Editor's Note: Prabhat Jha is a professor of public health sciences at the University of Toronto. Dean Jamison is an economist and professor in the School of Medicine at the University of California, San Fransisco. This article was originally published by Project Syndicate. For more from them, visit their new website and follow it on Facebook and Twitter.
By Prabhat Jha and Dean T. Jamison, Project Syndicate
With the United States Supreme Court set to begin considering the Affordable Care Act (the historic health-care reform derided by opponents as “Obamacare”), it is worth noting that the number of Americans without health insurance reached an all-time high in 2010, the year the law was enacted. Roughly 50 million US residents (one in six) pay out-of-pocket for medical expenses.
The 2008 recession is not the only reason for this staggering figure; long-term political and policy choices are also to blame. Globally, but especially for rapidly growing economies, the lesson is simple: avoid America’s private health-care model.
The US is one of the few high-income countries that does not finance health care through a publicly funded prepaid system. On average, wealthier countries spend roughly 11% of their GDP on health, with more than 80% publicly financed and only 14% of spending taking place on a fee-for-service basis. Public finance (or, in some cases, government-regulated cooperative insurance funds that amount to public financing) pays for most discretionary medical services, with private insurance supplementing only minimal extra services.
Most rich countries choose to finance their health care publicly for several reasons. First, free-market health care is usually inequitable and inefficient. Individual needs vary significantly, and private companies are often unwilling to insure the very people who need the most care (such as those who are already ill, or who have conditions like diabetes, which predispose them to other health problems). Moreover, those who buy care – insurers and patients – are unlikely to have the information necessary to choose the safest and most effective treatments.
At the same time, public spending acts as a brake on overall spending, and prevents the rapid cost escalation to which America’s private insurance companies contribute. The US spends 1% of its GDP annually simply to administer its complex, unwieldy insurance system. Without reform of the type now before the Supreme Court, total US health expenditures will rise from 16% of GDP today to 25% by 2025.
The economic impact of the current system already is severe. The last US census showed a marked increase in the number of Americans living below the poverty line, a fact closely related to lack of health insurance, which in turn reflects over-reliance on employer-based insurance coverage.
In emerging-market economies, governments should bear in mind five considerations when devising health-care systems. First, investments in health provide an important safety net against poverty traps, especially in times of economic upheaval. For example, each year, 37 million uninsured Indians fall below the poverty line because of catastrophic health expenditures (generally defined as costs exceeding 10% of a household’s total expenditures).
Second, public financing of health care frees the poor to use their money to satisfy other needs. In low-income countries, half of all health-care spending (about 2.5% of GDP) is out-of-pocket (compared to 2% in middle-income countries). This spending consumes a large proportion of poorer households’ income, precludes more productive household investments, creates few jobs, and often remains untaxed, as doctors and hospitals are frequently paid under the counter.
Third, publicly financing health could increase overall employment. Canada’s provinces phased in national health insurance from 1961 to 1975. Employment and wages rose where the program was introduced, even though average working hours were unchanged. Provinces with high levels of private insurance coverage, on the other hand, had lower employment rates and slower wage growth. More recently, Canada beat the US in a bid for a new Toyota plant, in part because private health-insurance costs in the US add several thousand dollars to the cost of manufacturing a car there.
Fourth, existing national health-care systems in wealthier countries can serve as models for emerging-market economies that choose to adopt similar systems. Importantly, public finance need not mean only public delivery; private hospitals and clinics can sometimes deliver services more effectively. Taiwan initiated a single-payer system in 1995, significantly curbing health-care costs and improving the population’s quality of life. Mexico’s new universal health-insurance system was implemented first in the poorest parts of the country.
China, on the other hand, provides a sobering example of the consequences of withdrawing publicly financed health insurance. In the early 1980’s, market reforms left roughly 100 million rural citizens without insurance, almost overnight. Out-of-pocket costs skyrocketed, infant mortality rates stopped declining, and the disease surveillance system was weakened, which may have contributed to the SARS epidemic in 2002-2003, which took more than 900 lives worldwide and caused economic losses worth an estimated $60 billion. The Chinese government has acknowledged that the reforms were a flop, and has committed to spending several billion dollars on publicly financed health care.
