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Getting it Straight - the Global Comparisons
Author: BobR    Date: 08/26/2009 12:32:11

Setting aside all of the absurd claims about the impending health care reform legislation (such as death panels), there are some other problems with the discussion as well. Terms like "socialized medicine" get tossed around, and the health care systems in other countries all get lumped together as if they are all the same. They are not; they are very different. So today, our effort is to clarify the language and terms we use when discussing health care systems.

I'll confess that I got the idea for this from an interview I heard on NPR Mon night. Author T.R. Reid was discussing a book he has written called "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care", in which he describes the various health care systems in the world and compares them to ours. He also summarized some of that information in an excellent column in the Washington Post, which I will use as source for some information below.

First, let's look at the term "Socialized Medicine". It was actually coined over 100 years, and was not a pejorative. It only became a negative in the 1930s when opponents of FDR wanted to smear his New Deal proposals. The smear came forward again during the McCarthy era as a response to communism, and again during the Reagan presidency. So the idea of any kind of government involvement in health care being referred to as "socialized medicine" is not really new. In fact, it's starting to get a little tired.

What is "socialized medicine" really? To be honest to the term, it is a system where the government owns the hospitals, and the doctors work directly for the government. That is really only the case in a small handful of countries like England. So let's look at what other countries have for health care systems:

  • The British Model: The British NHS is truly socialized medicine, with the doctors working for the government. For British citizens, it is looked upon as a government service paid for with taxes, like fire services, police services, and garbage pickup. Most neighborhoods have a family doctor (who will make house calls!), and patients never have to pay anything out of pocket. There is still some private insurance for things like plastic surgery.
    • Avg Health care costs per person: $2815

    • percentage of cost for administration: 5%

    • avg life expectancy: 79.1


  • The French Model: The French system can be referred to as "single payer", where there is a mix of private and public doctors and hospitals, and doctors are reimbursed directly by the federal government. There is still some private insurance for things like plastic surgery.
    • Avg Health care costs per person: $3,449

    • percentage cost for administration: 4%

    • avg life expectancy: 80.9


  • The Canadian Model: Their model is not actually single payer. It is publicly funded and regulated, but the funds are collected and administered at the local/provincial level. There is still some private insurance for things like plastic surgery, and to cover copay costs .
    • Avg Health care costs per person: $3,678

    • percentage cost for administration: 6%

    • avg life expectancy: 80.4


  • The German Model: This may end up being closer to what the current U.S. bills are proposing. It's a mix of private and public insurance. People below certain income levels are required to use the public system. Public system insurance coverage is not as good as private coverage, so there is some private insurance available to cover the gaps. Insurers must all offer the same coverage, cannot turn anyone down, and the insurance is bought directly by the consumer.
    • Avg Health care costs per person: $3,371

    • percentage cost for administration: N/A (couldn't find by the deadline)

    • avg life expectancy: 79.8


  • United States: We all know what we have here... It's a hodgepodge of private insurance, and government care for older people. In most cases, insurance is provided by your employer, rather than purchased directly by the individual. This creates a situation where people feel tied to their jobs over fears of losing their insurance. Approximately 15% of Americans have no health insurance coverage.
    • Avg Health care costs per person: $6719+

    • percentage cost for administration: 20% for ins. companies

    • avg life expectancy: 77.8

Here is a chart (based on 2006 data) that provides some comparisons on costs and availability of health care (this chart is a screen shot from the Canadian Health care link):

http://www.FourFreedomsBlog.com/uploads/HCStats2006.jpg


For some other comparisons, you can look at this report; appendix B (pg 59) is where the information is summarized.

So how else do these countries and their systems compare to the U.S.?

  • Everyone in all of these countries is covered.

  • The coverage provided is cheaper overall there than here. This is mainly due to efficiency and lower costs for malpractice insurance.

  • They have approx the same number of doctors and nurses per person as we do (in some cases more), so availability under a different system would be no different than it is now.

  • Private health insurance exists, but their companies must be not-for-profit. The United States is the only industrialized country where health insurance companies are allowed to make a profit.

  • Our VA system is actually socialized medicine; it is a microcosm of the British system.

  • Medicare is not socialized medicine, it is single-payer. It is a microcosm of the French system.

One thing that the U.S. "system" (if something so disjointed could be referred to as a "system") is good at is being a boogieman for other countries. In those countries, the best way to silence critics of their health care systems is to ask "would you rather have the American system?".

wow... doesn't that make you proud?

