Until recently, I was under the impression that all of the other developed countries of the world only had communist style socialized medicine. I thought that they were all owned and operated by the government. No private hospitals or doctors. No private insurance. Bureaucrats making medical decisions. The perception given by many is that what we have here in America is the best in the world and any system other than ours is a disaster. All you ever hear is horror stories, long waits for medical treatment, antiquated equipment, people suffering and dying due to a lack of funding, old people being refused treatment. You have heard the stories and probably most are true. But are these stories the norm for the average person or are they the exception?
In his book, "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care", T.R. Reid has gone around the world researching health care. Through his research and travels he is able to provide a window into the different health care systems that each country uses. He details the four major types of systems being used around the world today.
The Beveridge model was developed in Great Britain, and is used in Spain, Italy, Cuba, and most of Scandinavia. This is government run health care funded by taxes. No health insurance companies or private hospitals. Most doctors are government employees, but some are private and all are paid by the government. In America, the members of Congress have their health care needs meet through this model, as do the Armed Forces and the VA.
Originally developed in Germany, the Bismark model is also used in France, Switzerland, Belgium, and Japan. This system uses private doctors, hospitals and insurance. To control cost, the government regulates the medical community and the insurance companies, which are non-profit. If you have employer provided insurance or you purchase insurance privately, you are using a form of this model. Instead of the government regulating medical cost, your insurance company does and makes a profit for its investors.
Canada, Taiwan, and South Korea use the National Health Insurance model which has elements of both the Beveridge and Bismark models. Health care is provided by private doctors and hospitals, but the government is the insurance company and the citizens pay premiums. This is the system used by those who receive Medicare or Medicaid. By the way, the name Medicare originated in Canada.
Most poor countries have the Out-of-Pocket model because they do not have the ability to provide any of the others. This is the model that Americans without insurance must live with. According to the Census Bureau (Link) the percentage of people without insurance in America is 15.4% or a little over 46 million. It is not that these people do not receive any health care, its just that when they are seriously ill then the tax payer ends up paying much of the bill.
As you can see, the United States uses a variety of systems to provide health care. If these other countries are providing health care for all of their citizens, why can't this be done in America? America already has some "Socialized Health Care," through the Beveridge and the National Health Insurance models. Why does America spend more for its health care every year than any other country, 16-17% of GDP, but not everyone is covered? For those who say that the status quo is fine, how would you provide health care to the 46 million who have no insurance? Isn't someone already paying for any health care that the uninsured receive? Anyone who is seriously sick can go to the emergency room and receive services, this is mandated by Federal Law. But that is a very expensive way to provide coverage.
To me these are some of the questions that need to be asked. I hope that this has been helpful to you as the debate on health care in America continues.
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