Finally, following the principle, “everyone is covered, but not everything is covered,” governments must investigate which services are most cost-effective, and which should not be publicly financed, because they are both expensive and ineffective. The list of insured services can always grow in step with incomes and government revenues. In particular, higher tobacco taxes yield a double benefit: they reduce smoking, a leading cause of adult death, and raise revenue.
China, India, and South Africa have all committed to adopting national health insurance. Which country achieves this goal first will depend not only on revenue, but also on the political will to overcome vested interests. It will also depend on institutions’ ability to design rational health care, monitor delivery, and properly assess new treatments.
Health-care costs in the US are exorbitant, with low value for money. One can only hope that “Obamacare,” together with the models being implemented by the US’s future competitors, will nudge the US to adopt a long overdue universal, publicly financed health-care system.
© 2012 Cable News Network. Turner Broadcasting System, Inc. All Rights Reserved.
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American health care system is very dynamic. It needs work on basic health care. I also noticed one thing among unethical young doctors. Sometimes they make deals and give out way too many unneccessary tests to make lots of money fast. I guess this can be fixed easily.
Ordering a boat load of tests is not for profits! It is for fear of a law suit for missing the one-in-a-million rare disease that could be suggested by the patients' history however unlikely it might be.
I am very sure on this one. I have a personal friend who is a very rich doctor in TN told me this. I wouldn't say it if I wasn't 100% sure.
It also needs to enlighten people to take responsibilities for their own lives. No doubt the U.S. is a free country and people can live however they want. It's an abuse if someone lives an unhealthy life (out of choice) and expects somebody else to pay his medicial bills.
While many adults may neglect their health, the majority of people are NOT RESPONSIBLE for getting diseases or cancer.
And especially children.... no one choses to get leukemia. In essence, no one choses to get sick. You can do everythign in the world to be responsible, i.e. eat right, exercise and you can still end up getting sick. We have insurance and don't expect anyone else to pay our bills.... but I do expect and want a system that is more equitable! We pay through the nose for our insurance while my sister who is a teacher (teachers union) pays nothing, NOTHING toward her health care.
True, we all need to take responsibility but that includes educating people about wise choices in their health and having universal health care just like every other civilized nation. Don't give me a load of crap about the innocence of doctors. They make too much and healthcare and med school is too expensive. All costs could be brought down by gov intervention and should be regardless of what the naysayers say about it. It is shameful that every other nation provides better health care for less and that it is funded by the government unlike here where you go broke if you get sick even if it wasn't your fault. Stop trying to use the irresponsibility of some people to justify continuing a corrupt and inefficient system built on greed.
Most doctors do not get directly paid for the tests they order- the lab that does the tests gets paid (or the pathologist or radiologist, but neither order the tests they perform). Within a hospital system, ordering tests provides revenue for the hospital but not for the doctors writing the orders.
Excellent article and should be mailed to every Supreme Court justice and US government representative!
Two things are responsible for the failure at health care reform:
Profit in the Health Care sector http://biz.yahoo.com/p/5yied.html and....
And the reluctance to sever the employment-health care connection. Most employers like it despite the cost of health care (which is not taxable)... it keeps their employees in line, working harder, foregoing raisedsin REAL wages and reluctant to move to other jobs or decrease their work hours for fear they will lose health care.
We are in a quagmire in this country when it comes ot health care with no relief in sight with the Affordable Care Act, formerly known as the Patient Protection Affordable Care Act. Who dropped the Patient Protection part!?
Ditto
The question is not that health care is needed, it is what shape is our health care system going to take. That will come from the top medical professionals or bureaucrats. Until they can steer this ship in a different direction there is no point in putting band aids on it and spending countless dollars on a system that is moving in the wrong direction.
The health care system in Taiwan is not better than the US. I've experienced both. I'm not arguing that the US system is the best solution, but in Taiwan people abuse the system, going into the ER to get checked out for an ache or pain...mostly because they are bored and it costs them nothing (the older generation). At US$3 a visit, people will almost certainly visit the doctor for a simple head cold, wasting his time to deal with actual medical problems. And doctors have no incentive to do their job well anyway, as they get paid regardless.
How about a more equitable system: a gov't-backed insurance that covers non-life style choice health issues. That is, if you are a smoker, get pregnant, are shooting up, etc, you don't get covered for anything related. Those are all choices you make that someone else may not. And why should I support your lifestyle consequences? Then private insurance can cover insurance for everything else.
