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Healthcare plans in the USA, UK, Switzerland and Taiwan

By Art Stevens

I hesitate to call this a column of mine. Rather, it is a collection of facts and information about health care that I gathered from various sources with much coming from Fareed Zakaria of CNN. With our presidential election only a few months away, everyone should take a good, hard look at our health plan and how countries around the world handle health.

Zakaria: “America’s system of bringing us into this world, helping us stay alive and supporting us as we die is at a major crossroads. Two years ago, President Obama signed the most comprehensive overhaul of American medicine since Medicare. This week, the Supreme Court upheld almost all of the law with a dramatic 5-4 ruling, setting up what is sure to be a heated election year debate. Meanwhile, our out of control health care costs continue to climb. No other nation spends more than 12 percent of its economy on health care. America spends 17 percent. Our ‘healthy life expectancy’ ranks 29th in the world; our infant mortality rate ranks 30th, more than twice that of Sweden and Japan. So what is our problem? Let us go around the world, and see what lessons we can learn from others.”

During America’s debate over Health Care Reform, critics said ‘Britain’s government-run system was a system that rationed care to those in need. Were they right? The government pays for everything, owns most of the hospitals, and pays most of the doctors. But consider this. Compared to Americans, the Brits have a longer life span, a lower infant mortality rate and a health plan system that consistently ranks higher on every measure. All this, and everyone’s care is covered. No payments for doctors, no monthly charges from your insurance company, no co-pays and no fees. Nothing.

Surgeon in the UK: “When patients come to us, we only evaluate them from the point of view of their needs. Do they need a liver transplant? The cost never comes into it. As a surgeon, I love that because it means that the focus is on the care that I can deliver.”

In the USA, an estimated 137,000 people died over seven years because they were uninsured. Of course, the Brits do pay for their health care in another way: with taxes. The sales tax is a whopping 20 percent, and income tax is as high as 50 percent.

The least efficient payers in the world are the American private insurance companies. They have administrative costs of 20 to 30 percent. That’s a 30 percent tax on every dollar you spend on health care. It turns out that in health care, governments are doing this more efficiently than the private sector. One reason is that private insurers in America spend more money on non-medical costs, like ads and reviewing claims to help them stay profitable. Britain spends around $3,500 a person on health care. The U.S. spends about $8,500 per person.

British Health Commissioner: “We cover everybody, but we don’t cover everything.”

This is the British System’s most controversial element. The people that decide these critical questions are doctors and patients, not government bureaucrats.”

It costs $632 for one day in the hospital in Germany. In Switzerland, it’s $690. In the USA, that number skyrockets to $3,949.

Taiwan, in 1995, had 41 percent of its population uninsured. Before completely redoing their system, they checked the systems of all the major countries in the world. They finally opted for a ‘single-payer’ system where there is only one insurer in the market: the government. They combined that with private doctors and hospitals to avoid too much bureaucracy. The system looks like American Medicare, but it is for everyone, not just the elderly. Taiwan’s uninsured went from 41 percent to 8 percent in less than a year. Public insurance DOES WORK. The single-payer system DOES WORK.

Bankruptcies due to medical bills or illness in America: 500,000.

Switzerland, 20 years ago, adopted a plan that is almost identical to what is now being called ‘Obamacare’ in the USA. Everyone is now covered, and the care is still top-notch. The Swiss enjoy one of the longest healthy life expectancies in the world. Access is easy, and the waits are short.

Health-Care costs are rising all over the world, but in the United States, health care is almost twice as expensive as everywhere else.

Spending on Pharmaceuticals per Capita are at $381 in Britain, $500 in Switzerland and $919 in the USA.

All of these lopsided figures you are reading do not affect only health care. It also has a profound effect on the monies needed for education, infrastructure, science and technology, not to mention the military and Social Security.

Every year, an estimated 100,000 Americans die from an infection they got in a hospital.

USA’s Healthcare costs per family of four total $805 per month in 1999 and $1,420 per month in 2000.

We spend twice as much as other industrialized countries, and we cover fewer people.

According to the SSA Kaiser Family Foundation, the median wage in the USA is $26,000. The average USA health insurance premium in 2011 was $15,000. In 2021, tht’s expected to more than double to $32,000.

Zakaria: “A genuine insurance system can only work if everyone is insured. Otherwise, only the people who are sick will want to buy insurance, and insurance companies will spend most of their time and effort trying to keep sick people off the system or deny coverage to those who might get sick. That’s why the ‘Heritage Foundation,’ a conservative think tank, came up with the idea of the individual mandate, requiring that people buy health insurance in exactly the same way that people are required to buy car insurance. That’s why Mitt Romney chose this model as a market-friendly system for Massachusetts when he was Governor, and that’s why Newt Gingrich praised the Massachusetts model as the most important step forward in health care in years. The Affordable Care Act, currently known as Obamacare, and now upheld by the Supreme Court, expands access to 30 million Americans. That’s good economics, and it’s also the right thing to do, but it does little in the way of controlling costs.”

The USA system of private enterprise works and works well when you are selling a product, like a car, a TV or a refrigerator. It does NOT work for health care. The template should be thought of more like car insurance. You MUST have it for the safety and well being of everyone. Would you enjoy your Sunday drive as much knowing that there are 30 million drivers on the road that have NO coverage? The main goal of health insurance companies, being private, is the amount of profit shown in each quarter. The government’s goal SHOULD be, and hopefully IS, to care for the human rights of its citizens. Therein lies the problem I have with so-called conservative thinking. The word is ‘RIGHTS.’ They don’t believe people have the ‘right’ to see a doctor if they or their kids are sick. I do. The last time I brought this up to a conservative friend of mine, his response was, “What will you give them next: free TVs or cars?” It hurts me to see how he so obviously misses the point and puts the precious health of our citizens in the same category as selling products on the open market.

It seems to me that in the countries discussed here, everyone is covered. The plan in Switzerland is almost identical to Obama’s plan, and after 20 years is working well. I think the Taiwan plan (single payer system) is what really works best. Your thoughts? [email protected]

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