I see that the healthcare debate has taken a completely ugly turn in America and that is unfortunate. So what I want to do is separate fact from fiction in the health care argument and then talk about what I think works and does not work. What I will do is talk about the healthcare systems that I actually witnessed firsthand.
Canada
The whipping child of many American’s on how it is bad socialized healthcare. First let me point out that there is no Canadian health care. It is a provincial matter. So there are provinces with better or worse healthcare. Secondly depending on the province you can get certain things from the private sector. The favourite example is that MRI’s have a huge waiting list. Well that is a pile of crap! If you want an MRI you can get it right away, but you just have to pay for it! If you want it free, well then you have wait until your doctor approves it.
Does the Canadian system work? Sure it works! Does it help the general populace? Sure it does! Are there issues? Heck yes!
I wish to add a recent example (a couple of days ago) where a friend of ours fell off the roof and smashed his foot. He then was sent to the local hospital in Jolliette. But because there was no surgeon available he was flown to a premier hospital in Montreal that had a surgeon. My point is that he got the attention he needed right away.
America
An expensive health care system if you can afford it. Sure you get a doctor, sure you get attention, but it all boils down to whether or not you have the money to afford the plan to get the care you want. If you are not able to get the plan then you have a couple of problems.
What gets me about the American system is that they have the ability to cherry pick people and what they cover. This in my opinion is counter productive and leads to more problems than solutions.
Germany
A mixture of public and private probably similar to what America is pursuing right now. The German system has its issues and one of them is that the public health care client is getting short changed by the private system. You can get the immediate attention you want so long as you are willing to pay for it. In the German system there exists the same clauses where if you have heart problems you will not get private insurance for your heart.
Austria
A public health care system that seems to work, though I did not stay long enough to completely understand it.
France
A public health care system that REALLY works. The French health care system is great! Though the catch is that it costs 11% of your pay cheque. And that 11% is across the board for rich or poor. Though this system has immediate attention, you get the health care you want and you get the attention of your doctor. I actually like this system and think it would be a better role model than say the Canadian health care system.
But oh, talking about France to Americans would be a slap in the face! Well that is an American problem, no? My wife and I would have no problem retiring to France and paying the 11% since we know that it is a health care system that works.
Switzerland
This is an interesting health care system where it is completely private, but controlled by the public government. Think of it as Canadian with private. This system is actually not too bad. The costs are not that bad (eg the monthly costs) and the health care providers are not allowed to cherry pick. I would say that this system is actually pretty good, but it is overpriced for what you get. Though the Swiss people don’t help that by voting “crack pot witch doctor” medicine into the base system.
What I like about the Swiss system is that you have choice and you can get additional perks if you are willing to pay for it. Though there is no cherry picking allowed and no insurance company can refuse to cover you. I actually like this system because people get the urgent care they need, but can pay if they want more frills.
United Kingdom
This is a public health care system like Canada, except with the option of getting extended insurance to cover additional items. It is not like Germany where private competes against public, but one where private extends public. Not that bad of a system actually.
My Thoughts
I have gone through quite a few systems and have relatives (Ecuador, Russia) that have gone through other types of systems. The reality is that health care costs! It really does not matter what type of health care system you have whether private or public, it costs.
In the French system where the costs are distributed among the people and the same percentage is paid by both rich and poor you get a great health care system. But the key thing to remember is that the costs are distributed.
In the case of places like Canada, and the United Kingdom where health care is public the real problem here is underfunding. It is not a problem that the public health care system is bad, but the reality that it is underfunded. Canadian’s and British don’t want to pay for a quality health care system, unlike the French who are willing to pay. For example Quebec has a pretty good healthcare system. But guess what Quebec has the highest tax rate in Canada. My point stands that healthcare costs!
I do believe that the worst healthcare systems are the German, and American. Even though the German system has public it is underfunded and because it allows the private system to cherry pick you get real problems.
I am not a believer in a free market approach to healthcare. I do believe in the free market in general, but healthcare has the problem of having to deal with what we call humanity. When we are confronted with humanity we become irrational and we do things that many would not consider logical. But I feel that is ok since we are humans.
Let me add a personal angle. My mother is a breast cancer survivor. Fifty years ago she would not have been a healthcare problem because she would be DEAD! But now she is a drag on our healthcare system. And frankly I like it that way! Yes she sucks up healthcare dollars with her constant checkups and constant monitoring, but that is the society that I chose! As mothers or relatives are important to most people I cannot say my mother survives and yours doesn’t due to the fact that I might have the money to pay for it and you don’t.
Thus my only solution is to accept a regulated health care system. Does that mean everything has to be public? Can there be private extensions? Sure why not. But what I don’t accept is the cherry picking and control exerted by insurance companies.