The full costs of such price discounts eventually reduce access to quality care and hold health care markets hostage to political exploitation.
Before Medicare was passed, seniors were promised that the program would not interfere with their choice of insurance. However, existing rules force most seniors to rely on Medicare Part A to pay their hospital bills — even if they can afford to pay for private insurance.
Currently, many Americans choose to pay privately for health services to maintain their medical privacy. The answer is that the lack of universal coverage and high costs are intimately linked—both economically and historically.
Single-payer health-care in which the government pays for universal coverage, typically through taxes helps keep costs down for two reasons: It means that the government can regulate and negotiate the price of drugs and medical services, and it eliminates the need for a vast private health-insurance bureaucracy. Currently, the US spends two to three times as much per capita on health care as most industrialized countries.
They are wrong: The US ranks 28th, below almost all other rich countries, when it comes to the quality of its healthcare assessed by UN parameters pdf, p.
When did the country diverge from other industrialized nations and, rather than offering universal health coverage, built up a system that relied on private insurance? Labor unions also worried that it would weaken their own bargaining power, says Palmer, as they were otherwise responsible for getting their members social services.
In president Franklin D. Roosevelt imposed an effective freeze on labor wages, and companies started offering health and pension benefits as a way to retain workers instead. This was the beginning of employer-sponsored healthcare, though there was no government mandate to offer it except in Hawaii.
Unions began negotiating the benefits as part of what they could obtain for workers. Another turning point, Palmer says, was an exceptionally successful campaign by Clem Whitaker and Leone Baxter, the founders of Campaigns, Inc. According to Lepore, after successfully halting the reform in California, Campaigns, Inc. To respond to a column, submit a comment to letters usatoday. Facebook Twitter Email. We need a basic health care safety net for all.
Mandatory Medicare for All won't work. We need a basic government health safety net plus private insurance for those who want it. More choice, not less. Arthur "Tim" Garson Jr. Opinion contributor. I was walking along a township road, clearly out of place, and he was planting orchids with his mother. He stopped me and asked what I was doing there. I said I was a journalist from the US, reporting on health care.
In Australia, my colleague Byrd Pinkerton and I got caught in a rainstorm while walking through a park to one of our appointments. We took shelter in a small building with a cafe and tourist information desk, and one of the employees, Mike, introduced himself. Our project was made possible by a grant from The Commonwealth Fund. So I obliged. There were two moments when the audience audibly gasped: one when I explained how many people in the US are uninsured and another when I mentioned how much Americans have to spend out of pocket to meet their deductible.
People have often asked which system was my favorite and which one would work best in the US. Alas, that is not so simple a question to answer. But there were certainly plenty of lessons we can take to heart as our country engages in its own discussion of the future of health care.
The first necessary condition for universal health care is a collective commitment to achieving it. Every one of the countries we covered — Taiwan, Australia, the Netherlands, and the United Kingdom — has made such a commitment. In fact, every other country in the developed world has decided that health care is something everybody should have access to and that the government should play a significant role in guaranteeing it.
Except for the United States. Overall, including independents, 57 percent of Americans say the government has this obligation. In other countries, there might be disagreement about how to achieve universal health care, but both ends of the political spectrum start from the same premise: Everybody should be covered. Even in the Netherlands, which overhauled its health insurance in under a center-right government, there was no question about universal coverage.
I came across this quote from Princeton economist Uwe Reinhardt while I was starting to report this project, and it stuck with me throughout. From his most recent book Priced Out , which was published after he died in Canada and virtually all European and Asian developed nations have reached, decades ago, a political consensus to treat health care as a social good.
By contrast, we in the United States have never reached a politically dominant consensus on the issue. When I told people in Taiwan or the Netherlands that millions of Americans were uninsured and people could be charged thousands of dollars for medical care, it was unfathomable to them.
Their countries had agreed that such things should never be allowed to happen. I saw all kinds of health systems in action: true single-payer in Taiwan, a mix of public and private insurance in Australia, private coverage for everybody in the Netherlands. Each of them surpassed the United States in two critical ways: Everybody had insurance, and costs to patients were much lower.
Specialty care in the rural parts of the country is lacking. On the whole, the medical field seems to be ambivalent about the national health insurance. But raising taxes to more adequately fund the system or bumping up cost sharing to encourage more discretion in health care use is almost as big of a political challenge there as it would be here.
Nobody wants to pay more for health care next year than they did the year before. Australia has layered a private health care system on top of its universal public insurance program, and that gives both doctors and patients more choice about medical care.
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