Friday, August 28, 2009

Myths about Healthcare

Oh my. I have been working on this annoyingly long post about healthcare reform myths and then I came across this article which is so good and says everything I wanted to say. So there is really no point in my post anymore. So here is the article in its entirety. You can also find it here.

5 Myths About Health Care Around the World

By T.R. Reid
Sunday, August 23, 2009

As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.

I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:

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.

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?"

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.

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.)

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.

T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," to be published Monday.

Wednesday, August 12, 2009

Literal Videos

This has probably been around for a while but let's face it, I'm slow. These guys took some famous videos from the 80s and changed the song lyrics so that they describe what is actually happening in the video. Cracks me up big time. Here are two, and there a few more on their website,

Friday, August 7, 2009

My Political Spectrum Quiz results

Like any of you had any doubts...

My Political Views
I am a left moderate social libertarian
Left: 6.55, Libertarian: 2.99

My Foreign Policy Views
Score: -6.33

My Culture War Stance
Score: -8.76

Let's Compare Your Results to the Average

Average of All Quiz-Takers:

You can take the quiz here: Political Spectrum Quiz

My take on healthcare

I have been quiet on the subject, not because I don't care, but because frankly I care too much. Healthcare reform is something that I have very strong feelings about. I was pleasantly surprised when it suddenly became such a big deal. Supporters say Obama ran on a healthcare platform. That is of course not true. Obama ran on an anti-war, anti-Bush platform, and it was Hilary who had a stronger stance on healthcare. Nevertheless, healthcare suddenly exploded onto the national stage, and I was tickled pink. So why have I been keeping mum? Because I don't believe that the US is able to pass something as humanistic as universal healthcare and I didn't want to get my hopes up. I have not been disappointed in my pessimism, as single payer was taken off the table, now public option is going the way of the dinosaur, and the fight against healthcare reform has turned so dirty it would be funny (if it weren't so sad).

So here is where I stand. I think every country that is able, and that definitely includes the US, should make sure that every single on of the people in it, regardless of financial, legal, and even citizenship status, should have full and complete and good health care. Period. Are you a bum living on the street? Are you an illegal alien? Are you Donald Trump? Are you feeling off color? Go to the doctor and be made better. It's that simple. No exceptions. Not to mention that the care should be so fucking awesome that even Donald Trump will have nothing to complain about.

Who pays for it? Everyone who can. As with any tax I think the rich should pay a bit more, and the poor less. Those who can't pay anything, don't. So will my tax dollars go to pay for someone who has never worked an honest day in their life? Yes! And I am bloody fine with it, and I don't understand those who aren't. (As an aside, a huge number of Americans claim to be Christians, but are in my opinion greedy selfish bastards when it comes to taking care of their neighbor).

To those misinformation bastards out there who say that we don't have enough money to make this work, consider that we already spend out of our own pocket (or our employers pocket which really means less wages for us) more on healthcare than other countries, and we are so shitty even Colombia and Singapore (and 34 other countries) are better that us. You are telling me this country that is supposedly so great can't make something so basic happen?

And what irks me even more is how many people DON'T want universal healthcare. I have my doubts about their understanding of the subject. All these seniors who are being riled up, told that their Medicare will suffer (duh you stupid old buggers, Medicare is universal healthcare for you lot!!!). Don't you understand that you are being used by the sneaky powers behind healthcare companies and conservative think tanks? Probably not... (incidentally did you know that the average Fox viewer is over 65, white and doesn't have a college degree? - for more interesting demographic knowledge stuff check this out). Now the same nitwits who brought you teabagging are bussing in "concerned constituents" (who are probably birthers to boot) to disrupt town hall meetings.

As you can see, my feelings run high on this subject matter, and I have probably offended a bunch of you by questioning your intelligence, but so be it. It was all for naught anyway, because as I said before, the US won't have universal healthcare for a long time still. Whatever it is that will be passed this year will be something lame and watered down, and I am not even holding my breath. I probably wouldn't be so buggered if they didn't keep calling themselves "the greatest country in the world". As fucking if.