Currently, President Obama is in the process of putting a health care system in place for the United States. According to the Obama website, the health care system mission statement states this plan will strive to “provide more security and stability to those to who have health insurance. It will provide insurance to those who don’t. And it will lower the cost of health care for our families, our businesses, and our government. ”
Obama has made some progress on these promises, including signing the Children’s Health Insurance Reauthorization Act. This act provides health care to 11 million kids, of which four million were previously uninsured. The president has also signed the American Recovery and Reinvestment Act. Some of the benefits of this act include protecting health coverage for seven million Americans who are currently unemployed through a 65 percent COBRA subsidy. The subsidy will make coverage affordable as well as funding research for future treatment and wellness programs to improve general health in America and to reduce health care cost.
Many individuals feel that health care is a human right and that everyone, regardless of type of employment, should have access to health care. I watched an interesting documentary, “Sick Around the World,” that provided some answers to getting a health care plan in place. In the documentary, T.R. Reid travels to five different countries to compare health care systems.
Reid’s first visit was to the United Kingdom. In the U.K. health care system, the government pays and provides for health care and the Britons pay higher taxes. The doctors that work in public hospitals are paid salaries and general practitioners who run private practices are paid by the number of patients they see.
The Britons are satisfied with this plan since it is funded through taxes and it allows the administrative cost to remain low. The general practitioners are paid extra for keeping their patients healthy. This type of system is often referred as “socialized medicine,” and the only concerns are that the patients may have a long waiting list to get see a doctor and could have limited choice. To provide more options for patients the hospitals compete for National Health Service funds so patients are able to choose where they want to be treated.
Reid’s second visit was to Japan. In Japan, the type of system is that used is referred as “social insurance.” All citizens of Japan are required to have some kind of health insurance. The Japanese have to pay a medical bill of $280 per month, but employers usually pay more than half of that bill. Those who can’t afford health insurance are able to receive public assistance.
Some believe that Japan’s system is one of the best in the world. There is often no waiting list, like in the United Kingdom. The Japanese are able to see any specialist they want. One of the reasons health insurance is affordable in Japan is because MRI machines and they are cheap to produce there. The health check up is very quick and there is a fixed price for all procedures. The only concern seems to be that Japan spends too little on health care. Many hospitals are not making enough money to stay in business. A solution might be to charge more money.
T.R. Reid’s third visit was to Germany. In Germany, a “social insurance” is also used. This “social insurance is a little different from Japan. Instead of receiving insurance from work, the Germans are assigned to a community fund. The Germans have the opportunity to buy their insurance from one of more than 200 private or non-profit funds. It is similar to Japan in that as the individuals that are unable to afford to buy the insurance are able to receive public assistance.
Reid claims that average family in Germany pays about $750 per month or co-payments of 10 Euros ($15) every three months. Usually it takes about 10 days to see a doctor. It seems to be quicker than the U.K. but not as quick as Japan. The doctors earn half the salary as a doctor in the United States. Germans have the opportunity to see a doctor without seeing a gatekeeper doctor but they may have to pay a higher price.
The concern with the German’s health system is similar to Japan’s: the doctors can be underpaid. The film stated that “A family doctor in Germany makes about two thirds as much as he or she would in American.” It important to realize the differences between Germany and America, though. Reid says that in Germany the doctors pay less for malpractice insurance and may attend medical school for free.
Reid’s fourth visit was to Taiwan. In Taiwan, the health care system was developed from combining systems around the world, weighing out the positive and negative of each system and creating one system that could work. Taiwan’s system is referred to as “National Health Insurance” with only one government-run insurer.
The average price a family pays is $650 for a family of four. The cost is broken down into specific items and procedures; about $6.50 for the cost of drugs, $7 for outpatient care, $1.80 for dental and traditional Chinese medicine. If individuals are unable to pay the fee then they will be covered from the government. Reid claims there is no waiting time and everyone has equal access.
Taiwan uses a smart cord that shows the history of all the patients. The bill eventually goes to the government office. If a patient has been seen over 20 times a month or 50 times during a three month period then they may have to pay extra. Taiwan’s system is similar to Canada’s and the U.S Medicare program. The only concern with Taiwan’s system is similar to Japan and Germany: there is not enough money to cover the medical care that is provided to the patients.
Reid’s last visit was to Switzerland. Switzerland developed their health care system in 1994. The system is referred as “social insurance”, similar to Japan and Germany. It requires all citizens to have coverage. Citizens pay on average $750 a month. To those who can’t afford to pay the price, the government offers financial assistance. The insurance companies are not allowed to make a profit on basic care.
In Switzerland, Reid claims the administration cost is only 5.5% while in the U.S it is 22%. The concern for the Swiss system is that it is the second most expensive in the world. Even then it is still far cheaper than the U.S health system.
This documentary can help bring ideas to the United States for developing a health care system. There are three main policies. First, insurance companies must accept everyone and can’t make a profit on basic care. Second, everybody’s mandated to buy insurance, and the government pays the premium for the poor. Lastly, doctors and hospitals have to accept one standard set of fixed prices. In order to develop a health care system Americans may have to accept these ideas.
The documentary ends with an important question. Other rich countries have universal health care. Why don’t we? I hope individuals will become more involved in this important issue. For more information students are encouraged to watch the documentary “Sick around the World.”