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WORLD VIEW: Globalized Mythbusting

Do we have the best health system in the world? That's a complex question. A majority of Americans say the answer is ‘no,' but many are also terrified of the alternatives. Rather than let fear stifle the reform conversation, let's look at the facts -- just what are the alternatives? In The Washington Post this weekend, journalist and author T. R. Reid debunked myths about health care in the rest of the world. 

Socialized medicine?

We hear a lot about Canada and Britain when we talk about health care around the world. Both of these countries have national health systems where the government pays for health care through tax revenue. But most Americans don't want a single payer system, and that's not where the current health care debate is taking us. There are other ways of creating high quality, affordable health care for all Americans. All other industrialized nations have found ways to provide health care coverage for all of their citizens, for less money per person than we're currently spending covering only some Americans.

Reid points out that universal coverage doesn't mean government-run. Germany, Japan, and Switzerland are among the nations that provide health care using "private doctors, private hospitals and private insurance plans." And for all the complaining about "government-run" care, it already exists in some parts of the U.S. system -- well-liked parts such as Medicare and the Veteran's Administration health system.

Choice vs. rationing

In Germany, a citizen can sign up for any of 200 private plans, says Reid. If they don't like the plan, they can switch without having to pay more in premiums.  In France and Japan, you can't pick your plan (it's assigned based on your industry or employer), but you can see any doctor or health provider you want without having to worry about "out-of-network" rates or pre-authorization -- your insurance has to pay for any doctor you choose. It's true that you have to wait for non-emergency treatment in Canada, but this isn't true everywhere. In Japan, reports Reid, waiting times are so short some patients don't even bother scheduling appointments. They just drop in on the same day.

Foreign health care systems don't practice recission, (when insurers find a way to drop a customer when they get sick). Foreign companies must accept everyone (they can't deny coverage based on "pre-existing conditions") and can't cancel if you pay your premiums, reports Reid,

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.

Cost and innovation

Though the U.S. has some of the best educated medical professionals and most cutting-edge advanced hospitals in the world, we aren't responsible for many of today's most widespread the health care innovations. For example, hip and knee replacement surgery originated in France.

In Japan, patients see their doctor three times as often as Americans do, get twice as many MRIs and X-rays, and have longer life expectancy and higher rates of recovery from disease, reports Reid. Still, Japan spends less than half of what the U.S. spends on health care -- $3,400 vs. $7,000, per person annually. And, writes Reid,

Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

Patchwork health care

Reid calls the American system a "crazy quilt" -- we've got a little bit of everything in our system. Native Americans and veterans have a single payer system with no bills -- like the UK. People with private, employer-provided insurance split premiums between workers and employers, like in Germany. Medicare is like the Canadian system, where people see private health providers and pay premiums to a government-run plan. For those with no insurance, we're like a third world country, reports Reid, "In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die." Hundred of thousands of Americans go into bankruptcy each year because of medical debt.

Reid says what we really need is organization in our health care system. He argues, "All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess."

So it's time to fix it. Not by copying what works for another country, but by taking advantage of this unique moment in time to create an American health care system that works for Americans. Preserving what works in our system, and fixing what doesn't in ways that reflect the values that are important to us as a nation. We can have sustainable, affordable, quality coverage for all Americans without sacrificing important American values such as innovation, fairness, and choice.

(BTW we have T.R. Reid's new book The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care and we'll let you know what we think as soon as we have a chance to read it...)  

Comments

Theme : 6 Main Lies Have

Theme : 6 Main Lies Have Nothing To Do With This Promising Reform.

1. The contents of savings (below) in this reform 'have nothing to do with' limit to medical access, rationing, tax raise, and deficit etc.

Rather, without wiping out these wastes and roots of bankruptcy for middle class, all fronts are sure to face larger financial ruin than this recession, which leads to more limit to medical access, more rationing, more tax raise, and more deficit etc than today.

$1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).

$583bn (the revenue package) + $80bn (so-called doughnut hole) + $155bn (savings from hospitals) + $167bn (ending the unnecessary subsidies for insurers) + 129bn(mandate-related fine based on shared responsibility) + $277bn (ending medical fraud, a minimum of 3% , the combined Medicare and Medicaid cost of $923.5bn per year, as of July,) = $1.391trillion + the reduced cost of ER visits (Medicare covers some 40% of the total) + the tax code on the wealthiest more reduced than originally proposed = why not ? (except for a magic pill, an outcome-based payment reform & IT effects and so forth).

As lawmakers debate how to pay for an overhaul of the nation's health care system, a new report from The Commonwealth Fund claims that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020.

"Health reform can help pay for itself, but both private and public insurance choices are critically important," said Commonwealth Fund President Karen Davis, who coauthored the new report. "A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost."

