5 Myths About Healthcare Worldwide And A Few Myths About Our Own

In an August 23 articles for the Washington Post, T.R. Reid wrote about 5 myths concerning healthcare from around the world, dispelling most rumors of the atrocities of the healthcare system in countries like England, Canada, Germany and Japan, at the same time squashing a few rumors about the American healthcare system as well.

Most of the rest of the article is from Reid’s article except what follows after the “NOTE”. That is from me.

1. It's all socialized medicine out there.

Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.

In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.

NOTE: The VA’s healthcare system is considered the “purest” form of socialized medicine by Reid, and Medicare is also socialized medicine, as well the program that covers children of parents that can not provide healthcare for their child. So some people, we as a country think are too important to not be covered by some type of healthcare. For everyone else we say “good luck”.

2. Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.

In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.

Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.

As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.

In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"

NOTE: I have been to Canada, many times. Out of all the times that I have gone there, just once have I heard someone complain about the waiting and he was complaining about waiting to get a physical done. No one that has an emergency, especially a life threatening emergency waits in lines. The reasons for the lines is cost efficiency but also the fact that some people have emergencies and have to be moved to the front of the line. This happens in emergency rooms across America as well. A person in the emergency room for back pains has to wait a bit longer if someone with multiple bullet wounds shows up around the same time.

3. Foreign health-care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.

The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.

NOTE: Reid says that “roughly 20 cents of every dollar” the insurance companies in the U.S. spend on nonmedical costs. Keep that in mind when reading myth number 5. These companies spend a lot of time and money devising ways to deny paying for your healthcare.

4. Cost controls stifle innovation.

False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.

Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

NOTE: There is a major problem in the U.S. when it comes to technology. Many companies in the U.S. do not make technologies that are great and cheap, they try purposely to create technology that is going to be expensive. They know that if it’s expensive, then they can market it to hospitals using the thinking that “if it’s that expensive, it must be a great gadget”. Because of the way that insurance companies and hospitals are set up technology companies do not have to think about making their latest device cheaper. The device is likely to sell either way, so why not sell two devices that will profit the company two million dollars each, instead of try to sell a cheaper device to more hospitals in order to make the same amount of profit.

5. Health insurance has to be cruel.

Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.

Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.

In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.

This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.

Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.

NOTE: I’ve nothing else to say about Reid’s article except the most important thing that she has said, I’ve writing it in a much larger font.

Now as I finish writing this article I realize that even with what is written here, this is not going to change any minds, and that was not the intention of this article. This article was written to allow people confused about distortions in the media a place to get a few things straight.

The way healthcare is run in this country is not the best in the world, very far from it. And if anyone sounds like they are saying that it is the best are lying or just don’t have their facts straight. There are far better ways to run this system and healthcare reform is needed asap.

Before the economy gets better, it will continue to get worse. And majority of the people will not start feeling the recovering economy till after employment begins to rise, which is one of the last things to happen in a recovering economy. In that time frame many millions of Americans will not be able to afford seeing a doctor. These people are people with and without insurance.

It is estimated that tens of thousands of people will die this year from swine flu alone, how many of them could we have saved if they could have just gone in and seen a doctor? How many of them would have never gotten infected if someone else could have just gone in and seen a doctor?

Many people complain about costs of a public healthcare system. But by having a system where a patient does not have to worry about their budget before deciding whether or not they should go to a doctor will save the system a lot of money because people will be treated before a disease or any other condition gets to be so big that it is 10 to 100 times more expensive than if it was treated or detected earlier.

This will save more money than bogus malpractice lawsuits drive up costs. I personally rather risk phony lawsuits at the risk of having victims of malpractice be denied their lawsuit. Also statistics show that malpractice lawsuits are only about one percent of the costs of healthcare in the U.S. The highest estimation I have seen is 3%.

The only ones to profit from a for-profit based healthcare system, or a for-profit based insurance system is the health industry, not the patient. The current system is full of companies that are disease and accident profiteers. They are much like war profiteers, which use to be something that was considered a bad thing.

During this debate over healthcare, many are trying to paint the hospitals and insurance companies as victims and the sick and poor as the bad guys. While others just regurgitating political talking points.

Medicare took twenty years to pass. Truman tried to get it passed the first time and it wasn’t until LBJLBJ that it was finally approved. Kennedy tried to get it passed three times during his short presidency. While that process was going on, the same kinds of rhetoric one hears now was being spewed then. But after it passed, the same people that didn’t want it, are willing to fight their representative to keep it. The same will be true for healthcare reform as well. It may just end up taking longer than twenty years but when it passes, not many will want the old system back.