Other Voices: Looking abroad may give health care solutions
Letters to the editor on the subject have been flowing after Michael Moore’s movie hit the screen last week. I am amazed that even people defending the health care systems used by every industrialized country in the world (except the U.S.) fall into the trap of calling them, as coined by their detractors, “socialized medicine.”
Having spent a good part of my life in France, I can assure you that the system there is a prime example of a dynamic, free market. French MDs work for profit. So do pharmacists, hospitals, nurses, etc.
Medical insurance, on the other hand, is run by an independent agency similar to Medicare. The basic concept of insurance is to spread the risk among as many users as possible and, in the case of medical insurance, among the entire population.
The medical insurance industry in the U.S. has developed into an aberration that is a
disgrace to our country. They can choose who to insure (an abnegation of the insurance concept) and overrule MDs on required procedures.
Some of these insurance executives are even MDs, turning their backs on their Hippocratic Oath. In most countries in the world, such behavior would send you straight to jail. Instead, the culprits entertain our legislators with lavish dinners and make sure that their re-election campaign is well funded. Don’t worry about our congressmen: They voted an excellent health package for themselves.
Insurance companies absorb 20 to 35 percent of your premium in administration, sales commission, advertising, lobbying, etc. (Mathematica Policy Research. Inc), plus 5 to 15 percent profit, resulting in 50 percent for Blue Cross (Market Watch).
Medicare, a single-payer insurance system alive and well in the U.S., brings such figures down to 3 percent (Health Affairs Journal), which is at the lower range of overheads of single-payer insurance systems used all over the world. So, we can do it.
Private enterprises are overwhelmingly preferable to state-run agencies to best address most human needs, but there are a few exceptions. Do you believe that putting private armies in competition would be more desirable that a single one run by the state? Medical insurance, as every other developed countries has already found out, fall exactly into such a category.
Another tremendous benefit of single-payer insurance is the diminution of paper work. Most French doctors do not even have a secretary, unlike U.S. doctors who need several to keep up with the myriad insurance forms, denials of payment, collection of unpaid bills, etc.
The whole irony is that if you get sick and call your doctor in France, who has a skeleton staff, if any, by U.S. standards, he will show up at your door within 1 to 2 hours, instead of you going to the emergency room because the next available appointment is … in three weeks! And they try to make you believe that you have to wait forever for treatment when what they call “socialized medicine” is in force.
According to the World Health Organization, the U.S. spends more than twice per capita (currently around $7,000/year) than any other country in the world on health services to achieve a dismal 37th position in the overall ranking. How can a country like France or Italy ranked No. 1 and No. 2, respectively, achieve much better results with less than half the money (World Health Organization)? What happened to American efficiency?
Other benefits are the use of prevention (a loosing proposal/investment for an insurance company that doesn’t know how long you will be with them), the elimination of workman’s comp, Medicare, Medicaid, VA, etc., all pooled into the single-payer system. Furthermore, it reduces our anxiety about possible ruin from medical bills and improves our quality of life and yes, the pursuit of happiness.
The insurance industry is trying to make you believe that frivolous medical malpractice lawsuits are the cause of all our problems. This cannot be further from the truth. Only 3 percent of the lawsuits are truly frivolous (no injury occurred) (New England Journal of Medicine), and are usually dismissed by the courts.
Large settlements for non-frivolous lawsuits are a significant expense, but the American Medical Association doesn’t discipline the five percent of its doctors responsible for the majority of the claims (New England Journal of Medicine).
There are many other problems with our health care system: The cost of drugs, medical schools, etc. Here again, looking abroad, in countries where consumers still have a voice, might show us how to better address these problems.
Alain Lazard lives in Penn Valley.
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