Robert! Its a shame to suggest that people will go see a doctor for no good reason! Its un believable. Well well, all good countries have health insurance, because it does not have a policy that says so! USAID to Uganda, spends billions on all sorts of health issues, but because of bickering among silly politicians, American citizens actually can die for lack of the same care provided to somalis through USAID! Going to a doctor is already uncomfortable enough, no one will be visiting a doctor as if its an icecream bar! Its a shame for America for all it claims to be, its citizens can lack medical insurance, when all rwandese are insured in Rwanda that recieves funding from USA. Anyway, as america batters itself, we non americans read your papers and laugh!!! Super POWER! Canada is a much better SUPER POWER!! Sweden, Norway, Holland, France, all having better healthcare, better everything, and all AMERICANS spend on is BOMBS!
And how dare u say if woemn in America get pregant its a lifestle issue? Hmmmm, Child Delivery is a SOCIAL FUNCTION, for bringing NEW AMERICANS INTO THE WORLD! U think you will not grow old?
Habibi, maybe in Syria, people do not go to the doctor regularly, but in America it is common for perfectly healthy people to go for checkups.
Let me provide you with an example:
when a woman's mother dies of let say breast cancer, she is intelligent to go for a checkup regularly. This will ensure that if she develops cancer, it can be caught early and, inshallah, she will survive.
Get it?
I will admit I have been very fortuneate to limited need for the health care system in Canada but when I or my children have had to go to the Doctor or hospital I have never encountered any health care Doctor, Nurse or other staff that has not done their absolute best to provide care. So making a statment that they wont do a good job because they get paid anyway is a very poor and wrong statement. Poeple who enter that profession arent of that mindset to begin with
Well stated mart.
Agreed with Robert Smith that lifestyle induced diseases, e.g Type 2 Diabetes & metabolic syndrome (caused by obesity which btw is not a disease [95% of cases], it is the result of consuming more energy than a person uses), lung cancer (due to smoking), dental cavities and gum disease (due to not brushing and flossing every day), STD's(keep it in your pants and you won't get it!) should not be covered by insurance/public health care. People must learn that each action has a consequence, and if they don't, I don't want to subsidize their lack of self-discipline. Furthermore, access to healthcare is a privilege, not a right (think about people in 3rd world countries dying of curable diseases-is healthcare a right or a privilege?)
Lastly, private health insurance is the biggest money-making racket I have come across(I practice in South Africa). One of the biggest local insurers proudly announced that in 2010, they managed to improve the distribution of annual membership contributions so that "only" 70% went to admin costs and a whopping 30% went to payout of medical claims!!! So is a public system better? Who knows...
I would recommend this health insurance plan i found through~"Penny_Health"~to anyone with a growing family who is looking to minimize their medical expenses.
The author is wrong when he states "it is worth noting that the number of Americans without health insurance reached an all-time high in 2010".. Percentage wise it was MUCH higher in 1900.
It is the dumb idea of "big brother" having to take care of you if you mess up your health, that is causing the population not to take responsibility and therefore to live unhealthy lives and therefore drain the economy and create the whole vicious cycle.
For those who genuinely are too dumb or too unfortunate to take responsibility for their own bodies, there are charities. Bill gates gets more done with $1 than what the NHS gets done with £100.
ALL TIme is usually measured last 100 years! 1900 was not in the current century
"If you mess up your health". This really shows your ignorance and proves that you are (at the moment) a helathy personal, with just some serious mental health issues. But you would not realise that.
Most health problems are not related to one's behaviour, they just happen because of bad luck, age or genes. It is a minority that needs to be treated because they 'messed up their health'.
Be wary of the moment you will need healthcare yourself !
good retort! hehehe...
I am not going to read an article by two professors, I am one also at a D-1 University, from Canada and California! CNN extremely biased yet again!!!! I also lived in a socialist country for 3.5 years and know first hand that government run health care is not the answer!
I could claim to be a professor too. If you want to toss around your credentials and you want to be taken as seriously as the author of this article don't try to hide responsibility for your comments with anonymity. Either own up to your comments or don't act as if you are some kind of authority on the subject.
You would also sounds smarter if you did not confuse a nation with a public heath care system with a socialist nation. If you did think that having one implied having the other you would have to call the US with its welfare system, medicaid and medicare etc programs a socialist country. I do hope you are not a D-1 professor...I had higher expectations about the analytical abilities of those who teach the future of America.
damian,wanna bet ProfUSA is a teabagger??