Postscript: As I was finalizing this blog entry, I saw the news about the passing of Teddy Kennedy. Besides being a champion of liberal causes, he was an advocate for health care reform. Let's make this happen for Teddy...

45 comments (Latest Comment: 08/31/2009 13:31:29 by Raine)
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Comment by velveeta jones on 08/26/2009 13:08:49


Excellent blog Bobber!! This is a great source tool for people to refer to. I may print it out!

Sad news today on the death of Ted. I hear people on my radio saying "we should pass HCR in his honor". NO! We should have fixed the problem while he was still alive so he could have seen it happen!!!



Comment by velveeta jones on 08/26/2009 13:17:38
Oh. Lest I forget. Birthday shout outs to:

Mondobubba!!




http://www.freesmileys.org/smileys/smiley-hug011.gif


Comment by BobR on 08/26/2009 13:19:48
I'll echo VJ: Happy Birthday Mondo!



Comment by Scoopster on 08/26/2009 13:19:53
Happy birthday Mondooooooo and MNRN!



Comment by velveeta jones on 08/26/2009 13:22:17
And a Birthday shoutout to our very own nurse:

Happy Birthday!!!




http://www.freesmileys.org/smileys/smiley-hug013.gif


Comment by wickedpam on 08/26/2009 13:27:25
WooHoo! Happy B-Day Mondo & MNRN!!!!!



Comment by wickedpam on 08/26/2009 13:51:05
ugh this woman

Comment by Raine on 08/26/2009 13:54:11


Alicia was a little out there.

Good morning everyone.

I am not sure which bloggie to post in today. What an awful way to wake up.

Comment by BobR on 08/26/2009 13:54:29
I think the woman was trying to say that even though the cash-for-clunkers money goes directly to the dealer, the car buyer has to pay taxes on it as though it were income.

I don't know if it's true, but even if it is: what's the problem?

Comment by BobR on 08/26/2009 13:55:35
Quote by Raine:


Alicia was a little out there.

Good morning everyone.

I am not sure which bloggie to post in today. What an awful way to wake up.

Let's keep the fun stuff here. Let Tri's Ted post remain respectful.

Comment by Raine on 08/26/2009 13:57:03

http://cache.daylife.com/imageserve/04hv6Hz0795Ed/610x.jpg


WASHINGTON - AUGUST 26: The flag flies at half-mast over the U.S. Capitol the morning after Sen. Edward Kennedy (D-MA) died at his home in Massachusetts, August 26, 2009 in Washington, DC.

Comment by wickedpam on 08/26/2009 14:09:47
Quote by BobR:
Quote by Raine:


Alicia was a little out there.

Good morning everyone.

I am not sure which bloggie to post in today. What an awful way to wake up.

Let's keep the fun stuff here. Let Tri's Ted post remain respectful.


That was my thought too


Comment by wickedpam on 08/26/2009 14:14:39


Comment by Raine on 08/26/2009 14:22:39
Comment by Scoopster on 08/26/2009 14:25:59

VERY good news here.

Comment by wickedpam on 08/26/2009 14:27:05
I wish I'd known about the Reston town hall before 7am yesterday morning

Comment by wickedpam on 08/26/2009 14:27:17
Shelagh!

Comment by Raine on 08/26/2009 14:29:19
Shelagh!!!

Comment by BobR on 08/26/2009 14:34:28
Quote by wickedpam:
I wish I'd known about the Reston town hall before 7am yesterday morning

we all need to make an effort to get on the mailing lists of the astroturfers so we can be prepared.

Comment by wickedpam on 08/26/2009 14:39:21
Quote by BobR:
Quote by wickedpam:
I wish I'd known about the Reston town hall before 7am yesterday morning

we all need to make an effort to get on the mailing lists of the astroturfers so we can be prepared.



I just can't do it - its bad enough I get Jackson Miller's emails I just can't take the ugliness and lies of those other sites

Comment by Raine on 08/26/2009 14:44:41
Quote by wickedpam:
Quote by BobR:
Quote by wickedpam:
I wish I'd known about the Reston town hall before 7am yesterday morning

we all need to make an effort to get on the mailing lists of the astroturfers so we can be prepared.



I just can't do it - its bad enough I get Jackson Miller's emails I just can't take the ugliness and lies of those other sites
One thing I have learned -- the emails are how they share the information-- they don't use the web....

And they REALLY know how to use the twitter. It is gross, but it is the only way to know.

I wish someone would come up with an astroturf website that announces all the dirty crap that they are up to.


