RSS Feed
No perfect system
There is no perfect system outside the United States for health promotion, heath care or health insurance, but there is much done overseas from which we can learn. The French have been far more effective in driving healthy behaviors in schools and communities, but they have a more centralized government system than we do, with much less local government or individual autonomy.
India has pioneered innovative, low-cost surgeries like eye surgery at the Aravind Eye Care Hospital, where cataract surgery is about $15, and heart surgery that costs about 6 percent of what it does here, with equal or better quality. India also has led the way with some amazing telemedicine breakthroughs in rural areas, but its overall health-care system is poor.
The United Kingdom, because it has a centralized health care delivery system, has an excellent electronic health records system, but its system and the Canadian system only work because many citizens get care abroad for treatment they cannot get there with long waits or high costs.
Sweden has had good basic care in a single-payer system, but experiences significant delays in a wide range of surgeries, and is actually migrating more toward a combined public-private insurance model. Switzerland has universal, for-profit private insurance, but it has a significant individual mandate penalty and significant cost sharing (no Cadillac health plans in Switzerland), and has poor mental health coverage. The Dutch also have a hybrid model, with 95 percent of the coverage being funded by either employers or private insurance, with only 5 percent coming from the government, but care quality and satisfaction have decline in recent years.
The one common theme in these developed countries is that they are wrestling with fast-increasing and unsustainable costs and difficulty retaining high-quality care.
By
Michael Critelli
|
October 20, 2009; 6:02 AM ET
| Category:
Health Care Reform
,
Health costs
Share This: 
Technorati
| Del.icio.us | Digg | Facebook
Previous: My experience in the U.K. |
Next: Health care as a national value
Posted by: lensch | October 21, 2009 10:43 PM
Report Offensive Comment
I hear this statement about Canadians going abroad all the time - from Americans. My Canadian friends and relatives don't seem to even talk about that - I don't think it is even noticeable to them. Not one of their talking points. They do have shortages of doctors, but are opening more med schools. They do grumble too, but feel thankful they have a health system. They don't worry they will have no care or go bankrupt getting it. It is that simple. We have to do it. Quit fighting and get it done somehow.
Posted by: jhogg | October 21, 2009 8:38 PM
Report Offensive Comment
"but its system and the Canadian system only work because many citizens get care abroad for treatment they cannot get there with long waits or high costs."
Could you please provide a reference for this outrageous claim which Dr. Dommett can tell is just plain false.
Posted by: lensch | October 21, 2009 4:25 PM
Report Offensive Comment
I've heard enough about the myth of the Marching Canadians. Here is the definitive study:
http://content.healthaffairs.org/cgi/content/full/21/3/19?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=snow&andorexactfulltext=and&searchid=1
Here is what they say:
"the number of Canadians routinely coming across the border seeking health care appears to be relatively small, indeed infinitesimal when compared with the amount of care provided by their own system."
Here are some figures:
"These findings from U.S. data are supported by responses to a large population-based health survey, the NPHS, in Canada undertaken during our study period (1996). As noted above, 0.5 percent of respondents indicated that they had received health care in the United States in the prior year, but only 0.11 percent (20 of 18,000 respondents) said that they had gone there for the purpose of obtaining any type of health care, whether or not covered by the public plans."
And if you read the study, you will see that most of the Candaians who come to the US for Health care are sent here and paid for by their health care system because they have a rare problem that we see more frequently than they do because we are 13 time larger.
Enough already.