Spot on!
Have u lived in Canada, Norway, sweden, Holland, UK? France, or u just compare USA with Kazhakistani?
You puzzle us.
Your retort is very good.
ProfUSA–doesn't stand for 'professor' but for 'profits' as in "the USA is the only major industrialized nation where helath care is a fast industry for profit." You are obviously another of those swiftboaters they pay $5 to dishonor yourself posting lies on behalf of the Pox network and your corporate owners.
YEAH YEAH YEAH must be some kind of left or right or middle or sideways kind of thang!
hehehe...
A member of intelligencia, wow, do explain yourself?
We are all ears!
For those or you who get all high and mighty about people who "mess up their health." I guarantee you that in this life that is definitely assured. Lifestyle effects your health, but that is not the only factor. I know the healthiest people who developed cancer and the most unhealthy obese people who lived well into their nineties. I didn't have insurance when I was in my early twenties, and got a bill for $25,000 because of Appendicitis. Why save and build for a financial future that can be destroyed by medical emergency or at the whim of a private insurance company? I hope I never have to return to the US system.
If you had money to save, why didn't you have insurance? From what I read, you lost your savings because of poor decisions, not because of the healthcare system. Now if you had excellent insurance, and you got appendicitis and they refused to cover the bills they were supposed to, that's one thing. You're uninsured by choice, you choose to accept the risk, don't complain if you end up paying for it. You're still alive and you seem happy with your current situation. What happened before was your fault and your fault alone.
ex·pa·tri·ate/eksˈpātrēit/Noun: A person who lives outside their native country.
Adjective: Living outside one's native country.
Verb: Settle oneself abroad.
Synonyms: noun. exile – emigrant
verb. banish – deport – relegate – exile
In proper English, you simply can not be an Expat outside of USA – it makes you look stupid like an ignorant, nescient, unlearned, unlettered, illiterate, unknowledgeable, unknowing, unwitting, uninformed goof.
I kissed my way up to VP at a health insurance company. Now I take over $500,000 of your health care dollars for NO VALUE ADDED to your health care. And that’s just me. Now think about how many other VPs, Directors, Managers, etc. are at my company alone. Now multiply that by thousands of others at hundreds of other health insurance companies. From 10 to 25% of your health care dollars go towards administration that adds NO VALUE to your health care. But my company’s PAC dollars will continue to fool you little people into thinking that a single payer system will be bad. Little people like you are so easy to fool. Little people also don’t realize that a single payer system is the ONLY system that would allow little people (as an entire country) to negotiate better health care prices. Little people don’t realize that the Medical Cartels already know that. And that is the reason why the Medical Cartels spend so much PAC money from the hospitals and doctors lobbying against a single payer system. Some little people say that a single payer system would cost you little people more. But if that were true, then wouldn’t the hospitals and doctors WANT that extra money? Yes they would. So why do the Medical Cartels lobby against a single payer system? It’s because the Medical Cartels know it would allow little people to negotiate better health care prices. And that’s what the Medical Cartels are afraid of. Period.
But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easy to be fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $106,800 level. Now I only pay 1.3% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.
No cear friend. No one is fooling us ... You are bribing the politicians to have your way ... WE are not that easy to fool.
hehehe...
and the laughs keep coming.
"At the same time, public spending acts as a brake on overall spending, and prevents the rapid cost escalation to which America’s private insurance companies contribute."
I would like the authors to clearly clarify and/or elaborate on the above statement, when so many European countries are now over-indebted exactly because of a bloated welfare state, with a healthcare system that produces huge budget deficits every year.
From what I have been able to gather, neither private nor public healthcare system has been able to provide health services properly, no matter what either side says. Perhaps, a mixed system would be better, instead of just one or the other...
So, are you alluding to having to start killing people who are either poor or too ill because they are not able to afford health insurance and will cost the system too much?
ulaikamor, you shouldn't believe the propaganda feed you get in the US. The reason for the problems in EU are not because of a bloated welfare state, but because of the fallout of an unregulated and out of control financial system on Wall Street that caused the 2008 crash.
Your info is really dated.
Use different search engines, research your topic of interest, read and analyze the topics; and, come back when you have something intelligent and current to say.