Unlike high fuel price and mortgage rate in recent years as the roots of great recession and bankruptcy of middle class, the severity in the high cost of health premiums has come to light lately. Similarly, in an attempt to hide these deficit-driven corruptions and wastes, the greed allies struggle to turn the savings via removing these wastes into limit to medical access, rationing, tax raise, and deficit etc.

In contrast, not to mention a wide range of consumer protection, options across state lines, this promising reform takes initiatives in more primary care docs and improved long-term care. Unnecessarily, hope should not be replaced with all forms of malign lies, fear, just like people don't have to fear quitting drug.

2. Greedy insurers with no competitors by consolidation have nothing to do with the law of price, demand & supply.

Under the free market theory and the premise that the public health is also one of commodity like a house, if the demand decreases on a large scale, accordingly the price tends to reflect it, as in the case of house price, and it never happens for the price to spiral up. One step forward, in case the price is spiraling up, to be sure, the remaining clients should withdraw the contract or choose the other options. In practice, runaway premiums with no competitors by consolidation drive the enrollees out, and 4C + 2R (canceling, capping, cherry-picking, cash for special lobby, rationing, rapid premium hike) guarantee multiple times as much profit. Sadly, no way-out other than the prohibitive ER is allowed in America. Therefore, the victims today and tomorrow deserve long overdue protection from non-profit Government.

3. The plans to stem inflation in the House have nothing to do with crowd-out.
With the heartbreaking tears in mind (In no other industrialized country do 20,000 people die each year because they can’t afford to see doctor. Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs changes and should join together to complete this reform , as promised, otherwise, the runaway premium only has itself to blame while new firms are filling the void with competitive deals.
And It can be said that fair competition starts with a fair, sustainable market value.

However, the plan in the House is designed to keep people in an employer-based health insurance system, and the public option would be offered to those for whom employer-provided insurance is not available. And job-based coverage (indirect payment), some mandate code, ample capital, the reduced exorbitant ER costs, IT base to streamline the administrative processes and trim the costs might be favorable to the private market. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services. And focus should be on the uninsured, the underinsured.

-- Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada --

In an attempt to avert innovation, moderation, and social responsibility, accusing essential affordability, citing take-over, will be a dirty play.

4. Profit-driven markets have nothing to do with affordable, sustainable public health.

When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion : As to for-profit business, the more and longer ill patients get, the more profits they make, and it will debilitate the overall economy involving education for the future (Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007).

Under the most wasteful structure on the planet like no coordinated preventive care program waiting until people get ill, about 50% of idle world's best practices, a pay for each and every service reimbursement and frequent readmissions, no e-medical record and deaths, crushing litigations and the more profits via the unnecessary, risk-carrying procedures, and the most inefficient paper billing systems imaginable, overpriced pharmaceuticals, bloated insurance companies, incredible medial fraud, exorbitant costs by the tragic ER visits etc, it might be no wonder with the comprehensive, systematic reform in the pipeline, just one attitude of patient-oriented value in 10 regions has attained 16% of savings in Medicare while their quality scores are well above average.

Aside from the already allocated $583 billion and the savings of this reform package, 16% of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) is around $147.76bn per year and 1.4776trillion over the next decade, and this patient-oriented value alone could be enough to meet the goal.

Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

Today, another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

5. Inflation-driven greedy allies backed by the insurers have nothing to do with deficit-neutral.

When some part of our body is ailing seriously, we are going to lose competitiveness, equally, when some part of a nation is ailing servery, it is going to loose competitiveness, too. In case somebody in the house gets ill, health will be put over house, in practice.

6. The analyses of CBO have nothing to do with common sense and practice.

Costs of Preventable Chronic Disease account for around 75% of the nation’s $2.4 trillion medical care costs. U.S. health care spending is also expected to double in the next 10 years. and they are largely preventable -- 80 percent of the risk factors are behavior-related.

Unlike the analyses of CBO, world-wide outstanding public programs put heavier emphasis on preventive program equally, and preventable swine flu pandemic is expected to cost about $2trillion dollars world-wide for the lack of prepared vaccines. (Genes included in the new swine flu have been circulating undetected in pigs for at least a decade, according to a team led by Rebecca Garten of the federal Centers for Disease Control and Prevention who have sequenced the genomes of more than 50 samples of the virus).

If CBO asks the profit-driven interests about why they have hindered the budget request for preventive program in Medicare and Medicaid, they will say, " just look at the health Catrina special lobbying has made, we are professional, and we are now obstructing this reform, too " .

7. Conclusion : The public health is a fundamental human right.

As I said previously, patient-oriented value alone could be enough to meet the goal, and another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

If At least, some media pay attention to this flower of reform, people will feel empty as the past and current discussion has been time-consuming for sure.

Thank You !