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Given that fact, what is missing from our recent attempt at reform?
All three systems 1. ABSOLUTELY FORBID denying any claim whatsoever. 2. Have government dictated fees for health care services. No useless attempts (which have failed in 15 states here alresdy) to regulate medical loss ratios. 3. Have single universal comprehensive plans in which prices and itmes to be covered are specified by the government, and which must be offerred on a non-profit basis. In some cases, supplemental plans may be offered at a profit, but there are absolutely NO platinum, gold, silver and bronze people in any of these countries. 4. Do not allow age rating. 5. Have no deductibles, though co-pays may or may not be entirely covered, depending.
As you might expect, this results in systems where providers earn much less. However their lives are made easier by medical schools costs that are free (France and Germany) or cheap ($1500 per year tuition, usually partly reimbursed by local governments) in Japan. In France and Germany, doctors and hospitals keep no records--all health care information is digital and included in the healh care cards.
Also, universal guaranteed care removes the single most significant reason for malpractice suits here-- namely that future health care costs from malpractice (or even just bad outcomes not resulting from actual malpractice) cause patients serious financial hardship-- does not exist. In France, malpractice premiums are $170/year for GPs and $650/year for specialists. In Germany, the yearly cost is about $1400/year. In Japan, malpractice insurance is covered by the $100/month dues to the medical society.
(Information from T.R. Reid's book The Healing of America.)
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