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The Week. By James Lileks. And as the research shows, the US spends dramatically more for many common medical services compared to other developed countries:. For most developed economies, their aging populations will present a serious challenge of both cost and care delivery.
The chart below shows what countries were already paying notice the US lags significantly both overall and in public investment and then projects what they will be paying in Yi Li Jie, a spinal atrophy patient I met, has to pay out of pocket for her caregivers; she also has to pay a substantial share of her transportation costs to get to medical appointments.
On the other end of the spectrum, the Netherlands has a universal public program to cover long-term care, even though it has private medical insurance. Of course, the needs for these populations extend beyond the basic provision of medical care. No matter the health system, the most complex patients are going to have the most challenging needs to meet. Nobody has figured out a silver bullet for fixing that yet.
It would be the most equitable and the most efficient. But other countries, like Australia and the Netherlands, have found a significant role for private insurance even as they strive toward the same goal. Frankly, however, private insurance seems to be more of a political compromise and, by extension, to reflect some differences in societal values than a preferred policy solution. Australia had had private insurance for decades before its universal public insurance plan was introduced in the s; both of its major political parties have come to accept the existence of that program.
Private insurance in Australia has given the better-off more options in their health care; that comes at the expense of some equity, but it is a compromise the country has been willing to make as it tries to balance access and choice. Because a center-right government was in charge, they wanted to pursue a market-driven, managed-competition model to try to fix it. Universal coverage was still a shared goal for all the political parties, but they pursued private insurance to do it because it aligned more with the ideology of the ruling government.
Now critics say that was a mistake, that it has made health care more expensive in the Netherlands. But it was the pragmatic path available to the country at that moment. He had approval ratings for the single-payer plan on big whiteboards, and he had just been showing us the enormous spike in approval among the public for the national insurance plan and its steadiness over the years.
As recently as , 39 percent of physicians said they were either dissatisfied or very dissatisfied with national health insurance. Another 31 percent said they were neutral. Just 30 percent said they were satisfied or very satisfied a paltry 2. I encountered that ambivalence from the two doctors I met in a coffee shop in downtown Taipei. But such complaints are not unique to Taiwan or its single-payer system.
The data suggests physicians the world over are often frustrated by their health systems. Even in countries like the Netherlands and Australia, which have more of a role for private insurance and therefore for doctors to have more choice in their practice and the opportunity to make more money, opinions are split.
But at the same time, providers everywhere are generally happy about the actual practice of medicine. All of these systems, even with their varying approaches to insuring people, have had to add other reforms to improve medical care itself.
In Taiwan, that meant setting up a rural health program that employed doctors to work in clinics at mountain outposts and make visits to indigenous communities part of their daily routine. In the Netherlands, it was the doctors who saw a delivery problem and came up with a way to fix it. Years ago, every individual doctor was responsible for providing after-hours care to their patients if needed. So the doctors proposed a new model: What if they formed cooperatives so they could share the load?
His mother had recently undergone an expensive operation, and it had been tough to pay the bills. In all probability you will end by paying out much more than you will receive through this process. My own dentist has cut his work-week from five days to four because, in the words of his financial adviser, he was "working too many days for the government.
If you are serious in your alarm over high costs, you will resist a government program strongly. The vast majority of doctors do not like socialized medicine.
This, also, would increase costs. Americans who have the money to pay for insurance premiums have access to some of the greatest care in the world. Another pro of the American health care system is it has the ability to provide advanced surgical procedures and state of the art treatments not available in other countries. There are many cons of the American health care system that require the system to make a change. One major drawback of the system is that health care services are very expensive, and if one is uninsured or underinsured, they might not get the care they need.
Many Americans who are uninsured or underinsured forego medical treatment until their illness or condition becomes extreme. Treating an extreme illness is much more costly than preventative care. The US health care system is very wasteful; every year doctors order thousands of unnecessary tests and procedures, wasting money and resources. The American health care system spends more money than any other health care system in the world, and yet has worse health outcomes than other comparable countries that spend less.
A final con of the American health care system is that Americans who live in rural areas have less access to healthcare and services than Americans who live in urban and metropolitan areas. As you can see, no health care system is perfect. Each system has its pros and cons and each system needs changes.
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