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Solving The Health Care Conundrum

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colin_twiggs
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Tuesday, April 13, 2010 - 08:58 am:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)



The Lombardy region of Italy boasts one of the most efficient health care systems in Europe, with private and public hospitals competing for patients on an equal footing. The result has been a dramatic reduction in waiting lists, a corresponding increase in service standards, and a lower health care spend per capita compared to other regions.

See WSJ: Health Care Reform in Italy - Public v. Private


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colin_twiggs
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The United States spends more than any other nation on healthcare -- roughly 16 percent of its economy -- but still has higher rates of infant mortality, diabetes and other illnesses than other rich countries.

Reuters: Sweden Canada & India outrank US on Healthcare







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deanrosario
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Tuesday, May 04, 2010 - 10:08 pm:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)



Colin, you may want to have a look at this PBS Frontline documentary titled: Sick Around the World, which compared the 4 basic health care systems in the world:

The full documentary is definitely worth a look if you're interested (as I am) in this issue:

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/view/

1. The Beveridge Model (e.g. Great Britain, Spain, most of Scandinavia, Australia, New Zealand. Cuba represents the extreme application of the Beveridge approach)

* In this system, health care is provided and financed by the government through tax payments, just like the police force or the public library.

* Many, but not all, hospitals and clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government.

2. The Bismarck Model (Germany, France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America).

* fairly familiar to Americans. It uses an insurance system usually financed jointly by employers and employees through payroll deduction.

* Unlike the U.S. insurance industry, though, Bismarck-type health insurance plans have to cover everybody, and they don't make a profit.

* Doctors and hospitals tend to be private in Bismarck countries

3. The National Health Insurance Model (Canada, Taiwan and South Korea)

* This system has elements of both Beveridge and Bismarck and uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into.

* Since there's no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style for-profit insurance.

The single payer tends to have considerable market power to negotiate for lower prices;

4. The Out-of-Pocket Model
* The majority of the world has no organised health care system because nations are too poor and too disorganized.

* The basic rule in such countries is that the rich get medical care; the poor stay sick or die.


"Never commit yourself to anything you can't walk away from in 30 seconds." Neil McCauley (played by Robert de Niro) in 'Heat'.

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colin_twiggs
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Wednesday, May 05, 2010 - 09:15 am:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)



Dean,

Thanks for the link.

I believe there are two main elements to health care:
  1. The providers -- public or private service-providers or some combination of the two.
  2. The finance -- from taxes, from insurance, or paid for by the recipient

1. The Lombardy option appeals because public and private service providers compete on a level playing field. Whoever provides the best service at the lowest cost, wins.

2. Funding is far more difficult.
  • How do we avoid moral hazard -- where people don't take care of their health because they do not bear the cost?
  • Both insurance and tax-funded schemes include an administration cost.
  • Collective bargaining-power: some elements of the medical profession hold a virtual monopoly over the provision of services that is reflected in their pricing. How is this best countered?

Regards, Colin


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colin_twiggs
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Thursday, May 06, 2010 - 02:43 pm:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)




colin_twiggs wrote on Wednesday, May 05, 2010 - 09:15 am:

Funding is far more difficult.

* How do we avoid moral hazard -- where people don't take care of their health because they do not bear the cost?
* Both insurance and tax-funded schemes include an administration cost.
* Collective bargaining-power: some elements of the medical profession hold a virtual monopoly over the provision of services that is reflected in their pricing. How is this best countered?




Dean,
Following on from the funding questions raised yesterday:
  • Avoid moral hazard by creating incentives to look after your health (e.g. lower contributions for those who aren't obese, don't smoke, and don't abuse alcohol/drugs).
  • Administration costs should be kept to a minimum. The best way to achieve this is by making patients responsible for their own expenses. Here is one such example: issue each member a debit card that can only be used for medical expenses. Credit say 2/3 of contributions to the card; the other 1/3 goes to insure against expenses exceeding the card balance. Offer incentives to members who do not use up their contributions -- to discourage unnecessary expenditure.
  • The Lombardy option would allow public and private service-providers to compete with each other on a level playing field and break the monopoly enjoyed by either public or private services.

Membership of a health insurance scheme would have to be compulsory. Again, you could have competing public- and private-run schemes. Obviously taxpayers with little/no income would be subsidized by the state, but they should still be able to elect which fund to join.

Regards,
Colin


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colin_twiggs
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Tuesday, July 13, 2010 - 01:57 pm:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)



UK Plans To Overhaul Health System
Jeanne Whalen at WSJ.com


quote:

The U.K.'s new coalition government, grappling with weak public finances and rising health-care costs, announced an overhaul of the state-funded health system that it said would put more power in the hands of doctors and save as much as 20 billion ($30.12 billion) by 2014.




The new coalition government has targeted the bloated administrative costs of the NHS system. With 1.3 million employees it is the largest employer in Europe.

(Message edited by colin_twiggs on July 13, 2010)


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colin_twiggs
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Friday, April 15, 2011 - 08:48 am:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)




quote:

A new OECD report finds that the U.S. spends far more on health care than any of the other 29 OECD nations, and gets less health for its money. Annual public and private health-care spending in the U.S. stands at $7,538 per person, 2.41 times the OECD average and 51% more than the second-biggest spender, Norway. Meanwhile, average U.S. life expectancy is 77.9 years, less than the OECD average of 79.4.




Mark Whitehouse
Wall Street Journal: U.S. Spends 141% More on Health Care


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colin_twiggs
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Friday, April 22, 2011 - 02:39 pm:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)



Comparing US medical costs to other first world countries







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ironic
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Wednesday, December 19, 2012 - 09:53 pm:Copy highlighted text to 'New Message' boxEdit Post Delete Post Print Post    View Post/Check IP (Moderator/Admin only) Ban Poster IP (Moderator/Admin only) Move Post (Moderator/Admin Only)



Some very well organized old age home providers are providing all necessary and luxuries facilities for elders and seniors, at some reasonable prices. Which seniors really need at their stage of life to enjoy their life and live comfortably. Who are also provided with nursing facilities according to their needs and with complete privacy.


Ironic
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