This is Apples and Oranges people! You know, I'm far far left but these kind of articles I have to be honest and say are misleading. It is a mistake to compare the U.S. with other countries (especially European countries): European countries have much smaller populations living in a very very small geographic area with governments that are very centralized. The U.S. is enormously vast with over 50 cities 10 times larger than Paris, London, Berlin, and Rome combined and with de-centralized state governments that each have their own policies. What works in England can not and will not work in the U.S. The English economy is tiny in comparison with a total population less then that of many of America's smaller states.
The benefits systems in the richer EU countries work quite well because they are such tiny countries. The population of Paris is a little under a million. That is quite small by U.S. standards. There are less than 70 million people in England and you have that many in Texas alone. It is completely ludicrous to make any comparison.
Then why not instead compare all of USA to all of the EU?
Okay, go ahead.
We are waiting for your explanations, comparisons...
Your geographical knowledge is terrible.
1. "U.S. is enormously vast with over 50 cities 10 times larger than Paris, London, Berlin, and Rome combined" The size of London, Paris, Berlin and Rome combined multiplied by 10 is about the size of the Republic of Ireland. And the US has over 50 of such enormous cities? I don't think so.
2. " The English economy is tiny in comparison with a total population less then that of many of America's smaller states". By England, I assume you mean the UK as it is a common mistake. The UK has a population of around 62million; much more populated than the most populated US state, California at 37million. Even still, England itself has a population of around 50million.
3. "The population of Paris is a little under a million." Paris has a population of around 2.2million, with an urban population of around 10million.
4. "There are less than 70 million people in England and you have that many in Texas alone." Texas has a population of around 25million. That's about 37 million fewer than the UK.
In the interests of public decency, do brush up on your geography before commenting in future.
They told me AMERICA has miracles when it comes to naive stupidty, i refused. Now you man, or woman or whatever u could be, WIKIPEDIA alone, can tell you simple facts before u come to vomit rubbish in the public.
You are very obviously a product of your failing education system. I would be very nervous to live in a country with a faltering health care system and a completely faltering education system.
Well what is it like living in your country –Syria?
Are you so far left that you are now on the right?
Do your research – the population of Paris is approximately 2.2 million....
Why our healthcare costs are spiraling out of control. USA is closer to bankruptcy with medical costs spiraling.
Copy of this sent to editor USAToday, CNN and various other news media.
India's finesse in medicine. A lot of people may look at this skeptically but this is true and why we should learn from India. India is generating a new breed of doctors who are very technologically savvy and provide the best of the care to their patients with latest technologies.
They have some of the best cardiologists, optometrists, Nephrologists, Neuro Surgeons, Urologists, Eye surgeons, Dental surgeons, facial plastic surgery, radiologists etc.
The costs are just 10% of what it will cost in USA may be even less.
I was amazed at the latest equipment and technologies they have in their facilities. All the reports can be available elecronically.
I used to always rate doctors in USA are better than in India but it seems like due to their clinical experience due to large number of patients some doctors here have very good and precise diagnosis...nevertheless the young doctors are so tech savvy (having iphones and giving instant results to patients and advice). The medical facilities are very clean.
We know life is short and whenever there is vacancy in heaven for us, no one can stop us.
The quality of healthcare in USA is no doubt becoming expensive day by day. Some needful thinking is needed.
FYI,
I just got my entire body scan -- complete body function test..
- Chest X-ray, MRI, Abdomen ultrasound, Echo cardiogram, treadmill test, Kidney function test, liver function test pulmonery function test, and erectile color doppler test, vision test, dental test including cleaning done all for $375 that included doctor consultation from cardiologist to eye doctor, dental doctor to neurologist to urologist, and radiologists consultation.
Also included a rehab therapy for some muscles for three days for 2 week.
If I had opted to get these done It would have cost me more than 10,000 dollars.
May be recommend this to Obama as even if one includes the cost of the trip to visit India the trip will not cost more than $2500 and get the complete tests done here at the best hospitals here in heart of Delhi.
Al of these tests were conducted with latest technologies equipment.
Good deal. Maybe, we should outsource our health care to India.
While we can all understand those numbers, you are failing to cover a few other points.
Regardless of the coverage (if you are going to be comparing to rich nations), and regardless of poverty level – Do more people in the US go without treatment, or suffer from sub-standard treatment? The answer is – NO.
