I’d like to talk about mythology. Not Greek mythology or Norse mythology, but American Healthcare mythology. In his book, The Healing of America, TR Reid listed a number of healthcare myths he had busted in the course of researching his book. Some of these I knew about (because I have friends who are living or have lived in countries with universal healthcare) and some I didn’t.
Myth #1: “Universal healthcare is socialized medicine!”
(sound of game show buzzer) Wrong. Apparently even Michael Moore got this one wrong in “Sicko” when he dealt with the conviction of many Americans that “socialized” systems won’t work in our ferciely individualistic and capitalist country.
Bust #1: Most wealthy countries have privatized mechanisms to provide and in some cases pay for healthcare.
That’s part of the myth—that healthcare provision and insurance are synonymous. (There’s that buzzer again.) There are two parties involved in healthcare: providers and payers. Not all universal care countries handle this in the same way.
In England and Spain, the government pays for coverage and owns the facilities, but private physicians provide the services. Canada and Taiwan have private-sector hospitals, clinics and doctors and the government pays the bills. In Germany, France and the Netherlands, both care and payment are privatized, but since everyone is covered and, again, the government negotiates prices, insurance providers (sick funds) compete to enroll more people and to keep them as healthy as possible. Costs are kept lower because, among other things, malpractice insurance is inexpensive and the government bargains collectively with the funds and physicians on the price structure.
Here’s the kicker: so many people seem to get real charged up about “socialized” healthcare (though probably couldn’t really tell you why), but American healthcare—even before the ACA—was already more socialized in some aspects than most countries with universal coverage. Our veterans, government employees and elderly, for example, are covered under socialized programs. The VA is a far more socialized program than just about anything you can find in other countries. All these different programs are part of why we have problems containing costs. In Germany, people stick to their private insurance plans no matter how old they are. Of course, they can always choose a new provider if they’re not happy with the one they have.
How many of us have that option, especially if we’re covered by a policy offered by our work?
“Yeah, okay,” some of you might be thinking, “but those other countries control costs by rationing healthcare and offering limited choice.”
That’s Myth #2, which I’d like to explore in my next blog.
Care for the stranger as for one of your own; show to alien souls the same loving kindness ye bestow upon your faithful friends. — Abdu’l-Bahá