Comment by Scoopster on 08/26/2009 14:47:40
Quote by BobR:
Quote by wickedpam:
I wish I'd known about the Reston town hall before 7am yesterday morning

we all need to make an effort to get on the mailing lists of the astroturfers so we can be prepared.

There was an hour-long call-in town hall this morning on the local talk radio station with Sens. Whitehouse and Reed on healthcare (part of it ended up being about Sen. Kennedy). I didn't even hear about it ahead of time - I was on the bus and saw all the teabag losers marching in front of the radio station and was like "why the hell are they there?"

That also made me think of something else.. these folks have plenty of time to go protest against health care reform. Why is that? I'm sure some of them are out of work given the economy, and I'm positive some won't have health coverage in that case. And if they do, it will probably be COBRA.

I sure no one on that picket line breaks a leg.. but hey I'm sure someone else there will just reassure them by saying "PICK YOURSELF UP MAN, SHOW 'EM HOW IT'S DONE!"

Comment by Scoopster on 08/26/2009 14:58:40
Unfuckingbelieveable.. we have a running celebrity death thread over on the gaming forum that we try to keep relatively respectable.. even when Michael Jackson died, the whole weirdness, child accusations & drug problems thing was kept elsewhere.

Some asshole thought it would be respectful to post the goddamn newspaper clipping about Chappaquiddick.

Comment by starling310 on 08/26/2009 14:59:11
What Coburn doesn't get is that essentially single payer health care is "Asking your neighbors for help." It's all of us as fellow citizens (aka neighbors) putting money in the pot to pay for each other.

DoucheBag.


Comment by wickedpam on 08/26/2009 15:10:18
Quote by Raine:
Quote by wickedpam:
Quote by BobR:
Quote by wickedpam:
I wish I'd known about the Reston town hall before 7am yesterday morning

we all need to make an effort to get on the mailing lists of the astroturfers so we can be prepared.



I just can't do it - its bad enough I get Jackson Miller's emails I just can't take the ugliness and lies of those other sites
One thing I have learned -- the emails are how they share the information-- they don't use the web....

And they REALLY know how to use the twitter. It is gross, but it is the only way to know.

I wish someone would come up with an astroturf website that announces all the dirty crap that they are up to.



I see another project for a talented pair :p

Comment by Scoopster on 08/26/2009 15:12:34
Quote by wickedpam:
Quote by Raine:
Quote by wickedpam:
Quote by BobR:
Quote by wickedpam:
I wish I'd known about the Reston town hall before 7am yesterday morning

we all need to make an effort to get on the mailing lists of the astroturfers so we can be prepared.



I just can't do it - its bad enough I get Jackson Miller's emails I just can't take the ugliness and lies of those other sites
One thing I have learned -- the emails are how they share the information-- they don't use the web....

And they REALLY know how to use the twitter. It is gross, but it is the only way to know.

I wish someone would come up with an astroturf website that announces all the dirty crap that they are up to.

I see another project for a talented pair :p

It's kinda funny.. I was thinking about setting up a dummy email account just to subscribe to the tea party emails after seeing them marching at the radio station earlier just so I could keep an eye on them.

Comment by Will in Chicago on 08/26/2009 15:25:05
Good morning, bloggers!

Excellent post, BobR!! I will pass it on to a few people.

HAPPY BIRTHDAY MONDO!!!!!



Comment by Will in Chicago on 08/26/2009 15:25:06
Good morning, bloggers!

Excellent post, BobR!! I will pass it on to a few people.

HAPPY BIRTHDAY MONDO!!!!!



Comment by Scoopster on 08/26/2009 15:30:02
Mornin' mornin' Will Will!

Comment by livingonli on 08/26/2009 15:35:41
A belated good morning to everyone.


I thought I was going to bed early but I still went to bed at 3 AM.

Happy birhtday to Mondo and MNRN. I will still have to post on the facebook pages.



Comment by livingonli on 08/26/2009 16:22:35
What happened to the blog? It got awfully quiet.

Comment by Scoopster on 08/26/2009 16:35:59
Senator Byrd petitioning to name the pending HCR bill after Kennedy

"In his honor and as a tribute to his commitment to his ideals, let us stop the shouting and name calling and have a civilized debate on health care reform which I hope, when legislation has been signed into law, will bear his name for his commitment to insuring the health of every American."


A fitting tribute without question. It's already been said though that this legislation, which was his legacy, should have been passed while he was still here to see it happen.

Comment by wickedpam on 08/26/2009 16:40:27
Quote by livingonli:
What happened to the blog? It got awfully quiet.





