I find it difficult to really understand the US debate on healthcare reform – their current system quite obviously do not work and changes are needed but what changes due to what system errors are not so clear for me. But found today a for me helpful overview of various US think tank, including the powerful Americans for tax reform, positions on the latest proposals here.
I find the statement from Sally Pipes of Pacific Research Institute most interesting: “President Obama's health care proposal released today in advance of the Feb. 25 Summit is more of the same. It relies on increased taxes, mandates, subsidies, and regulation. It will not achieve the goal of affordable, accessible, quality health care for all. The cost estimate will greatly exceed the $950 billion over 10 years and will most likely be in excess of $2 trillion. All Americans will face higher taxes and quality will decline. Ultimately, this will set the stage for a total government takeover of our health care system-a single-payer, Canadian style system which I believe is the long-term goal of the President."
If she is right and Obama and his advisors have decided to not form the new system based on the good Dutch reform experiences but on the single payer systems in Canada and the UK for example they really should rethink. The Health Consumer Powerhouse various index over healthcare systems outcome from a consumer point of view shows systematically over the years how the UK and Canada do deliver below the expected standard in Europe.
But its important to see and work with the problems of insurances. The Economist recently published a good overview that you find here.
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Pacific Research Institute is a conservative think-tank. Sally Pipes portrayal of the health reform proposal as leading to a single-payer, Canadian style system is incorrect.
ReplyDeleteThe health reform that will hopefully be implemented over the next several years is based on the Dutch model of mandatory purchase of insurance by individuals with subsidies based on age and other factors.
There are elements within the Democratic Party that support a single-payer Canadian or French style system. Part of the support for a single-payer system as opposed to the Dutch model is that there is a great deal of suspicion in the US of the for-profit health insurers. The Dutch system uses non-profit health insurers that are highly regulated by the national government. In the US the health insurers are regulated by the 50 states, with little uniformity across the states. This will change as the reforms are implemented and the regulations become more consistent.
Part of the problem is that the majority of Americans are happy with their current health insurance, and they fear that reform will cause them to lose benefits or have to pay more. What many of these people do not realize is that there has been a continual erosion of coverage over the past seven years. Sally Pipes is correct when she says "All Americans will face higher taxes" - because employers are reducing their contributions to employer-sponsored health insurance, and either (1) employees directly pay more out of pocket for care, (2) contribute more to their own coverage, (3) pay taxes for new subsidy mechanisms through the "Exchanges" or (4) are uninsured.
The reform does more than cover the current uninsured - it provides protection for those who are now covered who might lose their coverage in the future. The reforms are designed to stabalize the entire system.