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Title: Which of these four health care system models do you prefer and why? Post by: greenforest32 on July 31, 2012, 06:31:05 AM Short definitions: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html
Title: Re: Which of these four health care system models do you prefer and why? Post by: afleitch on July 31, 2012, 07:04:49 AM The Beveridge Model. It's what I'm used to so I'm not in a position to comment on other models.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Antonio the Sixth on July 31, 2012, 07:05:53 AM The British NHS is really one of the greatest political conceptions of the twentieth century.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Vosem on July 31, 2012, 07:13:58 AM I voted Out-of-Pocket, since that's closest to what I want, though I don't believe in denying healthcare to someone who can't pay (who should then be indebted to the hospital, except for a few special groups which could be provided insurance by the government -- veterans, the elderly who cannot provide for themselves, children under 18 whose parents cannot provide for them, and pregnant women who cannot provide for themselves).
Title: Re: Which of these four health care system models do you prefer and why? Post by: Marokai Backbeat on July 31, 2012, 07:47:26 AM I voted Out-of-Pocket, since that's closest to what I want, though I don't believe in denying healthcare to someone who can't pay (who should then be indebted to the hospital, except for a few special groups which could be provided insurance by the government -- veterans, the elderly who cannot provide for themselves, children under 18 whose parents cannot provide for them, and pregnant women who cannot provide for themselves). The fact that you "don't believe in denying healthcare to someone who can't pay" doesn't change the fact that that is the practical effect of the policies you support. Title: Re: Which of these four health care system models do you prefer and why? Post by: Vosem on July 31, 2012, 08:37:35 AM I voted Out-of-Pocket, since that's closest to what I want, though I don't believe in denying healthcare to someone who can't pay (who should then be indebted to the hospital, except for a few special groups which could be provided insurance by the government -- veterans, the elderly who cannot provide for themselves, children under 18 whose parents cannot provide for them, and pregnant women who cannot provide for themselves). The fact that you "don't believe in denying healthcare to someone who can't pay" doesn't change the fact that that is the practical effect of the policies you support. I've already pointed out that universal healthcare pretty much always causes a degradation in quality, which is why I think the solution to the healthcare crisis would be to reform the way you pay hospitals, not to have the government do it for you, which not only do I think would cause quality to decline but would also set a very dangerous precedent. It is better, and fairer, to have some people have better-quality care than others instead of everybody having the same mediocre care. But let's finish the gay Republican debate first -- this is something both of us have argued dozens of times, whereas that one is more outlandish. Title: Re: Which of these four health care system models do you prefer and why? Post by: Supersonic on July 31, 2012, 10:45:45 AM A move to the National Health Insurance model would be my ideal system, despite the glorification of the NHS at the Olympic Opening Ceremony.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Redalgo on July 31, 2012, 11:30:09 AM Seeing as I look most favorably on the health care system of France, I voted the "Bismarck Model." Still, it's worth bearing in mind I am influenced by more than one model and tend to mix them a bit.
