Which countries have socialized medicine and no waiting lists?
France, for starters.
I can’t see why. A bad doctor won’t have many patients and will make less than a good one, be it in a public or private healthcare system. I’m not going to pick a bad doctor just because I live in a country with a public healthcare system. If doctors were all paid the same regardless the number of their patients or if patients couldn’t choose their doctor, it might be true, but as long as none of these conditions are met, there’s no reason to assume such a result.
This difference in efficiency has been discussed in several similar past threads. And it’s not obvious at all that the private sector is cost-efficient in this case. For instance, instead of a standardized universal system, each insurance has its own procedures, different documents to fill in by the doctors/ patients, procedure to agree or not for a given treatment (or even a given doctor), etc…resulting in a lot of administrative costs both on the assurance side and on the doctor side. And also in time wasting for everybody involved, patient included, before the assurance reimburse the expenses.
It’s not obvious at all that a private system is less efficient. I would suspect the contrary, actually.
I happen to believe that the funding stone of society is solidarity. Certainly, we’re hard-wired to need social interactions, but besides that, living together had a lot of advantages. I hunted and fed the tribe for years, taught my skills to the youngsters, now that I’m ill/wounded/too old, I expect the tribe to feed me. Together we can hunt moire efficiently, and can keep our ennemies at bay. And I believe it still applies, with the diference that we don’t know anymore personnally the child who must receive an education, the disabled who need to be helped, etc…and solidarity is mediated by the governement. So yes, I think all the members of the society (who benefited in various ways from its existence, anyway : going to school, driving on roads, etc…) have obligations towards all the other members. Other people may have different opinions.
I don’t think there’s serious relationship between the two. The attitude regarding drugs is mainly cultural, and cost rarely enter in the equation. The USA is one of the western countries which has the hardest stance on drugs and also the only one without a public healthcare system.
Logically, your salaries would rise, since actually the insurance scheme is merely part of the cost of hiring someone in your system. If they’re ready to pay X dollars as a salary and Y dollars to insure you, then it ensue that your work is worth X+Y dollars (the total cost) according to them. So, logically, they would have no reason to pay X+Y dollars directly to you.
Anyway, how much more taxes you would have to pay is difficult to know. Remember that you’re already paying for people who don’t have health insurance, since these people aren’t left to die in the streets but actually receive medical care at taxpayer’s expense.
It might even cost much more, since these people, unable to pay for basic and preventive medical care are likely to show up at the ER when their condition is seriously deteriorated, hence when the cost of their treatment will be much higher. Maybe this guy who’s having a transplant at your expense would have needed only much cheaper drugs is he had access to basic and preventive care that he couldn’t afford a couple years before. Actually, this is generally considered as one of the reasons why healthcare as a whole cost much more as a whole in the USA than in other countries, other reasons mentionned being the lawsuits (apparently a huge part of this cost), overequipment of competiting private hospitals, and as a result overprescription of unecessary examinations, much higher cost of drugs since there’s no “single payer” able to haggle with the pharmaceutical companies, costs related the lack of uniformity of procedures by private insurance companies (though this one could certainly be solved while keeping the system private), etc…
I would suspect it would drop, on the basis that when this question had been asked on this board, it turned out that the US doctors had significantly higher incomes (when figures have been found). Now, would a reduction in income result in less talented people being attracted to the professions, or would it result in eliminating those who choose this job essentially for the money?
I put this in great debates because I don’t think that these questions have clear-cut factual answers.
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I don’t think so, either. Especially since there are significant differences between the public healthcare systems in different countries. For instance is there a co-pay system (the patient still have to pay a little part of the bill from his own pocket or not? Are there still private insurances availabale for what isn’t covered by the public system? What is the status of doctors not involved in the public healthcare system? Is the cost of say, a home call, fixed by the government or freely chosen by the doctor, the patient being only reimbursed for the basic “official” cost? Is the healthcare system handled directly by the government or not (for instance, in France, it’s regulated by an independant organization headed by an equal numbers of elected representants of the unions and of the employers, not directly by the government, for historical reasons)? There’s a lot of potential different systems, which won’t have the same results.