Comment by Scoopster on 08/26/2009 17:13:21
Have some myooooooooosic!



Comment by Scoopster on 08/26/2009 18:24:39
Limbaugh is fucking vile.. I'm not even going to link to the crap he said today.

Comment by AuntAzalea on 08/26/2009 18:50:58
Happy Birthday to Mondo and MNRN!!!

Comment by Raine on 08/26/2009 20:22:04
Quote by Scoopster:
Limbaugh is fucking vile.. I'm not even going to link to the crap he said today.

Vile is really an understatement.

As a side note, Nancy Reagan will be on Ron Reagan show this evening to talk about her close friendship with the Senator.

Comment by livingonli on 08/26/2009 21:21:46
Why does it seem like I don't get anything accomplished on my days off

Comment by livingonli on 08/27/2009 03:36:49
No one seems to post here at night anymore.

Comment by Scoopster on 08/27/2009 05:49:45
Been home for a lil while, but it was a loooong night.

Some drunk idiot at the bar offered me a shot of irish whiskey dropped into a pint glass of salt water

Comment by Raine on 08/27/2009 15:45:18
Goody! My new Microphone is here!

Comment by Will in Chicago on 08/27/2009 15:57:44
Quote by Raine:
Goody! My new Microphone is here!


I am glad to hear it.

Anyways, I guess we are using this blog today. So, good morning bloggers!

Jeff Farias will be in for Randi Rhodes today and tomorrow. (Herb "Sarge" Phelps will be filling in for Jeff at the Jeff Farias Show and Roots Up Radio from 6 PM to 9 PM Eastern/3 PM to 6 PM Pacific.)

Comment by murphyj87 on 08/31/2009 08:04:09
This is an excellent post. The Canadian payment system is slightly more complicated than is mentioned here. Each province and territory adminsters it's own plan, as was pointed out here, but that's done under federal legislation to set standards and with subsidies from the federal government (AKA transfer payments).

As a Canadian who lived and worked in the US for seven years, there is no doubt in my mind that I get better care in Canada than what I had to endure during my seven years in the US system. This might come as a shock to some Americans, but this is my experience.

I am almost 60 years old and have been retired for almost four years. I have a decent pension, but I could never afford health insurance or health care in the US, even if they would accept me because of a couple of "pre existing conditions". I have just over five years before I would be eligible for Medicare in the US. This makes absolutely no difference in Canada. I have, and always have had, access to health care whenever I need it here.

I have had a couple of serious surgeries with long wait times ... 4 days once for a serious one (to specialist one day, into hospital the next, testing and CT the third and surgery the fourth) and 16 days for a potentially serious one (GP to otolarygologist to surgery for removal of a laryngeal lesion (turned out to be benign) and then surgical reconstruction of the vocal cords in 16 days) I have also been going to a speech language pathologist every two weeks since that surgery (two months ago) to assist in recovering my voice (paid by the health care system) . My voice is close to getting back to normal, because of what the speech pathologist has done.

My mother had bypass surgery at age 72 within 2 1/2 days (some of that was to stabilize her so she would be more likely to survive the surgery). She also had cataract surgery at age 77, diagnosis to surgery 14 days.

My experience in the US in the 1980's is that the insurance company run around for approval would take longer than it took me to have surgery here.

Incidentally, for those fools who say there is no health care for seniors in Canada, beside the examples I have already mentioned, 1200 hip replacements done in Canada last year were done on people 85 years old or older.

Many Americans simply have no idea of the quality and efficiency of the Canadian system and opponents of reform have made up self serving lies about it. The American Patients United Now commercial with Shona Holmes, for example, was pulled by the FCC as false advertising. The "brain tumour" from which she "would have died" because of the Canadian system, was actually a non life threatening benign cyst, which her physician had prioritized as such, and had made appropriate appointments for her, based on that physician's opinion of her condition's priority. No system is perfect and our system may occassionally need some tweaking, but 92% of Canadians far prefer what we have, and would totally reject an American style one. This is the best measure of which we consider to be better anyway.




Comment by Scoopster on 08/31/2009 13:16:25
Welcome to el bloggerino, murphy! And thanks for sharing your story with us. I think the thing I found most enlightening is the part about wait times for surgery. Not just the part where it's actually less time than having to wait for an insurance company's blessing, but also that the wait time includes all the pre-op work. That's something I'm fairly sure isn't mentioned in our current debates here.

Comment by Raine on 08/31/2009 13:31:29
Thanks for your insight Murphy.