From what I understand (which may of course be flawed), there is public insurance for everyone but co-pays which reduce the detrimental impact of moral hazard. The state reimburses some of those costs (35%-100%) in some instances in an effort to encourage folks to take cost-effective medications, seek preventative care, and get treatment for chronic conditions that will otherwise worsen in their severity over time - which threatens to become more financially burdensome for both the system and afflicted individuals. The public plan is only basic, so folks get supplementary insurance privately (often through their employers). People who cannot afford it receive state aid. There are public and private hospitals and care providers alike from among which one may choose and individuals are given discretion in deciding whether to pay for higher qualities of health care. Then again, it would be quite helpful for me if someone from France were to explain some of the pros and cons of their health care system, seeing as I have only read about it through American authors and am almost surely overlooking a few important considerations. Title: Re: Which of these four health care system models do you prefer and why? Post by: Antonio the Sixth on July 31, 2012, 11:45:53 AM Seeing as I look most favorably on the health care system of France, I voted the "Bismarck Model." Still, it's worth bearing in mind I am influenced by more than one model and tend to mix them a bit. From what I understand (which may of course be flawed), there is public insurance for everyone but co-pays which reduce the detrimental impact of moral hazard. The state reimburses some of those costs (35%-100%) in some instances in an effort to encourage folks to take cost-effective medications, seek preventative care, and get treatment for chronic conditions that will otherwise worsen in their severity over time (which threaten to become more financially burdensome for both the system and afflicted individuals). The public plan is only basic, so most folks get supplementary insurance privately through their employers. People who cannot afford it receive state assistance. There are public and private hospitals and care providers alike from among which one may choose. Then again, it would be quite helpful for me if someone from France were to explain some of the pros and cons of their health care system, seeing as I have only read about it through American authors. You summed up the main traits and I don't really know the details of the French system. One of the recurring problems pointed out about the French system is the tendency of doctors to prescribe excessively. Since they are reimbursed by a public insurance, patients tend to ask for medicines even in cases they are not needed. And since doctors exert their profession privately, they tend to second their "clients"' desires. That's why recent reforms have focused on putting a heavier burden on the purchaser, with the obvious problem that poorer people might actually renounce to useful medical acts. The health insurance agency (like the other branches of France's social insurance agency) also has a pretty huge and ever-increasing deficit since the early 2000s. There is also an issue with the universal insurance for the poorer, the so-called CMU. It seems that reimbursements through the CMU are slow to come, and many doctors outright refuse to perform medical acts to the people covered by it (even though it is illegal). In short, it's not a perfect system, but it works relatively well and allows to erase most of health-related inequalities. I still prefer the British model, though. Title: Re: Which of these four health care system models do you prefer and why? Post by: Napoleon on July 31, 2012, 12:04:55 PM Like Redalgo, I picked the Bismarck model.
Title: Re: Which of these four health care system models do you prefer and why? Post by: TNF on July 31, 2012, 01:18:29 PM The Beveridge model is my ideal, but I think that the Bismarck model or the National health insurance model are the most likely end games for the United States.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Lief 🗽 on July 31, 2012, 01:41:34 PM The Bismarck model has been the most successful at expanding coverage universally, keeping costs downs, and protecting the quality of healthcare.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Okay, maybe Mike Johnson is a competent parliamentarian. on July 31, 2012, 02:28:21 PM Bismarck model with a National Health Insurance model-esque public option, which I believe is the case in Israel, Japan, and a few other countries.
Title: Re: Which of these four health care system models do you prefer and why? Post by: H.E. VOLODYMYR ZELENKSYY on July 31, 2012, 03:18:12 PM NHI.
Title: Re: Which of these four health care system models do you prefer and why? Post by: courts on July 31, 2012, 03:18:31 PM I voted Out-of-Pocket, since that's closest to what I want, though I don't believe in denying healthcare to someone who can't pay (who should then be indebted to the hospital, except for a few special groups which could be provided insurance by the government -- veterans, the elderly who cannot provide for themselves, children under 18 whose parents cannot provide for them, and pregnant women who cannot provide for themselves). The fact that you "don't believe in denying healthcare to someone who can't pay" doesn't change the fact that that is the practical effect of the policies you support. I've already pointed out that universal healthcare pretty much always causes a degradation in quality, which is why I think the solution to the healthcare crisis would be to reform the way you pay hospitals, not to have the government do it for you, which not only do I think would cause quality to decline but would also set a very dangerous precedent. It is better, and fairer, to have some people have better-quality care than others instead of everybody having the same mediocre care. But let's finish the gay Republican debate first -- this is something both of us have argued dozens of times, whereas that one is more outlandish. Title: Re: Which of these four health care system models do you prefer and why? Post by: Dereich on July 31, 2012, 08:00:04 PM I could never vote for the Beveridge model, just because it leave the capacity for politics to hurt peoples healthcare, a la the Yes, Minister episode http://en.wikipedia.org/wiki/The_Compassionate_Society
Title: Re: Which of these four health care system models do you prefer and why? Post by: TheDeadFlagBlues on July 31, 2012, 09:11:57 PM Bismarck model with a National Health Insurance model-esque public option Title: Re: Which of these four health care system models do you prefer and why? Post by: Fmr President & Senator Polnut on July 31, 2012, 09:16:31 PM I love how people who don't live in a universal healthcare system talk about how bad things are for those of us who do...
