Yodel-lay-hee-hoo! I’ve blogged about the Massachusetts model for governmentally administered healthcare, but the focus is now shifting to one “government” – notoriously efficient Switzerland – that covers the entire spectrum of its national healthcare with a plan that is run solely through the private insurance companies. As Blue Dog Democrats seems to be putting the kibosh on the “public option” – where the government itself would provide “one choice” in consumer alternative healthcare options (and by creating an alternative that doesn’t have a profit margin, create a cost competition to force insurance companies to cut costs to be in the game) – folks are looking at what else is out there that works.
Having just come back from a business trip in Canada, the talk up there is about how stupid we seem in battling over the evils of national healthcare and how we think the people up there would much rather have the choices we have. Not for anything! To a person, they fiercely defended their system. And it’s a pure public option plan.
When I told my Canadian friends how much I spend on health insurance (plus co-pays and deductibles), they simply blanched. They smiled smugly and said, while they did have to share some of the costs when they accessed the system and the wished some treatments could move along faster, they truly appreciated the fact that they never every worried about medical issues. They thought the number of American families who go bankrupt every year was supremely callous.
But that form of government-provided plan is dead in the water in the US. We’re still going to pay through the nose, but we seem to be heading towards legislation that will run healthcare through the private insurance carriers, eliminate rejection or termination for pre-existing conditions or extreme medical issues, create “pools” of policies at various levels that can be accessed by anyone, mandate health insurance coverage even for the “young invincibles” and subsidize those who cannot afford the cost of coverage. The insurance carriers love that we are forcing people to become their customers!
The Swiss do it a bit differently. They require the carriers to offer a basic plan as an option (for which they are not permitted to make a profit!), but anything beyond that basic plan is simply “business as usual” for these profit-seeking companies. Carriers cannot exclude or refuse any applicant for any reason. Seems almost like a public option being provided by the private carriers as a tradeoff for building their business. Everyone is required to have coverage. The Swiss government subsidizes those who cannot afford coverage, and has no separate plan for the elderly.
The October 1st New York Times: “The Swiss government does not ‘ration care’ — that populist bogeyman in the American debate — but it does keep down overall spending by regulating drug prices and fees for lab tests and medical devices. It also requires patients to share some costs — at a higher level than in the United States — so they have an incentive to avoid unnecessary treatments. And some doctors grumble that cost controls are making it harder these days for a physician to make a franc.
“The Swiss government also provides direct cash subsidies to people if health insurance equals more than 8 percent of personal income, and about 35 to 40 percent of households get some form of subsidy. In some cases, employers contribute part of the insurance premium, but, unlike in the United States, they do not receive a tax break for it. (All the health care proposals in Congress would provide a subsidy to moderate-income Americans.)”
The cost of healthcare in Switzerland is 10.8% of their GDP (versus our 16%). Doctors cost less as well: “[S]pecialists in Switzerland earn three times more than the nation’s average wage, compared with 5.6 times for American specialists. General practitioners in Switzerland make 2.7 times more than the average wage, versus 3.7 in the United States.” And if it is determined that a doctor ordered an unnecessary treatment, well, that doctor is required to pay the system back and refund the money!
We do have choice, and we do need a system in place now to end this soon-to-be unaffordable-for-almost-everybody cost of healthcare. Think a bill will pass this year?
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