France, Germany and Japan: private insurance, universal care at half the cost of ours

[eridani]

Given that fact, what is missing from our recent attempt at reform?

All three systems
1. ABSOLUTELY FORBID denying any claim whatsoever.
2. Have government dictated fees for health care services. No useless attempts (which have failed in 15 states here alresdy) to regulate medical loss ratios.
3. Have single universal comprehensive plans in which prices and itmes to be covered are specified by the government, and which must be offerred on a non-profit basis. In some cases, supplemental plans may be offered at a profit, but there are absolutely NO platinum, gold, silver and bronze people in any of these countries.
4. Do not allow age rating.
5. Have no deductibles, though co-pays may or may not be entirely covered, depending.

As you might expect, this results in systems where providers earn much less. However their lives are made easier by medical schools costs that are free (France and Germany) or cheap ($1500 per year tuition, usually partly reimbursed by local governments) in Japan. In France and Germany, doctors and hospitals keep no records--all health care information is digital and included in the healh care cards.

Also, universal guaranteed care removes the single most significant reason for malpractice suits here-- namely that future health care costs from malpractice (or even just bad outcomes not resulting from actual malpractice) cause patients serious financial hardship-- does not exist. In France, malpractice premiums are $170/year for GPs and $650/year for specialists. In Germany, the yearly cost is about $1400/year. In Japan, malpractice insurance is covered by the $100/month dues to the medical society.

(Information from T.R. Reid's book The Healing of America.)

[dkf]

1. How do you change the ground rules on doctor compensation?

Also how do their systems handle malpractice?

[eridani]

2. Unless we change how med school is paid for, we'd have a hard time changing doctor compensation

Perhaps a place to start would be free tuition for general practitioners.

In most other countries, malpractice is handled by government review boards. The point is that there are many fewer complaints because people don't have to worry about how to pay for the extra health care that is usually reguired by less than desireable outcomss, whether those outcomes are caused by real malpractice or not.

[PoliticAverse]

3. Unfortunately, the time has passed.

We got what we got.
And any significant improvement doesn't seem likely until at least after the next election.

[eridani]

5. Correct with respect to national efforts

State efforts are another thing altogether. Vermont looks like it's going first.

[PoliticAverse]

7. I agree.

If major change is going to happen it's going to be the states that have to lead the way in the next few years.

[PufPuf23]

4. Our medical system is inefficient and corrupt.

Back in the 70s, I took the same undergrad science core as the premeds. I was into soils and forest ecology and headed to grad school and concurrently working in a federal research lab for the USDA. Many individuals get into medicine not because of talent or idealism but because of money and family. Private insurance is finance types skimming more from the system and are unnessary and more so regressive towards health at fair costs.

[xchrom]

6. recommend

[puebloknot]

8. K&R Obvious as the noses on our faces. Which we regularly cut off. nt