With all of this chit chat over health care since before Obama's election, I figured it would be nice to take a look at some of the more successful health care systems from around the world. I would prefer to not state any of my own opinions about health care with regards to what I think we should do, because, quite frankly, it is a pretty daunting task to fix fifty years of awful, entrenching health care policy. But what I do know is that other countries from around the world have found a way to make it work much better than we have. So why not try to take a lesson from them?
According the World Health Organization (WHO), the United States' health care system sucks. In its 2000 Global Health Report, the WHO ranked the health care systems and overall health (among many other figures) of 191 countries. Our system ranked 37th and our overall health 72nd. The report also looked at the amount of money per capita that countries spend on health care. The United States spends $4187. Second place? Switzerland with $3564. Third place? Germany with $2713. It just keeps falling from there. We spend significantly more money on health care, yet we get increasingly worse results. We can surely do better than this since our country IS the greatest superpower EVER. Right? Hmmm...health care says otherwise.
For once in our history, we need to start looking at what other countries are doing to try to learn from them how to improve our system. Capitalism has done a lot of wonderful things for our great nation, but it doesn't work in health. Health care can't be sold like computers, produce, or cars. Sometimes people just get sick or accidents happen, and, without appropriate regulation, they may be left without treatment. Something as important as health care can't be left entirely to the capitalists. (OK, so I guess I will include some opinion) Health care costs keep rising, Americans keep getting sicker, and the thing is starting to spin out of control.
What I'm going to do is write a series of blog posts, each focusing on one country's health care experience. Just look at each system and ask yourself if you could live with it. Easy, right? My sources are plenty for this series of posts, but my research was primarily done on Maggie Mahar's "Health Beat Blog" and through two books: 1) The Healing of America, by T.R.Reid and 2) Comparative Health Policy, by R.H.Blank and V. Burau.
To start things off, I would like to outline the four primary models of health care systems that you find around the world: Bismarck, Beveridge, National Insurance, and Out-of-Pocket.
Bismarck Model (examples include Germany, Japan, France, Belgium, Switzerland, and most Latin American countries)
- health care providers and payers are private
- health insurance is financed jointly by employers and employees
- health insurance companies are non-profit
- a Bismarck system is often highly multi-payer
- there is tight government regulation of services and fees
Beveridge Model (examples include UK, Italy, Spanish, most of Scandinavia, Hong Kong, Cuba, and United States Veterans Affairs hospitals)
- health care providers and payers are mostly government
- health insurance is financed through taxes
- there is tight government regulation of every aspect of the health care system
National Health Insurance Model (examples include Canada, South Korea, and Taiwan)
- health care providers are private
- health care payer is government run insurance program
- no marketing, no profit to be made leads to low overhead and easy administration
- usually long waiting lines and limits on services provided
Out-of-Pocket Model
- need health care? how much money do you have in your pocket...
- no government regulation since there really isn't a system
- health care providers are mostly private
- health care payers is the patient
- no health insurance
The countries that I will touch on in this series of posts are: France, Germany, Japan, UK, Canada, and lastly the United States.
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