Essay:US Health Care: 4 models in One Messed Up System
The United States Health Care system has got to be one of the most preposterous social programs (or sets of social programs, when you include medicare, medicaid, ect) ever devised by mankind. The U.S. pays over $8000 per person for health care costs yet, there are 50 million Americans who are without access to health insurance and require emergency room visits to meet their health care needs. Unfortunately, these emergency rooms visits increase the costs of preminum for those who have health insurance. Furthermore, U.S. citizens with health insurance are still at risk of not being covered if they have pre existing condition. Long story short...a lot of people get screwed through the US health care system.
The major issue with US health care is the fact that it is four different system serving four different types of people. The American government decides to implement this policy rather than being smart like other westernized countries and choosing one system for the entire country! Then, this is America: Land of the Ignorant and home of the Stubborn!
The Four systems within US health care include:
The Bismarck Model: This is the classic model that most employed Americans are familiar with. If you are reading this blog post, I'm betting that you use this model for your health care services. It is named after the 19th century Prussian Chancellor Otto von Bismarck, who implemented welfare policies for the unification of Germany. The Bismarck system uses an insurance system provided and funded by employers and employees through payroll deductions. This model is used in Germany, France, Belgium, the Netherlands, Japan and Switzerland. Unlike the US, however, these countries mandate that all citizens are covered by health insurance. And although hospitals tend to be private in these countries, they are subjugated to government cost-control policies and hospitals do not make a profit. Unfortunately, because health insurance and the hospital are privately run, administrative costs continue to be high and this is reflected in the ovarall health care costs.
The Beveridge Model: This model is named after William Beveridge, who designed the National Health Service (NHS) in the United Kingdom. In this system, health care is provided and financed by the government through tax payments, just like the police force or the public library. Most of the hospitals are government run and the physicians and other health care specialists are gov. employees, although there are private ones who take fees from the gov. The government has sole control over the costs of health care services and prescriptions. Countries using the Beveridge plan or variations on it include its birthplace the United Kingdom, Spain, most of Scandinavia countries, New Zealand and Hong Kong.
National Health Insurence Model. This system has elements of both Beveridge and Bismarck. It uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into. Since there's no need for marketing, no financial motive to deny claims and no profit. As a result, it is often more efficient and cheaper than the American-styled health care system.
The single payer tends to have considerable market power to negotiate for lower prices; Canada's system, for example, has negotiated such low prices from pharmaceutical companies that Americans have spurned their own drug stores to buy pills north of the border. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated.
The classic NHI system is found in Canada, but some newly industrialized countries -- Taiwan and South Korea, for example -- have also adopted the NHI model.
Out of Pocket Model: Nations that have this model are often too poor to provide an adequate health care system to their citizens. As a result, citizens of these countries are forced to pay out of their own pockets to obtain basic health care services that are often taken advantaged of by first world citizens. Many of these citizens are unable to afford health care and as a result, they get killed from diseases that could easily be prevented by a simple vaccine shot or a pill.
In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. Many villagers in these nations rely on a traditional healer who provides treatments ranging from ayurvedic and siddha to natural herbs. Unfortunately, these treatments are ineffective compared to modern medicine.
In the United States, The Bismarck system is used by most employed workers. They receive health coverage through their employer. However, in the United States, there is little regulation when it comes to pricing and coverage. In fact, until Obamacare was implemented, a health insurence company could drop a customer, based on a "pre-existing condition". Retirees use the NHI model, although in the US, we call it Medicare. The government pays for health care services but they have access to private doctors and hospitals. Military Veterens have access to the Beveridge model where they utilize health care services from VA hospitals. These hospitals are completely owned by the government and the health care providers and specialists are gov. employees. The 15 million people without health insurence use the out of pocket model. However, many of them use emergency rooms to get free health care services. For every emergency room service provided, the premium paid by citizens who do have health insurence increases.
The Affordable and Prevention Act of 2010, aka Obamacare, has improved health care in the United states in many ways. This act encouraged a mandate that forces people to buy health care insurence, as an attempt to prevent premiums from increasing. This act guareetees that adult children, up to the age of 26, are still covered by their parents' health care plan. In addition, this act also provides subsidies to many low-income families who are unable to afford health insurence. This act does indeed provide numerous beneficial health care opportunities to citizens, however, it does not go far enough to remedy the disfunctionality of the US health care system.
Obamacare does not address the intense corporate control of the health care industry. Insurence companies and pharmaceutial companies are focused on making a profit for themselves, rather than providing decent health care to citizens. I am a pharmacy student however, I believe that the pharmaceutal companies are distorting the objective of American medicine and ripping off naive patients and customers. The United States is the only country where pharmaceutical companies market their drugs and other pharmaceutial products DIRECTlY to patients rather than through doctors and clinical pharmacists, as they do in other industrialized countries. The customers are implanted with the idea that they need to buy a unnecessary drug. Nowadays, it seems that pharma companies and customers are more concerned with the distrubution of drugs manufactured in order to enlarge a man's penis! As a pharmacy student with a passion for health care, I am appalled and outraged.
Economically speaking, I lean towards the political right. I believe in a free market as the most efficient means of accumlating wealth to the masses. However, unlike political pundits like Glenn Beck and Jonah Goldberg, I do not regard the free market as a holy diety. Unlike other industries, I do not believe that the standards of the free market should apply to the health care industry. Unlike motor vehicles, real estate and technological advances, health care is nota luxery. It is an necessity. If the possession of weapons is regarded as a right in the United States (under the 2nd amendment), so should health care. It's only logical. How can you expect to have productive employees interacting in the free market if health care and wellness are not encouraged?
So yes, I do think that violations of unbreakable commandments of the free market is necessary in the care of the health care industry. Curse me for being a heretic! Price control and (some) government intervention is a necessity. A mandate should be implemented in order to acheive universal health care status, similar to other industrialized countries. Health insurance companies, Big Pharma and hospital should be expect to make a profit. In fact, pharma companies should NOT be allowed to market directly to naive customers. Although I am an economic rightist, I dont belive that the free market is ALWAYS effective. The United States spends more on health care and any other country. Why is that? Because of administive costs and marketing that is associate with the profit-driven health care industry we have in the United States
In addition, this countries needs to adopt one system instead of four different ones. I propose the US adopt a single payer system similar to Taiwan. This is the NHI system This way, hospitals and physicians will remain private yet insurance will be provided by the government. This would prevent massive administrative costs while promoting some competition among private physicians. In addition, prices will be controlled by the government to prevent outrageous costs to the patients.
Now is the time for Americans to get their heads off their ass and realize that our health care system sucks! It is as preposterous as it is disfunctional. The solutions are clear yet our politicans continue to espouse the so-called "evils" of government run health care while promoting the "free market".