This weekend, I was going through PBS' video collection because I had run out of things to watch, and I came across a very eye opening documentary from Frontline entitled, "
Sick Around The World." It's a 60 minute documentary that you can watch online for free. The premise is that the US still does not have universal health care, so the host takes a look at five other democratic capitalist countries to see what their health care systems are like, and what we can learn from those systems. The countries highlighted are the United Kingdom, Japan, Germany, Taiwan, and Switzerland.
Here's a snippet of what you will see in the documentary:
Reid reports next from Japan, which boasts the second largest economy and the best health statistics in the world. The Japanese go to the doctor three times as often as Americans, have more than twice as many MRI scans, use more drugs, and spend more days in the hospital. Yet Japan spends about half as much on health care per capita as the United States.
One secret to Japan's success? By law, everyone must buy health insurance -- either through an employer or a community plan -- and, unlike in the U.S., insurers cannot turn down a patient for a pre-existing illness, nor are they allowed to make a profit.
It's quite remarkable that in the US, about 700,000 people a year declare bankruptcy because of a medical emergency. This happens when someone falls ill and doesn't have the money/insurance to cover the costs. The host of the show asks health officials from each country, how many people a year go bankrupt because of medical bills? All of the officials look very puzzled when presented with the question, and they all answer, no one in our country goes bankrupt over medical bills.
As I worked my way through the documentary, I had a few conclusions:
- A pure public health care system does not work because there's no competition in the system, so cost overruns, poor service, and long wait lists are problems.
- A pure private health care system like the US just doesn't seem ethical because the poor don't have access to proper health care. It's also scary that if you lose your job, you'll usually lose your health insurance as well, and that's quite a gamble. It seems morally unethical that people can go bankrupt because of poor health.
- What seems to work is a hybrid system where there's universal health care, but you introduce the good parts of a private health care system, which is competition/market forces. For example, hospitals who don't control costs, or provide poor service will ultimately be replaced with better more efficient hospitals which are competing for patients.
- Information Technology seems plays a big role in keeping costs down. For example, in Taiwan, when a patient pays medical premiums, only a few percent of that goes towards administrative costs. Contrast that with the US where about 15-18% of premiums goes towards administrative costs.
- Countries are able to get drugs at a much lower price if they the country negotiates on behalf of all patients with drug companies. This allows the country to say, for this drug, we're willing to pay $x for this. This is using the country's buying power to the advantage of the the public, and thus reducing costs.
I find myself quite appalled by the American system, as I see how much money my company pays each year for my medical insurance, and it's orders of magnitude more than the premiums I paid in Canada. I feel like the company is getting ripped off by such high premiums, but I've been told these types of premiums are normal in the US. It's also quite scary that most people depend on their jobs for medical insurance, and if they lose their jobs, they lose their insurance.
What I also find remarkable is that some of my friends don't have medical insurance, and they argue that they're young and they don't need it. This seems incredibly foolish because you're basically gambling with your financial security; one serious accident can wipe you out financially.
I've also had debates with some staunch Republicans about health care. The buzzword they use against universal health care is "socialized health care," and it seems to be a dirty word because it's a stone's throw away from communism in their minds. Their main argument is that a public health care system just means a big inefficient government program that will waste tax dollar money. They believe a public system with no competition will mean lots of mediocre results. Instead they believe the market and private industry is better able to deliver health care to Americans. What I find remarkable is that these arguments kind of fall flat if you watch this documentary and discover that public systems in other countries are actually more efficient than the US system.
I'll leave off with a paraphrase from one of the health officials. In the US, if you're rich, then the health care system is excellent. If you have medical insurance, then the system is pretty good. If you're poor, then the health care system is no better than a third world country's health care system.
It is this notion that I think a civilized nation cannot tolerate something like a US style health care system.
