Tuesday, July 18, 2006

America's uninsured

Who are America's uninsured? It may not be who you think. Check out this week's podcast from www.healthpolitics.org

Dr Mike Magee says:

Careful and deliberate economic studies have revealed that the current public dollars spent on coverage for the vulnerable, support of uncompensated care, and safety net infrastructure exceeds what would be necessary to actually insure all of the current uninsured. Thus, an increasing number of experts believe that what we call a crisis is in fact mismanagement on a massive scale.

Mismanagement on a massive scale. The US spends more on health care than any other nation, and has poorer outcomes than almost all industrialised nations and far less equitable coverage.

In the podcast, Dr Magee highlights that the healthcare market in the US is characterised by lack of information and perverse subsidies and incentives. He believes there is a market solution - by bringing in new players. I don't. He thinks that new entrants can solve the information and structural problems. I don't (though they might have some benefit in the short to medium term).

I think the health care market in the US is broken, that it's a tangled web of misinformation and perversities which have been lobbied hard for by health care corporations and producer interest groups (e.g. the American Medical Association). They've set up a playing field where very few consumers can win and the producers make a ton of money by offering inadequate services for most and overtreating others. While these market corrupting distortions remain, new entrants to the market have no real incentive to playing differently.

5 comments:

stormare mackee said...

I agree. What I don't understand is the stupid conception that public healthcare is "socialism" but public education is not... What's the difference? You can't be a productive member if you're unable to work, whether it's because you're uneducated or because you're sick.

genderist said...

What we call "healthcare" has issues... on *every* level...

"John Galt" said...

In another post, VA wrote, "Pets get much better health care than do humans in Britain, thanks to the wonders of the NHS."

NHS is broken. The US system is broken. Whose system works?

Vol Abroad said...

France, Germany, Scandinavian countries have systems that work.

Anyway, that was my husband - not me who said that. As far as dispensing antibiotics goes - I'm on them, too - and I got just as good care as my cat. My GP saw me right away. The Vet saw Fancy right away. I got drugs. She got drugs. My care was free at the point of delivery and my drugs were very cheap. On the other hand, I dropped about a hundred bucks on that cat.

The reasons the NHS is broken are many and varied. I would never suggest a straight copy of that system for anywhere. But - it's there. And nobody in this country stays in a dead end job because they have a pre-existing condition that they can't transfer to a new plan.

Vol-in-Law said...

Vol:
"I got just as good care as my cat. My GP saw me right away"

The Vol sadly ignores the desperate begging phonecalls that the ViL had to do to get the Vol re-registered with her surgery, which had dropped her in a fit of pique when she wouldn't come for a smear test, and to get her an emergency appointment at the same time. With the cat, we were customers - pay money, get service. With the NHS we're supplicants, entirely dependent on the good will of those people for treatment.

I'd say traditionally our system was superior to the US overall (though the US better for the top 40% of the population by income), but here they have vastly increased spending (mostly on doctor's salaries) without improving the service, so now we're about even. All other western countries I know of are much better, including relatively poor ones like Spain & Portugal.