The overall "quality" ie, prestige of care is higher in the US (the more money you have, the better access and outcomes you have)... however, if you look at the overall health outcomes of universal systems, they are higher than the US. Why? because access is guaranteed and people generally have the assurance that if they're sick, they don't have to worry about not being able to pay for their treatment. The more people have access to quality care, the better the outcomes will be. I'm extremely happy to live with the system I do. Title: Re: Which of these four health care system models do you prefer and why? Post by: Yelnoc on July 31, 2012, 09:24:30 PM Could some of our Canadians talk about the National Health Insurance model?
Title: Re: Which of these four health care system models do you prefer and why? Post by: Fmr President & Senator Polnut on July 31, 2012, 09:26:29 PM Could some of our Canadians talk about the National Health Insurance model? Australia uses the NHI model... Title: Re: Which of these four health care system models do you prefer and why? Post by: The world will shine with light in our nightmare on July 31, 2012, 10:05:07 PM I went with Bismarck, but would someone mind listing the pros and cons of these?
Title: Re: Which of these four health care system models do you prefer and why? Post by: TheDeadFlagBlues on July 31, 2012, 10:08:22 PM Could some of our Canadians talk about the National Health Insurance model? Australia uses the NHI model... One of the many reasons why Gough Whitlam is my favorite PM. Title: Re: Which of these four health care system models do you prefer and why? Post by: Marokai Backbeat on July 31, 2012, 10:28:43 PM Ideally I would like the Beveridge model but a robust NHI model at least as a basic option is an absolute minimum even in a Bismarck style of system.
Title: Re: Which of these four health care system models do you prefer and why? Post by: True Federalist (진정한 연방 주의자) on July 31, 2012, 10:42:45 PM Bismarck, which is what Obamacare is edging us toward.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Lief 🗽 on August 01, 2012, 02:57:42 AM I went with Bismarck, but would someone mind listing the pros and cons of these? This is a fantastic (and easily read) book if you're interested: http://www.amazon.com/The-Healing-America-Global-Cheaper/dp/1594202346 Title: Re: Which of these four health care system models do you prefer and why? Post by: Swedish Rainbow Capitalist Cheese on August 01, 2012, 04:30:38 AM Bismarck model with a National Health Insurance model-esque public option Sounds like a good combination Title: Re: Which of these four health care system models do you prefer and why? Post by: So rightwing that I broke the Political Compass! on August 01, 2012, 07:10:36 AM I prefer the Singaporean model, and am annoyed that it wasn't included.
Title: Re: Which of these four health care system models do you prefer and why? Post by: courts on August 01, 2012, 07:22:42 AM national health insurance model financed through taxes on things like natural resources.
Title: Re: Which of these four health care system models do you prefer and why? Post by: bore on August 01, 2012, 10:48:33 AM The Beveridge model for me, but the NHI and the Bismarck system would also be better than what the US has at the moment.
I voted Out-of-Pocket, since that's closest to what I want, though I don't believe in denying healthcare to someone who can't pay (who should then be indebted to the hospital, except for a few special groups which could be provided insurance by the government -- veterans, the elderly who cannot provide for themselves, children under 18 whose parents cannot provide for them, and pregnant women who cannot provide for themselves). The fact that you "don't believe in denying healthcare to someone who can't pay" doesn't change the fact that that is the practical effect of the policies you support. I've already pointed out that universal healthcare pretty much always causes a degradation in quality, which is why I think the solution to the healthcare crisis would be to reform the way you pay hospitals, not to have the government do it for you, which not only do I think would cause quality to decline but would also set a very dangerous precedent. It is better, and fairer, to have some people have better-quality care than others instead of everybody having the same mediocre care. But let's finish the gay Republican debate first -- this is something both of us have argued dozens of times, whereas that one is more outlandish. What's your source for this? Title: Re: Which of these four health care system models do you prefer and why? Post by: Filuwaúrdjan on August 01, 2012, 11:35:11 AM At some point an obnoxious know-it-all is going to point that 'the Beveridge Model' is a nonsensical term in the context of health policy as William Beveridge had very little to do with the design or implementation of the NHS.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Leftbehind on August 01, 2012, 11:52:54 AM Bevan must be rolling in his grave. Obviously the NHS model.
