“Universal health insurance does not necessarily mean universal access to health care. In practice, many countries promise universal coverage but ration care or have extremely long waiting lists for treatment. Those countries that have single-payer systems or systems heavily weighted toward government control are the most likely to face waiting lists, rationing, restrictions on the choice of physician, and other barriers to care.”
“Those countries with national health care systems that work better, such as France, the Netherlands and Switzerland, are successful to the degree that they incorporate market mechanisms such as competition, cost-consciousness, market prices, and consumer choice, and eschew centralized government control.”
“While other countries spend considerably less than the U.S. on health care both as a percentage of GDP and per capita…the average annual increase for per capita health spending in European countries was 5.55 percent, only slightly lower than the United States? 6.21 percent. As the Wall Street Journal notes, Europeans face steeper medical bills in the future in their cash-strapped governments. In short, there is no free lunch.”
“While no country with universal coverage is contemplating abandoning a universal system, the broad and growing trend in countries with national health care systems is to move away from centralized government control and to introduce more market oriented features. As Richard Saltman and Josep Figueras of the World Health Organization put it, The presumption of public primacy is being reassessed. Thus, even as the U.S. debates adopting a government-run system, countries with those systems are debating how to make their systems look more like the U.S.”
Horizontal inequity in healthcare access under the universal coverage in Japan; 1986?2007.Authors:Ryo Watanabe
Affiliation:Department of Health Economics and Epidemiology Research, The University of Tokyo School of Public Health, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Source:In Social Science & Medicine October 2012 75(8):1372-1378.
Abstract:Universal coverage of healthcare aims at securing access to appropriate healthcare for all at an affordable cost. Since 1961, Japan?s national health insurance has provided an equal package of benefits including outpatient, inpatient, dental, and pharmaceutical services. Reduced copayment and other welfare programs are available to the elderly. However, social health insurance may not be a panacea to achieve healthcare for all, especially when facing household impoverishment due to economic stagnation. Using time-series cross-sectional data of a nationally representative survey of Japan, we assessed the degree of inequity in healthcare access in terms of the ?equal treatment for equal needs? concept, to identify the impact of changing economic conditions on people?s healthcare access. Concentration indices of actual healthcare use (CM) and standardized health status as a marker of healthcare needs (CN) were obtained. We decomposed CM to identify factors contributing to inequalities in healthcare use. Results showed that horizontal inequities in healthcare access in favor of the rich gradually increased over the period with a widening health gap among the poor. The inequality in favor of the rich was specifically observed among people aged 20?64 years, whereas high horizontal equity was achieved among those aged >65 years. Decomposition of CM also demonstrated that income and health status were major contributors to widening inequality, which implies that changes in household economic conditions and copayment policy during the study period were responsible for the diminished horizontal equity. Our results suggest that the achievement of horizontal equity through universal coverage should be regarded as an ongoing project that requires continuous redesign of contribution and benefit in the nation?s healthcare system…
Copyright:Copyright Ã???Ã??Ã?Â© 2012 Elsevier Ltd All rights reserved…
It appears to me that universal health insurance does not, “level the playing field,” like so many think it does. As the first article points out, nations using a universal system are modifying thier approach to include free market mechanisms to better the system.
This issue reminds me a lot of the China. A governement controlled economy that in recent years/decades has shifted to, gasp, many free market principles. Why do they do this? Because they work… [/quote]
I posted 2 articles. The second, is peer reviewed research, that contradicts several aspects of Reid’s opinion piece. [/quote]
The article you posted does not disprove that we spend twice as much as any other country and that we force record numbers of Americans into BK for healthcare.