You can point to figures of who can and cannot afford health insurance all day long (and I am one who cannot) – however I do not feel that the current view of "let's make everyone else pay for my insurance" is fair and it dangerously close to moving towards a socialist way of thinking.
Reform insurance companies? SURE! How about trying that, before you start turning me into an unwilling welfare recipient?
Reform the OTC regulations? SURE! How about not forcing people to pay $100+ for a doctors visit, just to get a prescription shampoo for dandruff?
Try fixing the problems before creating a much larger one.
It was the free market system that created the advancements in medicine that came about in the US...
It was the free market system that created the prolonged life span we now enjoy...
Let it work – just fix the things that the government has already had its hands in, and let it work.
Do more people in the US go without treatment? The answer is yes. I don't know why you think that isn't the case. And as far as you, "being turned into an unwilling welfare recipient".. I just don't know what strange perversion of teh facts you have been listening to.
If the advancement of medicine benefits only rich people then there is no use of this advancement, it become a human right issue.
TAHIR when Oh when did you learn about "human rights"?
Not from your arab homeland, not from all the ca ca you have been spewing in all the other discussions?
I thought you said earlier that AH was your hero, and that you were sorry he did not finish the job?
OH OH OH I know, human rights are only for the followers of allah the magnificent.
The free market system created longer life expectancy? Look at China, hardly a free market system over the last 50 years. yet, their life expectancy grew significantly more over the last 50 years than that of US citizens.
And what to think of the evident trend in the USA that life expectancy is going down, maybe related to dialbetes/obesity and poor outcomes of an unaffordable healthcare system. Are they not really consequences of a free market system / macDonalds and KFD rings a bell ?
1. In 1979 China had an incredibly inefficient communist system and was poorer than India, poorer than sub-Saharan Africa. It was an almost completely statist economy with incomes below 10% of US levels.
2. China has moved to a mixed economy. These reforms might allow China to eventually reach something like 60% of America’s per capita GDP (which isn’t very impressive.) During the transition from Maoism to this mixed economy, China can expect to grow really fast. There is no miracle here; all the other capitalist East Asian economies also grew fast during earlier decades. Chinese incomes will plateau well below US levels without further market reforms. If they take further market reforms (and it seems almost certain they will) then they may plateau at 80% of US incomes, like some other developed economies. If they go toward a low tax, relatively free market model (such as Hong Kong), they might even surpass the US some day.
My goodness, it seems that we have soooo many "Perfect People" living perfectly planned out lives on these post! It appears that many of you are prepared to swear on your mothers' lives that you don't presently, nor have you in the past, ever harbored a bad habit or made an unwise decision that could possibly effect your health. Please!!! give me a break. We all have closets and they all have skeletons in them. The only difference is some of us are just luckier than others. Try not to be so naive and paint everybody else with such a broad brush.
pssst pssttt vote for Obama health care blah blah blah pssst vote for Obama health care.........verrrrrrrrrrry subtle, CNN
You are as sharp as a tack aren't you habibi?
Nothing gets past you.
hehehe...
If 1) every other civilized country has universal public health care, and
2) theirs works great, while ours is a bad joke, and
3) theirs costs less -
why the blazes are we different? The answer is corruption. Vulture capitalists control the law. It is time this stops.
Crime rate is USA does not show that USA is a civilized country.
And since nothing is reported in Iran, then it does not happen.
There is no crime whatsoever in Iran.
if we have the means – and wealthy countries do – and the will, we need to start seeing equal access to health care
as a basic human right
Okay then we have decided, from now on we are a socialist state.
If what you say is true, then why do so may Canadians come here to America for treatments and operations? It is a fact that many Canadians and people from all over the world come here for health care procedures. If Canada has such a great system, then why do its citizens seek treatment elsewhere? Also, there are millions of people doing everything they can to come to America (legal or illegal). I don't see millions of people fighting to cross the border to get into Canada or the UK or Ireland! Your viewpoints are very skewed and do not look at the bigger picture of freedom and individual choices that make the USA the destination of choice for the majority of people wanting a better life.