A move to the National Health Insurance model would be my ideal system, despite the glorification of the NHS at the Olympic Opening Ceremony. A Tory wanting to do away with the NHS - despite the "glorification" of being included in an opening ceremony - imagine my surprise. Title: Re: Which of these four health care system models do you prefer and why? Post by: Antonio the Sixth on August 01, 2012, 12:32:07 PM Yeah, I noted that as well but didn't bother pointing that out. I referred to as the NHS model, anyways.
Title: Re: Which of these four health care system models do you prefer and why? Post by: True Federalist (진정한 연방 주의자) on August 01, 2012, 01:17:01 PM Fixed that for you, altho I think of you more as curmudgeonly than obnoxious. Title: Re: Which of these four health care system models do you prefer and why? Post by: Redalgo on August 01, 2012, 01:23:59 PM I went with Bismarck, but would someone mind listing the pros and cons of these? This is a fantastic (and easily read) book if you're interested: http://www.amazon.com/The-Healing-America-Global-Cheaper/dp/1594202346 Alternatively, although I am sure this is far from being complete and is less authoritative, here are some basic points I picked up during health care debates in my time as an undergrad student: Canada (National Health Insurance Model) - Its method is arguably centre-left and typical of social liberalism - Average waiting times don’t seem markedly longer than in the States - State price bargaining lowers the cost of treatments but hinders R&D - Physicians have more time for patients yet less for each, individually - Administrative costs and complexity are much lower than in the U.S. - Queues are not always first come, first serve - One is basically stuck with using this system France (Mixed / Bismarck Model) See Antonio’s post (https://uselectionatlas.org/FORUM/index.php?topic=156719.msg3369285#msg3369285) for a basic breakdown of the system. Germany (Bismarck Model) - Its approach is more or less centrist and typical of ordoliberalism - Numerous private, but non-profit health insurers / sickness funds dominate the market - Insurers compete yet are regulated to avoid unjust discrimination - Funds redistributed from sickness funds with the healthiest folk to those with the least - Patients inefficiently use up hospital beds for almost twice as many days as in the U.S. - Health care costs per capita are markedly higher than in the U.K. - Opting out is a choice but very few people actually want to do so United Kingdom (Beveridge/NHS/Whatever Model) - Its method is arguably left-of-centre and typical of social democracy or socialism - Health care costs per capita are 60% lower than in the U.S. - New and/or expensive tests and treatments get rationed for budgetary reasons - Physicians have more time for patients yet less for each, individually - Use of resources benefits the young and those with minor ailments - Yet olds and sufferers of dire ills often get the short end of the stick - Quality of care can greatly vary by location (i.e. the NHS is a “postcode lottery”) United States (Mixed / Out-of-Pocket Model) - Its method is right-of-centre and vaguely reminiscent of low-GDP countries - Private insurers compete in a regulated market; patients buy what they want - People have very low rates of mortality from many treatable diseases - Physicians have less time for patients yet more for each, individually - Administrative costs are high and interactions with insurers complex - Costs are rising but at rates somewhat similar to in other high-GDP countries - The VHA offers its best quality of care yet uses the Beveridge/NHS/Whatever Model Title: Re: Which of these four health care system models do you prefer and why? Post by: The world will shine with light in our nightmare on August 01, 2012, 01:56:48 PM Thanks. Looking at that, it seems that either the Bismarck or Beveridge system is the best option.
Title: Re: Which of these four health care system models do you prefer and why? Post by: Donerail on August 02, 2012, 08:35:56 AM From Redalgo's information, I'd be willing to support a Bismarck or out-of-pocket system as the superior options.
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