“Sick Around the World”
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
The U. S. is 37th according to the World Health Organization in Quality Fairness
Great Britain
National Health Service is Britain’s provider of health insurance/care
Half as expensive as the U. S. system
Infant mortality rates are lower than the U. S. rates
longer life expectancy in Britain than the U.S.
“Should never have to pay a medical bill”
citizens pay through tax revenue
doctors are salaried employees
no medical bills, no medical bankruptcy
emergency care and primary care are “good”
elective care (hip or heart were examples) take longer to get solved if non emergency
above examples may take 2-3 months to have surgery
hospitals and insurance companies compete in order to survive – cannot profit
Britain citizens protest if they do not agree with medical issues
Doctors earn bonuses for making patients healthier – up to $180,000 per year
Example of British doctor being charged $67,000 for a heart surgery in U. S. (vacation)
Positives
No bills
NHS has worked to improve waiting times for patients
Excellent preventative medicine
Negatives
Too much government?
May be too cheap – patients can come to see the doctor twice a week (lonely)
Japan (130 million people)
Have no natural resources – extremely capitalistic
Everyone is covered, Japan spends ½ what the U.S. does
8% of GDP
Japan has fabulous health statistiscs
Longest healthy life expectancy in the world
Lowest infant mortality rates in the world
Diet and lifestyle is healthy
System is supported not just with taxes – work and community sponsored
Social insurance system, poor are covered by the government
80% of hospitals are private
Everyone in Japan is covered - best
Citizens go to the doctor 3 times as often as U. S. people
Can see any specialist they want
No appointments are necessary
Average appointment takes 3-5 minutes
Longer hospital stays, technology is loved
Tight governmental controls on health prices (fixed prices)
If hospitals try to boost the price by doing more – price of procedure goes down
Ex. MRI – MRI in the U. S. - $1200, in Japan - $98
Price regulation – charge what the government says
To spend the night in a hospital –
$90 for a private room, $10 if a person share a room with 3 others
prices are the same throughout the country
doctors cannot get rich
Community insurers – cannot turn people down due to preexisting conditions and do not
make a profit
Any money left over at the end of the year carries over to next year, if there is a lot left
over, premiums are lowered the following year
Average premium for a Japanese family - $280 a month, employer paying half
No waiting lists, rock bottom costs, longest life expectancy, excellent health results
Negatives of the system
No system is perfect
50% of hospitals are in financial difficulties
may spend too little on health
very popular system – may increase fees
“Never heard of someone going bankrupt due to healthcare costs”
Germany – 3rd richest economy in the world, invented aspirin and X-Rays
The Bismarck model – credited with inventing the healthcare system used today
About 90% of people choose to stay in national system
Covers mental health, dental, optical, spa, among other coverages
Hospitals and doctors are largely privatized
Pay premiums based on income to more than 240 private insurers (sickness funds)
More expensive than Japan or UK, cheaper than the U. S.
Earning $60,000 per year, split $750 mo. Premium with employer (rich pay for poor)
Co payment is about $15 once every three months
Health insurance does not change due to employment
Insurance systems are not able to profit
many different choices, quality similar to the U. S.
Prescription medication is covered, small co pays
System is efficient
Drugs are a bargain
All sickness funds negotiate medicine costs “economies of scale”
Not able to raise prices
35 yr. old doctor earns $80,000 yr. – 1\2 of what a U. S. doctor would earn comparatively
works between 12-16 hours a day, up to 7 days a week
family doctor $120,000 yr., pays $1400 yr. for malpractice insurance – about 1/10th cost
of U.S. malpractice insurance
Doctors have protested salaries in past, nothing happens
Health insurance through employer
Took profit out of health insurance
Taiwan
Set up a committee that looked at all possible solutions to health care issues
Consulted experts from throughout the world
10-15 countries were examined – U. S. was not one of these countries
“wanted everybody to have access, free choice of doctors, no waiting time, encouraged
lots of competition among medical providers”
Finance – National Insurance, forced everyone to pay
Rich were not allowed to opt out – different than Germany
Similar to U.S. medicare and Canada’s medical system
No gatekeeper, no waiting
Believe in state-of-the-art informational technology
Everyone has a smart card
Lowest administration cost in the world
Too many visits per time period – government official will visit that person
No bankruptcy due to medical bills
Taiwan’s GDP = 6.2%, America 16%
Government is borrowing from banks to support healthcare costs
Politicians are afraid of increasing premiums due to voters becoming upset
Switzerland (8 million people)
10 years old – La mall – the sickness (law originally passes nearly 50% against law)
everybody had to buy insurance except the poor
Not allowed to make a profit
“Everybody has the right to healthcare”
“Basic human right”
Drug and Insurance companies – many are non-profit already
Lack of profit – no lack of competition
Ave. administration costs in U.S. 22%, Swiss 5%
Supplemental coverage can make a profit – ex. Better hospital rooms
Companies make 1\3 of their profits from U. S. sales
700,000 people a year go bankrupt in U. S. due to hospital\medical bills
Average monthly premium is $750, 2nd most expensive in the world, U. S. is 1st
“100% free market in healthcare cannot work”
Summary of Countries Studied
1. Insurance companies must accept everyone and cannot make a profit
2. Everyone is mandated to buy insurance, government pays for the poor
3. doctors and hospitals have to accept price controls, there are standard set of
prices – fixed prices on medical expenses for consumers
“Foreign Healthcare Ideas Being Not That Foreign”
American Veterans = Britain’s NHS
Seniors and Medicare = Taiwan
Working Americans = Germany
Non Working Poor and People without Insurance = Any other Poor Country