- Myth 1: It's all socialized medicine out there
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.
- Myth 2: Overseas, care is rationed through limited choices or long lines
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.If you think about how long it takes in this country to get an appointment for the doctor who will be performing elective surgery, you get up to similar waits in this country.
When I lived in Denmark, I could get an appointment with my family doctor the same day I called. I was never refered to a nurse practitioner or PA. The emergency procedures were done immediately. I had a (benigh) breast tumor removed the day I discovered it.
- Myth 3: Foreign health-care systems are inefficient, bloated bureaucracies.
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.My family doctors' office had minimal staff, who could even do simple lab procedures, because they didn't have to spend all their time on paper-work.
- Myth 4: Cost controls stifle innovation
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.)
- Myth 5: Health insurance has to be cruel
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.
- Corollary to Myth 5: 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.I have family members who persist with this one. Some of the conservative men in my family are small business owners (who would benefit from any Obama plan, so they could provide health benefits to their employees.) Both receive their health benefits from their wive's job as school employees.
Tuesday, August 25, 2009
5 Myths About Health Care Around the World were rebuffed by T. R. Reid in the Washington Post on Sunday.Here are some short quotes from the article, with comments from my own experience.