The articles written in Al Jazeera are pretty well balanced and factual, sometimes with a little bias. They are not a propaganda outfit.

[yurbud]

5. some of what we see as bias is what we would expect our news to do--how does it affect US first

and everybody else second.