Why No Universal Healthcare?

Well, the healthcare bill is almost law. It is not a universal healthcare law, but it’s a significant improvement. Many health reform ideas were battled over, none of them offering universal healthcare.
Seriously, why the heck not? And why not start discussing it tomorrow.
I think we could have just gone straight to universal in one fell swoop. Not should have. Could have, as in “quite possibly.” The debate could easily have been about what kind of universal we would adopt, not a struggle over whether or not to improve healthcare in the USA at all.
Since Obama, once again, spoke against it, let’s check out Single Payer. Single Payer is but one kind of universal. Under it, you belong to one plan: the same one everyone else has. It is the plan, the only plan, the government-run insurance plan, and you pay into it on a sliding scale based on income. Doctors, hospitals, pharmaceuticals are compensated automatically the minute your card number goes through the scanner, and everyone is issued one.
Another kind is not-for-profit private insurance with regional pools. Believe it or not, it works. You go seek out the best deal you can get for health insurance – and plans will run the gamut from basic coverage to the kind CEO’s get. You fail to shop for a private plan, can’t afford one, or just didn’t want no stinkin’ plan, you are automatically enrolled in the local “health pool.” The burning question is: why would a not-for-profit insurance company fight for your business, when they can’t profit from it? They like having their jobs. If they suck, clients go to somebody else, and everybody there loses their job. So, it’s a wage and living driven motivation, not a wall street profit driven motivation, and that leads to astonishingly good healthcare from these not-for-profit health insurance companies. This is the Swiss system, and there, 90% have a private plan. The Swiss health system is highly regulated, but everyone can obtain a private plan, of which there are many to choose from.
There’s a universal healthcare system that you don’t even have to join. Until you have to join. You can just pay everything out of pocket in France as long as you are healthy. You can enroll for national health while young, but being young and healthy and won’t get you much help – maybe 20% of the cost will be covered. However, the sicker you are and the older you are, the more help you get, with 100% of all expenses paid when you have the worst, most expensive conditions to treat. The French system is one-of-a-kind, and enjoys unanimous #1 world ranking for fairness, quality and lack of hassle.
There’s a universal system that exploits the fact poverty enjoys a rather tiny presence in the population it serves. I’m talking Singapore. In Singapore, saving is required by law. You must put 20% of all earnings into the bank, any bank, with 7% reserved as “health savings.” When you need healthcare, your own health savings are spent. There are incentives not to overspend health savings money, so everyone shops for the best bargains. All medical services in Singapore compete for business using prominently displayed prices, driving costs down using the free market system. When you run out of health savings, the government picks up all costs after that. That may happen sooner than later of you have a serious condition or you worked as janitor and not as a business manager. All told, 80% of all Singaporeans will never require a dime of government assistance in their lifetime, many never coming close to emptying their medical savings account. Compared to Singapore, American healthcare is a nanny state. There are brilliant ideas to adopt in the Singapore system, like health savings and a simplified pricing structure and competition driven savings. Hillary Clinton’s 1994 healthcare plan borrowed heavily from Singapore.
Oman has an interesting system, for it rises out of desert sands where once was no modern anything at all. Oman is a traditional monarchy moving to Constitutional. The King has mandated his government develop a world class healthcare system and for it to made available to all the people and be key to bringing Oman’s standard of living out of the Third World. It was established 30 years ago and now has garnered the World Health Organization rank of #8 in the world for fairness and quality!
Taiwan is a very recent democracy, a country where 10 years ago only 50% of its people had access to healthcare, despite Taiwan’s economic success. The young Parliament set about the task of putting together a Universal Healthcare program for the people. They put it this way: “we become a wealthy country, it’s about time we have a wealthy country’s healthcare system”. They studied the entire world for ideas of how to build the best system. They chose to go with a variant of Single Payer that incorporated Japanese-style patient freedom of movement and choice. From traditional Chinese medicine to seeing a back specialist, Taiwan has the shortest wait times to see a doctor in the world.
That’s my short tour of Universal Healthcare in the world. Surely it’s about time we adopted it too.

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1 Comment

  1. JBernoulli

     /  March 21, 2010

    I am glad that this topic was discussed on this blog, totally agree with all the above, but there are some problems in the legal regulation in the light of recent changes in legislation. I would not wish to write here in great detail, much is written on the site http://moslegist.ru … But thanks anyway!


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