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  #1  
Old 12-23-2009, 02:32 PM
astro astro is online now
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In the end what nation's health plan will the US national health plan most closely resemble?

Given the current direction of the US national health plan legislation, if it is passed, what other developed nation's national health plan will ours most closely resemble?
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  #2  
Old 12-23-2009, 02:52 PM
fandango fandango is offline
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Given that the US is the only industrialized nation with a for profit health care system (no cite, sorry!) and that isn't going to change with this bill, the nation whose health care plan will most resemble the new US plan will be...

DRUM ROLL......


....

...

the US.
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  #3  
Old 12-23-2009, 03:46 PM
astro astro is online now
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Quote:
Originally Posted by fandango View Post
Given that the US is the only industrialized nation with a for profit health care system (no cite, sorry!) and that isn't going to change with this bill, the nation whose health care plan will most resemble the new US plan will be...

DRUM ROLL......


....

...

the US.
Don't other countries have for profit health care existing side by side with the nationalized plans?
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  #4  
Old 12-23-2009, 03:50 PM
drhess drhess is offline
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I don't think what we are getting is a nationalized plan. But yes, in some countries (increasingly) you can buy insurance on top of the national plan. I believe this is just for getting "rock star" treatment or greater assistance if catastrophic situations arise.
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  #5  
Old 12-23-2009, 04:29 PM
fandango fandango is offline
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Originally Posted by astro View Post
Don't other countries have for profit health care existing side by side with the nationalized plans?
Yeah, you are right. I think I should amend mine to say that we have (for the general population--not counting Medicare, etc.) an exclusively for-profit insurance industry, for the most part (I think some states are different--Minnesota?), and we will continue to have this.

All indications are that whatever bill that will be passed will not have transformative reform, and for most people we're likely not to notice the difference.

Last edited by fandango; 12-23-2009 at 04:30 PM..
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  #6  
Old 12-23-2009, 04:32 PM
Candyman74 Candyman74 is offline
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Originally Posted by astro View Post
Don't other countries have for profit health care existing side by side with the nationalized plans?
Yes. fandango's statement is incorrect. The UK, for example, has a number of private healthcare providers alongside the NHS, often provided as a benefit by an employer (the largest one being BUPA).
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  #7  
Old 12-23-2009, 05:08 PM
md2000 md2000 is offline
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One of the key provisions of the Canadian health care system is a distinct hostility to for-profit providers. Some provinces forbid them entirely. The doctors themselves are for-their-own-profit, however. they just get stuck with the rate paid by the province for each form of treatment, so the only flexibility is number and type of patients... and office charges. (i.e. $X/page to transfer medical records to another clinic...)

Each province here sets the rules, based on the feds' "golden rules" (He who has the gold, sets the rules). It's so simple - if you are a resident, you are covered. Everyone has the same coverage, the only thing you provide when going to the doctor or hospital is your provincial health number and sometimes some idetification. Doctors know what is covered (pretty much anything except "electives" like plastic surgery) and all their billing goes to one place, same form.

The US is going to have some bastard system that will be confusing for all and satisfy nobody. The only saving grace is that you will get rid of the weasly "pre-existing condition" clause. I predict decades of traumatic fist-waving as more and more medical services are gradually brought under a standard single provider who forces doctors to toe the same fee schedule. As each private insurer or formerly lucrative medical gouging institute is brought to heel, there will be much wailing and gnashing of teeth, especially on Fox News.
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  #8  
Old 12-23-2009, 06:04 PM
Harriet the Spry Harriet the Spry is offline
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Paul Krugman had a column in the NY Times describing how the proposed new US plan would be similar to Switzerland's, in that it achieves near-universal coverage through private insurance providers.
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  #9  
Old 12-23-2009, 06:08 PM
fandango fandango is offline
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Originally Posted by md2000 View Post
The US is going to have some bastard system that will be confusing for all and satisfy nobody. The only saving grace is that you will get rid of the weasly "pre-existing condition" clause.
I don't think it is necessarily gone entirely. Sure, they won't be able deny you coverage based on a pre-existing condition, but there's nothing there that says they can't charge you a whole lot more because of it.
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Old 12-23-2009, 06:55 PM
Harriet the Spry Harriet the Spry is offline
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Originally Posted by fandango View Post
I don't think it is necessarily gone entirely. Sure, they won't be able deny you coverage based on a pre-existing condition, but there's nothing there that says they can't charge you a whole lot more because of it.
No, pre-existing conditions are gone. From the Kaiser Family Foundation website, which has a detailed comparison of all proposed plans "Require guarantee issue and renewability; allow rating variation based only on age (limited to 2 to 1 ratio), premium rating area, and family enrollment." The extent to which age can be used to set rates continues to be an active point of debate.

Compare the proposed reform bills to your heart's content here: http://www.kff.org/healthreform/sidebyside.cfm
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  #11  
Old 12-23-2009, 06:56 PM
Sage Rat Sage Rat is offline
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Originally Posted by fandango View Post
Given that the US is the only industrialized nation with a for profit health care system (no cite, sorry!)
Both Switzerland and Israel base their health care systems around profit-based private insurance. Japan has public care for students and the self-employed, but most people are signed up for profit-based private insurance.
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  #12  
Old 12-23-2009, 06:58 PM
qazwart qazwart is offline
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Remember that the House and Senate bills must be reconciled in a conference committee. When a bill is reported out of the conference committee, both houses vote on the bill without debate and with a 50% + 1 majority vote.