The only reason why people from Canada and other EU countries travel to America for healthcare is because many very expensive operations that have costs in the tens or hundreds of thousands of pounds is usually not paid for by the state because it simply is not value for money, the NHS mostly do a great job in my country, however there are always rare cases where for example children with muscular diseases that cant be fully treated but can have surgery to stem many problems that comes with the disease. but this surgery is usually cutting edge, extremely risky and expensive, therefore is not seen as worth the money. the NHS works on the basis of treating everyone and cannot afford to spend huge amounts on surgery on the few that will not even save lives, so usually people fund raise to get this kind of treatment in the U.S because you cant get it here due to the fact that you have the availability to do this surgery because you leave the poorest and most vulnerable in your society without adequate health care, which is very very wrong.
honestly im amazed how americans are selfish. me, me, me.... in a so-called christian nation (at least for the republicans (who are usually the oponnents to universal health care)), how dare they do something that MIGHT help someone else and not me?(irony).never heard: help thy brother as would help yourself?
the diference in the ratio quality/price between US and the rest of the world is just studering. people in the US pay more and they have a lower quality of service. but americans still defend their (private) health care. BTW do you know that in developed countries there are also PRIVATE companies competing with the public sector?
Americans, or better yet, Christians believe in the importance of the single human being, whereas ummah refers to the community of Muslim believers. As a theological concept, the ummah is supposed to transcend race, ethnicity, nationality and class – all Muslims are supposed to be fully equal members of the ummah. If you do not belong to ummah, then allah the magnificent and his profiteer state that you should be killed.
I have a short tale to tell about why our health care system is not a "market-based" system that so many like to call it.
A couple of years ago, my doctor recommended an elective diagnostic test for me and referred me to the U. of Washington med center. Since we carry a rather high deductible on our insurance, I naturally asked the nice lady what the test would cost. She seemed flustered & surprised that I asked, and said she didn't know, but 'interestingly', someone else had asked the same question a few days before. She promised to find out for me and get back with me. When I didn't hear from her, I called & talked to another lady who didn't know anything about the first lady's promise and also didn't know the cost. So, since it was elective, I just dropped it.
To me, the moral of the story is, if no one knows the cost of an item or service and you can't shop around unless you have a price to compare, where is the market?
Imagine going into Target to buy, let's say, a vacuum cleaner, but there are no prices on the ones they have for sale. So you go ahead & pick one out, but at the checkout register, no price comes up when it is scanned. The salesperson instead tells you that the amount will appear on your bill in a month or two – & do have a nice day.
How can we expect our current system to hold costs down if the users (us) have not a clue how much something costs? Insurance companies have no real incentive to hold costs in line because they can simply raise your rates (I'm sure no one reading this has had their rates go up recently). Is this the "invisible hand" of market capitalism that Adam Smith referred to?
A single-payer system is the only thing that makes sense. And most of the rest of the developed world has left the US standing at the train station...
rgreeniwa,
In most other countries the costs for your elective procedure are irrelevant. The social system takes care of your costs, and your elective procedure will be done, no questions asked. yet, these countries spend far less on their healthcare budgets than the USA does, where the vast majority of the $$ disappears in the wallets of some doctors, but above all in the pockets of the Insurance Executives, lawyers and other parasites. You have to cut that slack to get to a social system that is cheaper and more effective and delivers better results, as on a global scale, the USA performs very poorly in mortality, morbidity and severe complications of interventions.
If you can not be helped with your elective surgery, then you do not have a health care system
The people in USA decide about wars unanimously without any difference but for health care they are worried about the tax money and have so much debate. Is this the true face of USA?
So what are you implying?
Every one can understand what is implied.
im·ply/imˈplī/Verb: Strongly suggest the truth or existence of (something not expressly stated): "the report implies that two million jobs might be lost".
Tahir, you have to actually make a point and state facts before an implication can be made.
As a citizen of hte rest of hte world the health care in my nation both benetfits and suffers from the US system. Because there is so much profit in the American system, there is money for research which drives health care in other countries. However that same profit drives costs, both in the US and in other countries, and so is carried on into our cost structure as equipment and drugs are developed in the US. This works to limit health care available elsewhere where the expenditure of dollars must be more closely considered. The level of medical care available under the US system to the well-insured also raises expectations of the level of care in other countries with "it exists and could save me, so why can't I have it" thinking.
Generally though, in other OECD countries, few cannot see apparent hypocrasy in a country claiming the be the superpower yet denying decent health care, that in other countries is regarded as a basic right, to many of its citizens.
