Wednesday, August 19, 2009

The Four Systems of Healthcare
discusses the four ways countries can run their health systems. We are primarily #4, but have elements of each:

1. Nationalized medicine (UK)
Government runs hospitals and pays doctors. No one in Congress is proposing this, although we have this for our veterans. The VA runs their own hospitals and pays their own doctors, and no one screams socialism.

2. National health insurance (Canada)
The doctors and hospitals are private, but the government foots the bill. U.S. again has the form of Medicare.

3. Regulated fee-for-service medicine (MA)
Hospitals and doctors are private, and insurance is private. What the government does is set strict ground rules, such as insurance must cover to a basic standard, everyone gets the same price regardless of medical history, etc. Also, companies don't have to offer health care: the competition is between insurance companies. Mitt Romney and the Massachusettes legislature set something like this up for their citizens.

4. Unregulated fee-for-service medicine (US)
Everything is private, and the government doesn't regulate anything. Free-for-all. The majority of our nation operates like this. If someone has a pre-existing condition, no job, low-wage job, whatever...they just don't get insurance. The community pays for their health care with the inevitable trips to the emergency room. Their is no gaurantee of anything but apparently higher premiums.

The author of this article, which attacks both our current system and all the bills currently floating in Congress, has an unorthodox solution. Real reform, it is argued, is bypassing the insurance industry alltogether. I disagree, but the article raises some very strong points many have not considered.

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