There’s also cultural differences in medical practices. I remember a study in the EU which showed that the UK had way higher nurse/patient ratio than other european countries, while people stayed vastly longer at the hospital for the same condition in Germany than in other countries (and when I mean vastly, it mean, say, three or four times longer than in France for the same basic surgery). There’s also the emphasis given or not to prevetentive care, etc… These cultural differences can impact too on the cost, population health, etc…
Just to clarify: clairobscur, on post #64, Bill H. made the quote, not me.
Sure. And Canada and the UK are precisely the two countries which are famous for these waiting lists. It still make them abberations.
My sister-in law hs been diagnoscized with cancer last year. She had an apointment with an oncologist the very same week, and surgery took place very quickly too (can’t remember how long it took exactly, sorry). So, it went exactly in the same way you described for the US, and still I live in a country with a public healthcare system. So perhaps you should wonder if your beef should be with public healthcare in general of with the canadian system.
And people generally prefer to go to public hospitals for serious conditions, over here, because they have, on the overall a better reputation, better physicians and surgeons (for various reasons I’m not going to explain in detail), and a better equipment. Good, large, not highly specialized private hospitals aren’t that common. They’re great if for an appendicitis, because the staff will be more friendly, the rooms more comfortable, the relations with the doctors more individualized, but if I get someday something really serious like a cancer, you can bet I’ll go straight to a major public hospital.
Except that the situation in the US public hospitals are precisely the result of the private healthcare system. The people you saw in the emergency room would have had called their doctor long ago with a public healthcare system.
That’s an interesting but different question. Though western countries can still provide excellent care, it becomes more and more costly every year. We certainly could run in a wall someday. But it’s true with both systems.
Thank you for the place to start. It seems that France uses something called “price rationing”. Can you explain what that is? Also, while many acknowledge that waiting lists do not seem to be a problem, I have read of complaints about “chronically insufficient care for the elderly.” These are the people on actual nationalized health care are they not? Aren’t the rest simply forced to carry medical insurance? I would very much appreciate your comments.
EU- AP article about the heat wave.
This is correct, partially. Part of the impetus for the development of HMOs was to control the demand for medical services. When people do not see the costs of visiting doctors, they will go more often. Reducing the costs further will increase the demand. This is simply unavoidable. Now, it may be that a particular universal health care scheme has a method for dealing with this increased demand. However, most of the proposals that I am aware of simply ignore it.
Can you tell me if this article is at all accurate? I cannot find much on the overall health care system in France (in english, anyway) so I cannot judge whether this article got mush or even anything right.
Also, it seems that French health care system is one of enforced insurance coverage, rather than nationalized health care. Can you point me to information on the cost of such a thing? For instance, how much do you have to contribute to the national health coverage? Does that coverage cover all medical treatments, or is there a list? How expensive is the “top up” insurance I’ve heard mentioned. I’ve seen that the French public system pays for somethin between 70% and 85% of treatment on a reimbursment basis. Are these number accurate? Also, how long does it take to get reimbursed?
Finally, the idea of paying up front and then getting reimbursed from the social security system seems intriguing to me. Can you tell me how people who cannot afford the up front fees pay? I have not been able to locate info on that either.
Thanks in advance for any information you can direct my way.
Oh, darn. The second quote and the rest of my last post was directed at clairobscur. Sorry for the confusion.
I hope this is not a repost of informatiion, but just so we are all on the same page, waiting lists are here in America too.
Great post Zagadka. Your story tells us what it’s all about. It’s about people and their suffering, not about nations or macroeconomics.
Ugh. Here we go again.
Everyone knows that the health care systems in Canada and Britain are terrible. TERRIBLE! And because of that, these two systems (and a couple of others) are heavily used by the privatize movement to argue that national health care sucks big time. So, once and for all, let’s all say it together: CANADA AND BRITAIN ARE TERRIBLE AND IS NOT REPRESENTATIVE FOR NATIONAL HEALTH CARE IN THE REST OF THE UNIVERSE.
In the rest of the modern world national health care is a success. I should head off now to find some cites about waiting lists is Norway, Denmark, Sweden, Finland, Iceland, Germany, France, Italy, Spain, Portugal, Belgium, Switzerland … and he continue and continues - but I’ll tell you a story instead.