I live in Spain and in spite of crisis and reforms towards privatizing parts of the health care system, most of the people is very happy with universal healthcare.We have one of the best in Europe, as people from other EU countries come for "medical tourism".It also cost us a lot in taxes, so Government is looking to privatize parts of it.
Altgouh you guys may not want this system, from what I read in the comments, there is something very wrong and out of control in your all private system.Insurance companies are crazy about profits and doctors scared of lawsuits
To end The post, you really need a reform and regulations. Don't you?
It is ironic in the extreme that the Republican's bitter refusal to consider a government financed universal health care system is actually anti-business, as the Toyota example demonstrates. America fails to compete with most of the developed world. Of course, the nearsighted short-term thinking of the Republicans is to simply offload all insurance premium costs onto the individual and exempt both the government and employers from providing health coverage.
Can't afford the premiums? Don't get sick.
Can't afford the treatments if you are sick? Then die.
What is amazing to me is the 150 million Americans who keep voting for politicians who overtly hate them. The right wing has unfortunately decided to bamboozle Americans into believing that poverty + misery = freedom.
Yours is the best post by far. Agree with everything you've said.
Yeah let's riot in the streets after mosque tonight, lets ga ng ra pe a few females or males or children, lets overturn cars and burn buses, lets kill a few non-believers...
Oops wrong country!
hehehe...
Europe, Canada, Australia-New Zealand and many other countries look since many years with horror at the US healthcare system, that has so many drawbacks, that no country, not even developing countries would mirror it.
This for many reasons:
1. The system is inequitable, good access to health care depending on the size of your wallet. There is a national reluctance to share the burden is a social system, as in almost any other first world country. yet, the US spends (wasts!) more than any other country oh healthcare.
2. if one compares outcomes (mortality and morbidity), then it shows that US patients get no bang for all these bucks. More people die from very common disorders in the USA than in any country of the EU. The mortality caused by unnecessary interventions is higher than that of Indonesia !
3. The quality of training for health care professions is low, apart from some pribiliged doctors/nurses that come from renowned training centres. When Us doctors travel to overseas hospitals, they feel how porrly they have been trained compared to their peers they have to work with. it is for this reason that US doctors are not very popular overseas.
4. The system has a libiality culture built in where the fear for liability leads to over-investigation with all the related problems, like costs, side effects of unnecessary procedures etc. For doctors this creates a fearful and unhealthy working climate.
5. In their arrogance, health care leaders are refusing to look at the rest of the world, where almost everywhere better healthcare is delivered to more patients for less costs.
6. The pharmaceutical industry is so powerful in the USA that they manage to keep inflated prices on their products. This is a by-effect of poor legislation protecting industry, and working against the interest of patients. This is a society-problem. look at other powerful lobby-troublemakers like the NRA.
7. In a money first and me-first culture there is no chance to develop a healthy, cost effective and equitable health system. The USA should look at countries where this works well since many decades, liike Canada, Australia, New Zealand, Europe and get rid of its adversary system that makes lawyers rich and patients sick and poor.
"it is worth noting that the number of Americans without health insurance reached an all-time high in 2010, the year the law was enacted. Roughly 50 million US residents (one in six) pay out-of-pocket for medical expenses."
Even with private insurance- you still payout of pocket. Maybe not full price, but you still pay something beyond premiums and co-pays for a good number of procedures and tests. Do they think we all have 'cadillac plans'?
Health care is a business and in business the primary goal is to take care of the customer. The customer is the one who typically pays. In the American system that would be the insurance companies. The patient is not the customer in this system but rather a commodity, much like mortgages became a commodity to trade. There is no basic incentive to drive the health care system to be more efficient to the customer. And patients usually choose to seek care based on location, rather than on quality and certainly not on price since patients rarely pay directly.
Customers who do not typically pay are not customers–they are thieves.
The GOP thinks that only rich people should have health care.
Is this where I say that this is a left or right or middle or sideway thing?
I forgot what my imam said to say.
hehehe...
Americans spend more per GDP on health care because they're the only industrialized nation still conducting R + D. Let's not fudge the numbers.
Right, first off can we please stop misinforming people on these comment sections. As if all other industrial nations don't have universities conducting R&D in medicine and biology, or even bio-engineering for that matter.
Secondly, nothing is a larger threat to the United States then denial, and to say that treating the medical system like a business is ethical, well your either in denial or insane.
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