author: T.R. Reid
average rating: 4.27
book published: 2009
read at: 2009/09/27
date added: 2009/09/29
shelves: economics, health, history, non-fiction, politics
Fascinating overview of health insurance systems around the world…Reid uses the treatment of his shoulder as a trope for seeking care in several different countries, but ranges all over the history, politics, and economics of these systems.
Really, what he does is clarify the whole debate with a straightforward description of options and maybe more importantly, illuminates the underlying issue, beyond the technocratic questions of how. Do we believe that everyone deserves basic health care?
(My answer, obvs, is yes, absolutely!)
As it turns out, there’s really just four basic models of how to pay for health care:
* Beveridge (Britain): government owns the health care system (for the most part) and pays the bill via taxes. Also rather like the VA.
* Bismark (Germany, France, Japan, Switzerland): employers and employees buy insurance from private non-profit insurers, with government providing the insurance of last resort, and generally setting rules for payment schedules. Care providers are independent but highly regulated. Kinda like insurance for many working Americans, only w/out the profit motive.
* National Health Insurance (Canada, Taiwan): government provides insurance, with individuals paying premiums and copays. Care network rather like in the Bismark model. Basically the same as Medicare, to the point of that being the same name as the original Canadian system!
* Out-of-pocket (India): if you have money, you get care. If not, well, that’s just how it is. This is the model that prevails in the third world…and for uninsured Americans who have too much money for Medicaid and are too young for Medicare. 🙁
Personally, it seems like a straightforward embrace of the Bismark model is most likely to work here.