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| | |-+  Which of these four health care system models do you prefer and why?
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Poll
Question: Which health care system model do you prefer?
The Beveridge Model   -12 (27.3%)
The Bismarck Model   -13 (29.5%)
The National Health Insurance Model   -13 (29.5%)
The Out-of-Pocket Model   -6 (13.6%)
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Total Voters: 44

Author Topic: Which of these four health care system models do you prefer and why?  (Read 4751 times)
greenforest32
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« on: July 31, 2012, 06:31:05 am »
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Short definitions: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html
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afleitch
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« Reply #1 on: July 31, 2012, 07:04:49 am »
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The Beveridge Model. It's what I'm used to so I'm not in a position to comment on other models.
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Antonio V
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« Reply #2 on: July 31, 2012, 07:05:53 am »
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The British NHS is really one of the greatest political conceptions of the twentieth century.
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« Reply #3 on: July 31, 2012, 07:13:58 am »
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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).

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Marokai Backbeat
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« Reply #4 on: July 31, 2012, 07:47:26 am »
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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.
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« Reply #5 on: July 31, 2012, 08:37:35 am »
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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.
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« Reply #6 on: July 31, 2012, 10:45:45 am »
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A move to the National Health Insurance model would be my ideal system, despite the glorification of the NHS at the Olympic Opening Ceremony.
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« Reply #7 on: July 31, 2012, 11:30:09 am »
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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.
« Last Edit: July 31, 2012, 11:39:23 am by Redalgo »Logged
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Antonio V
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« Reply #8 on: July 31, 2012, 11:45:53 am »
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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.
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Our numbers are dwindling. Our words are confused.
Some of them have been twisted by the enemy
until they can no longer be recognized.

Now what is wrong, or false, in what we have said?
Just some parts, or everything?
On whom can we still rely? Are we survivors, cast
away by the current? Will we be left behind,
no longer understanding anyone and being understood by no one?
Must we rely on luck?

This is what you ask. Expect
no answer but your own.


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« Reply #9 on: July 31, 2012, 12:04:55 pm »
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Like Redalgo, I picked the Bismarck model.
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« Reply #10 on: July 31, 2012, 01:18:29 pm »
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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.
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« Reply #11 on: July 31, 2012, 01:41:34 pm »
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The Bismarck model has been the most successful at expanding coverage universally, keeping costs downs, and protecting the quality of healthcare.
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« Reply #12 on: July 31, 2012, 02:28:21 pm »
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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.
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« Reply #13 on: July 31, 2012, 03:18:12 pm »
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NHI.
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« Reply #14 on: July 31, 2012, 03:18:31 pm »
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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.
nothing about either of your posts makes any sense.
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« Reply #15 on: July 31, 2012, 08:00:04 pm »
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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
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« Reply #16 on: July 31, 2012, 09:11:57 pm »
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Bismarck model with a National Health Insurance model-esque public option
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« Reply #17 on: July 31, 2012, 09:16:31 pm »
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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.
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« Reply #18 on: July 31, 2012, 09:24:30 pm »
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Could some of our Canadians talk about the National Health Insurance model?
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« Reply #19 on: July 31, 2012, 09:26:29 pm »
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Could some of our Canadians talk about the National Health Insurance model?

Australia uses the NHI model...
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« Reply #20 on: July 31, 2012, 10:05:07 pm »
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I went with Bismarck, but would someone mind listing the pros and cons of these?
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« Reply #21 on: July 31, 2012, 10:08:22 pm »
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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.
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« Reply #22 on: July 31, 2012, 10:28:43 pm »
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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.
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« Reply #23 on: July 31, 2012, 10:42:45 pm »
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Bismarck, which is what Obamacare is edging us toward.
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« Reply #24 on: August 01, 2012, 02:57:42 am »
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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
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