Health Care in France

Dr. Sanjay Gupta of CNN news examines the French Healthcare system in a short video (about 4 min.). In France, health insurance used to be tied to a job - like the U.S. system - until 2000. Since then, everyone has mandatory health insurance. 92% of the people also have supplemental health insurance. Insurance is not free, but the costs are mangeable, according to interviewees. The combination of insurance policies pays most medical costs. The out of pocket expense for any medical procedure is minimal. This is a very nice feature of ALL the universal healthcare plans in the countries that have them. (See the Frontline post and please watch the video.) No one wil be bankrupted by a severe illness or a medical condition, such as a pregnancy, with complications.

A Conservative View of Healthare

I was looking around for something that would give a thoughtful conservative's view of what to do about the health insurance mess and I found this by Ramesh Ponnuru in Time magazine. He says basically this: the problem with U.S. health insurance is that it is employer based (and thus tied to employment), it is employer based because companies get tax breaks when buying health insurance but individuals don't, therefore the way to fix things is to give individuals the same tax breaks that companies get to buy health insurance and the market will flourish. I think this accurately represents the conservative opinion of how to fix things, but I am doubtful. This does nothing to address the adverse selection problem that pervades the underwriting of individual insurance. Employers buy GROUP insurance for their employees. In group insurance, the actuaries can apply statistics to determine reasonable rates and the adverse selection is diminished.

McCain on Healthcare

Presidential candidate John McCain talked about his healthcare plan in a speech at the Cleveland Clinic. You can watch it here (about 4 min.). He is against the government requiring any insurance mandates on principle, and believes it should be made easy for patients to shop for health care by price. The cornerstone of his plan is a $5000 tax credit for each individual to purchase insurance. This would decouple health insurance from employment. He also says he would work with state governments to build good guaranteed access plans (GAP) for those people who are denied regular coverage. McCain's ideas are similar to those of Ramesh Ponnuru talked about in an earlier post ("A Conservative View of Healthcare"). My opinion of these ideas is also in that post. These are radically different proposals from the two democrats (whose plans are pretty similar), so this election offers a clear choice on the health care front.

Frontline

Frontline on public television recently had a program that explored the healthcare systems in other capitalist democracies to see what we could learn from the way other countries do it. You can watch it online here. Basically, they discussed the way universal healthcare is implemented in these countries and discussed what is good and bad about each implementation. Taiwan was one of the most interesting countries. They brought in universal healthcare relatively recently. Before they did, they studied many other systems, taking pieces from different ones to make their own.

Doctors Support Universal Healthcare

A survey reported in the journal Annals of Internal Medicine found that more than half of all doctors support national health insurance. 59% of doctors say they support national health insurance, while 32% are opposed to it. In a similar survey done in 2002, the results were 49% of doctors favored national health insurance while 40% were opposed to it. This was reported in a Reuters news article, available online.

The Health Care Crisis, Part I

Dr. Hui (physician and economist), explains the health care crisis in the United States to Pinky (a cartoon character cat) in a nice 15 1/2 minute video. The basic ingredients of the crisis are high and rapidly increasing costs, and many uninsured people. There is an in-depth discussion of managed care organizations (like HMOs, PPOs, etc.) and how and why these have failed to control costs. The universal health care solution is only brought up at the end, as the video ends with the fundamental question: Do people living in an advanced society have a basic right to health care? This question has been discussed previously on this blog. There is no Part II to this video up yet, I checked.

Comparing Healthcare Plans

Paul Krugman has a column in Monday's New York Times (2/4/08) comparing Obama's and Clinton's healthcare plans. He is strongly critical of Obama's plan for its lack of mandated coverage. Obama's plan mandates insurance coverage for children, but does not for adults. This, in Krugman's opinion, would allow some adults to chance going without coverage, and then be treated at taxpayer expense if they suffer a severe illness. Krugman does not believe universal healthcare can work unless it includes a mandate that all people must be insured.

Is Healthcare a Right?

One of the basic questions - maybe THE basic question - in discussing universal healthcare is - Is healthcare a right? If it is, we have to find a way to do it, regardless of the cost. If not, then it would have to be considered in a cost / benefit analysis along with all other government activities, and costs more is a stong argument against it. Also, should our basic rights to services expand as society becomes wealthier or are they fixed? For example, in the United States now every student has the right to a free and appropriate public education (through grade 12). It did not used to be so. In my opinion the answer to both questions is yes. Yes, healthcare is a right, and yes, the services we all have a right to should expand as the society grows wealthier. Others may have different opinions. Comments?

Neat Cartoon

I found this health care cartoon at Monte Asbury's blog.

Blog Purpose

In this blog, I want to focus on the social and economic consequences of our health care system with a particular emphasis on these major questions: Is it possible to have universal health care without breaking the fiscal budget? What restrictions might have to be imposed? What is the system for universal health care in the countries that have it and what are the possible ways to do it here? What are the chances it will be adopted here? and What are the alternatives to a universal health care system?