A few years ago I fell badly and hurt my lower back. My doctor suspected a prolapse and said I needed an MRI. Since this was Dr. Nice he even recommended where to do the scan. I called, talked, and got an appointment at 11AM the day after (they detected a medium prolapse)
Fast forward until last year. I fell and hurt myself again, this time my neck (yeah, I know, I fall a lot). Given my history and a few other things, my second doctor wanted to do a plain x-ray to check for any hidden fractures, and a CT to check for prolapse. He gave me the requisition and off I went. I came outside and headed down the street to someone which I knew performed those services.
Inside, the woman at the desk asked my to wait. I waited a long time, almost 30 minutes. Then the woman called me over to the desk and said: -“Give me $10 and I’ll give you the x-ray.” So I gave here the money. I did the scan, and then the scan-man said: -“Since you’re already here, we’ll do the cat-sacn as well”. All was good.
To those who oppose national health care: You fail to recognize that national health care has been a success in virtually all modern countries on earth. You fail to see that you [american citizen], pay a lot more for health care, with the same quality, than the rest of world does. That’s fair, it’s your country, just don’t claim that you pay less.
You talk like national health care services is something handed out on a street corner. It’s not. In a national health care system, hospitals, while state-owned, are often getting paid per treatment and has to keep costs down to go break even. The difference is that everyone is equally entitled to medical treatment, no regard to their income.
There is no real “resource gap” in a national health care system, only artificial ones. If there’s a shortage in the system, you put more money into it. People don’t go around getting transplants or blood transfusions out of consumer desire. It’s not like buying a coke. The bulk of the cost is not related to people visiting the doctor because they feel sick. Most of the money goes to treatments, as in “get well and back to work”.
The money for health care services is paid for by taxes. If people don’t want to pay that much they vote for a party that promises to lower the quality of health care services. It’s democracy.
The two-tier system is very common. The ratio between state-run and private differs. A former girlfriend of mine experienced headaches for a brief period. She wouldn’t have gotten an MRI from the state if she had asked, so she went private. Paid $400. All was good.
Nope.
- National health care is not free. It’s co-paid in addition to tax-paid.
- People don’t want to be sick or hospitalized, they go to the doctor when they feel sick. The hypochondriacs go there anyway.
- People can’t just “go to the hospital”. They can see their doctor, who then determines whether a hospital trip is necessary.
- If some people feel sick and can’t afford to go to the doctor, it’s sad. It could be that cancer growing inside them. Imagine all the tax-money used to educate that person - and then he goes off and dies!!
Silly. “- Please Mamma, give me more eggs and pork so I can get a big heart attack because now we have socialized medicine.”
I tell you, if the fear of not being able to work and support your family isn’t keeping people from living unhealthy, then nothing will.
Silly. Do you currently buy shoes through your insurance? Are you dependent on your shoes to perform any work? Are you a burden to society or your family if you don’t have shoes?
A majority. I can wait two months for an MRI at my local hospital or I can wait two days for the same at the regional hospital. You can wait two months for an MRI at the best health supplier, or you can wait two months for the same at the crappy company. You choose.
- Unlimited dialysis for life: Check
- Hospitalization for life: Check
- Socialized drugs for life: Check
- Heart transplants: Due to limited availability of fresh hearts, such organs are given to those with the best survival rate, ie. young people.
Nope.
Nobody complains that the rich use private companies outside the system. Quote the opposite, it frees up resources for those who are not rich.
Usually, in a state-funded education system, doctors have to work x years at a state hospital before they can go private.
I have a question for you: Have you ever personally experienced health care within a successful national health care system, and if not, where is the cites for your arguments? Because what you are saying is simply not true based on my own experiences.
Everyone is dissatisfied with their own system, Americans, Canadians, Europeans, because the perfect system doesn’t exist. But I’ll bet you $10.000 that the reason for any dissatisfaction in Europe is that they want more money and *more natinal health care[/], not less. Please bet $10.000 against me?
Explain this: Nowwhere is health care more expensive than in the US, why? Surely, drugs cost more if they are not subjected to price control, but why do other health services cost more?