[U.S Healthcare Systems HSC 301 02 - Online]
Healthcare Reflection Paper
The documentary shows countries throughout the world that have extensive medical coverage for all citizens at lower prices than what a typical U.S citizen would pay. The documentary shows that the U.S could fix their healthcare system if it could take the technology and services offered by some countries while reforming the insurance industry. The U.S has a user pay, market dominated system in which citizens are concerned about their privacy so adopting some of the best features of health care system from around the world may be difficult.
Most governments throughout the world try to regulate medical insurance so that the free market makes insurance companies competitive and profitable. (Palfreman, 2008) The government also wants insurance companies to provide goods and services that are accessible to people who need it the most. The British system does have private medical insurance; however, the state provides free medical care for all citizens through the NHS. This is paid for by the state through taxation revenue. Privatization has not happened in the UK except for the Blair governments attempt to stop waiting lists for operations by making hospitals unprofitable if they provide poor services. Hospitals now have to compete for government money. This is the same for general practitioners that are provided bonuses for keeping patients healthy. The downside to the NHS is that it is unprofitable because the prices are too low and it promotes overuse by certain segment of the population. The U.S could see significant improvements in the health of all its citizens with such a system, however too much government interference would not make it a particularly good choice.
Unlike the British system of taxation for paying for health, 70% of Japan’s healthcare is paid for by companies and 30% by the consumer. Insurance is provided by community run insurers for those with less money however for the most part, the Japanese system is privately run (about 80% of hospitals) and people can see a doctor or specialist almost immediately. Long hospital stays and MRI technology is cheap for patients. The system does not allow for private services or doctors that raise prices because if a medical practitioner increases their prices, the government decreases the cost and therefore it is impossible to make profits outside of the existing system. The profitability of the industry is tightly monitored by the government and fixed prices are negotiated between hospitals, practitioners and the state. Cheap technology like MRI would be beneficial for many people with long term injury and health problems. Government intervention, although unpopular could help to minimize the power of the doctors charging too much for services in the U.S.
There is a National Health system in Germany that 90 % of users participate in although citizens can opt out. There are also 240 private insurers called sickness funds that cover employer health insurance, which is divided between the insurer and the employee. If a person loses their jobs, then they do not lose their health insurance. The insurance companies compete for companies by offering add ons to the required minimum cover of insurance. The people in the company benefit from providing better services and attracting new clients through higher commissions and wages. The Germans pay premiums based on their income and patients pay small co-payments. The system is a good balance between a single pay and for profit system. Medical providers and sickness funds negotiate prices that cut admin fees and drugs are also cheap because all of the insurance funds negotiate prices with medical providers and insurance companies because the buying power of the insurance funds. This is a feature that would save many people in the U.S thousands of dollars as the cost of pharmaceuticals can be astronomical for some.
Taiwan adopted a Health Care system after rapidly developing the country in the 1980’s. At that time many people had no medical insurance. Taiwan has tried to create a system of equal access and everyone should be forced to join a national system of health that gives an individual no chance to opt out. They adopted one government insurer that is similar to the U.S Medicare system for the elderly. The system has the lowest administrative costs in the world costing only 2% of GDP because of the use of technology makes it cheap and efficient. For example, someone from the insurance bureau will visit patient to determine the patients need if the person is using the system very regularly. The U.S could take the approach of Taiwan by researching many countries systems and also using technology effectively to cut down on administrative costs.
Switzerland was becoming similar to the U.S system. Huge pharmaceutical companies are part of Switzerland’s economy, medical insurance was voluntary and linked to employment with some people losing cover if they lost their job. ‘La mal’ or ‘the sickness’ was introduced and everyone had to buy insurance with the state paying for the poor and comprehensive medical care for all was introduced. Insurers and medical companies protested, however the law was passed stopping them from cherry picking the young and healthy. The companies are not allowed to make profit on basic care, only supplemental coverage. Competition still exists with insurers wanting to keep their customers resulting in better and competitive healthcare for everyone. The Swiss example demonstrates that the power of citizens demanding better health care is possible.
All of the countries reported high consumer satisfaction despite the economic difficulties of patients not paying enough for services and doctors complaining of being underpaid. Patient waiting times are often reported in the media and there are strong reactions of the public because of this. This is particularly true for Great Britain where media reports of long waiting times for elective surgeries like hips and heart replacements are common. However, prevention in the UK is still comprehensive as a result of strong primary care because General Practitioners receive bonuses for keeping people healthy. Similarly, Japan reported high consumer satisfaction and people can see any specialist they want quickly. The average doctor visit is from 3 to 5 minutes and annual physical help with prevention of diseases. MRI’s scans and technology keep costs low. There are no waiting lists and costs are low for all patients. The German system is highly accepted, although it is not perfect. Some patients requiring special care do not pay for services such as the pregnant and the cost of drugs are low. Universal coverage exists for all patients that extends to mental health and dental as well. 10% of consumers opt out of the German the system and it relies on the rich to pay for the poor. The Taiwanese can see specialists immediately without having to see a doctor and universal health care is the norm for people in Switzerland. Prevention and treatment is much better than the U.S and nobody goes go broke paying for treatment in all of these countries despite economic and efficiency concerns.
Japan and Taiwan rated highly for the use of technology with the Japanese making extensive use of MRI technology, which is well used by the Japanese patients. Taiwan has a smart card that records all useful medical information about the patient and the number of visits so that the insurer can monitor the best health arrangements for frequent users.
The U.S could benefit from the Taiwan approach of looking at various models of healthcare to create universal system for everyone instead of certain segments of the population benefiting more than others. This approach already exists in the U.S and veterans have a system that allows them free access like the NHS in the UK. Seniors receive Medicare similar to Taiwan in the U.S and workers are insured from their insurance fund. The U.S system only requires that disadvantaged people and the unemployed are covered better under the system and that insurance companies are made more accountable. A new approach that moves away from user pay is possible in the U.S as shown by Switzerland’s attempt to change their system.
Reference
Palfreman, J. (Producer). (2008). Sick Around the World. The United States. Retrieved July 31, 2016, from http://www.pbs.org/wgbh/frontline/film/sickaroundtheworld/