I believe the bill that will be reported out of the conference committee will appear more like the House version.
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  #13  
Old 12-23-2009, 07:24 PM
Balthisar Balthisar is offline
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Mexico has different systems. Government workers (ISSTE). Employees (IMSS). Uninsured, based on a sliding scale (Seguro Popular). Since other than my co-workers (IMSS) all I know are professionals, they're all privately insured or just pay cash. The vast, vast majority of free-standing clinics and private hospitals are all non-affiliated with the government system. The government systems seem to work for basic care, but they're nowhere near as nice as my own employee-provided, private insurance in the USA (which doesn't work while I'm working in Mexico, by the way, so we have supplemental private coverage here).

So, this is just to help illustrate the point that the USA is certainly not the only nation with a profit motive in medicine (and profit isn't a bad thing anyway).
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  #14  
Old 12-23-2009, 08:38 PM
Ravenman Ravenman is offline
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Originally Posted by qazwart View Post
Remember that the House and Senate bills must be reconciled in a conference committee. When a bill is reported out of the conference committee, both houses vote on the bill without debate and with a 50% + 1 majority vote.

I believe the bill that will be reported out of the conference committee will appear more like the House version.
Check out the other thread in GQ. A conference report can be filibustered in the Senate, requiring 60 votes in order to get to a majority vote on passage of the bill.

IMHO, the House bill's approach stands no chance of getting 60 votes in the Senate.
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  #15  
Old 12-23-2009, 09:06 PM
fandango fandango is offline
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Originally Posted by Sage Rat View Post
Both Switzerland and Israel base their health care systems around profit-based private insurance. Japan has public care for students and the self-employed, but most people are signed up for profit-based private insurance.

Switzerland's basic health care plan is NOT for profit. Supplementary can be, but as stated in this thread already, this is true for many countries that offer UHC as well.

Ditto Israel.

From Wikipedia:

Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Federal Act. It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They may not make a profit off this basic insurance, but can on supplemental
plans.

In 1995 the National Health Insurance Law came into effect, which made membership in one of the four existing not-for-profit Health Maintenance Organizations compulsory for all Israeli citizens. The law determined a uniform benefits package (סל בריאות) for all citizens - a list of medical services and treatments which each of the Health Maintenance Organizations is required to fund for its members.

In the Japanese health care system, healthcare services, including screening examinations for particular diseases at no direct cost to the patient, prenatal care, and infectious disease control, are provided by national and local governments. Payment for personal medical services is offered through a universal health care insurance system that provides relative equality of access, with fees set by a government committee. People without insurance through employers can participate in a national health insurance program administered by local governments.
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  #16  
Old 12-24-2009, 07:44 AM
Cat Whisperer Cat Whisperer is offline
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This is the reason that I find it extremely distasteful to keep bringing Canada into the US healthcare reform debate - it is not going to end up anything like Canada's system, for better or worse.
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  #17  
Old 12-24-2009, 09:58 AM
Nava Nava is offline
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Originally Posted by md2000 View Post
Everyone has the same coverage, the only thing you provide when going to the doctor or hospital is your provincial health number and sometimes some idetification.
Woah! You get a different number in each province? Must make life hell for people who move often, similar to the pain in the bum that's moving often between EU countries. One of my biggest reasons to have become self-employed is to avoid collecting even more SSNs from even more countries (you can get a "EU number," but it's valid for getting medical attention in a country you're visiting, not to be employed there; otoh, being self-employed means that if I get hired by a company in a different EU country they're hiring "me the company," not "me the individual", and I still pay and get covered by SS "back home").
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  #18  
Old 12-24-2009, 11:36 AM
Spoons Spoons is online now
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Woah! You get a different number in each province? Must make life hell for people who move often, similar to the pain in the bum that's moving often between EU countries.
Yep, Canadian health care is provided by the provinces. Not the federal government.

Most Canadian provinces are pretty big, so when people move, it is often within the province itself. Alerting the provincial health care authorities of an address change is thus all that is necessary. Folks do move between provinces, though. When they do, it's generally no problem to get into a province's health system--fulfil the residency requirements, and a phone call or filling out a form usually does the trick. Your old province's health coverage remains in place while you're fulfilling the residency requirements, so there is no gap in coverage.

At any rate, you do not need a number from every province to be covered in every province--if you travel around Canada for a vacation or business or whatever, your home province's health care plan covers you no matter where in Canada you happen to be. By law, the provinces must honour each other's plans for residents of Canada travelling in Canada--so if I go to Ontario for some reason and needed health care while I was there, I'd use my Alberta health card and be covered by Alberta's plan. Residency is key; you can only be covered by the plan of the province in which you reside, meaning you'll never have more than one health care number at a time.
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  #19  
Old 12-24-2009, 12:31 PM
Nava Nava is offline
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... more than one health care number "active" at a time, I hope. I mean, if you lived in Alberta, moved to Quebec and move back to Alberta, I imagine you get your old number back, rather than a new one, no?

Spain is moving towards having SS managed at the regional level but, since it was originally at the national level and since it's simultaneous with the move to eventually synch all EU SS's, it's only one number in the whole country. There's been talk for ages of getting rid of SSNs and just using the National ID number, too. My EU-SSN is linked to my Spanish National ID, not to my Spanish SSN.

Last edited by Nava; 12-24-2009 at 12:33 PM..
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  #20  
Old 12-25-2009, 11:17 PM
Spoons Spoons is online now
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Originally Posted by Nava View Post
... more than one health care number "active" at a time, I hope. I mean, if you lived in Alberta, moved to Quebec and move back to Alberta, I imagine you get your old number back, rather than a new one, no?
I honestly don't know. I've never moved back to a province that I previously resided in, so I'm unable to speak from experience. I do know that there are concerns about fraud, so I wouldn't be at all surprised if once a number is reported to the issuing province as defunct, it was permanently retired.
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