From Jonathan Cohn, Certified Health Wonk and much smarter than most on those nasty socialist health care systems that undermine freedom by, you know, working better and for less money than ours:
“I DON’T WANT America to begin rationing care to their citizens in the way these other countries do.”
That was Arizona Senator Jon Kyl, speaking last month about healthcare reform. But it could have been virtually any other Republican, not to mention any number of sympathetic interest groups, because that’s the party line for many who oppose healthcare reform…
Typically the people making these arguments are basing their analysis on one of two countries, Canada and England, where such descriptions hold at least some truth. Although the people in both countries receive pretty good healthcare – their citizens do better than Americans in many important respects – they are also subjected to longer waits for specialty care and tighter limits on some advanced treatments.
But no serious politician is talking about recreating either the British or the Canadian system here. The British have truly “socialized medicine,” in which the government directly employs most doctors. The Canadians have one of the world’s most centralized “single-payer” systems, in which the government insures everybody directly and private insurance has virtually no role. A better understanding for how universal healthcare might work in America would come from other countries – countries whose insurance architecture and medical cultures more closely resemble the framework we’d likely create here.
Last year, I had the opportunity to spend time researching two of these countries: France and the Netherlands. Neither country gets the attention that Canada and England do. That might be because English isn’t their language. Or it might be because they don’t fit the negative stereotypes of life in countries where government is more directly involved in medical care.
Over the course of a month, I spoke to just about everybody I could find who might know something about these healthcare systems: Elected officials, industry leaders, scholars – plus, of course, doctors and patients. And sure enough, I heard some complaints. Dutch doctors, for example, thought they had too much paperwork. French public health experts thought patients with chronic disease weren’t getting the kind of sustained, coordinated medical care that they needed.
But in the course of a few dozen lengthy interviews, not once did I encounter an interview subject who wanted to trade places with an American. And it was easy enough to see why. People in these countries were getting precisely what most Americans say they want: Timely, quality care. Physicians felt free to practice medicine the way they wanted; companies got to concentrate on their lines of business, rather than develop expertise in managing health benefits. But, in contrast with the US, everybody had insurance. The papers weren’t filled with stories of people going bankrupt or skipping medical care because they couldn’t afford to pay their bills. And they did all this while paying substantially less, overall, than we do.
via Healthy examples: Plenty of countries get healthcare right – The Boston Globe.
So next time you hear some saying that Obama is going to make American health care more like Europe’s socialist systems, just applaud and say it’s about damned time someone did. The only real danger here is that reform doesn’t go far enough to control costs. If coverage is expanded, but costs are not controlled, we will have a budget buster. Sadly, the cost controls are the easiest piece to attack and them most dangerous to entrenched interests like health insurance companies and the AMA. Without effective cost controls, the whole enterprise is doomed to failure. This is of course true even without reform. The current rate of growth cannot be sustained in the absence of change.
