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Near-universal Mexican Healthcare Coverage Results From Science-informed Changes
ananyo writes about improvement to Mexico's healthcare system. From the article: "A revamp of Mexico's beleaguered health-care system is proving to be a runaway success and offers a model for other nations seeking to reform their own systems, according to a review published this week in The Lancet (abstract). The key to the scheme's success is the way in which it has modified its reforms in response to scientific assessments of their effectiveness, the authors say. Launched in a law in 2003, the Mexican scheme was designed to sort out widespread inefficiencies and inconsistencies in the country's health-care system. Some 50 million Mexicans — nearly half the country's population — who previously were not covered by health insurance are now enrolled, leading the scheme's architects to claim that the country has near-universal health-care coverage. As well as the increased coverage, the scheme has seen the number of conditions treated under Mexican public health insurance nearly quintuple. Admittedly, the former health minister Julio Frenk, now dean of the Harvard School of Public Health, is a co-author on the paper."
Translation: "We did some things we thought would work, and then later we stopped doing the things that weren't working and did more of the things that were."
In an ideal world, governments behaving sensibly wouldn't make headlines.
You mean, using someone who actually understands the field he's working in instead of a politician with little or no qualifications, actually gives better results? OMFG this is revolutionary!
Sounds like the problems the opponents to universal health care in the States are always worried about.
The problem of making health care cheaper so there isn't so much profit in it?
told her to take her mother, who they suspected had liver cancer, for tests in the neighboring state of Morelos.
Given the choice of travelling for a few hours to have (free) tests, or the American alternative of selling your house to pay for them, I wonder which is the worst?
Hey, you forgot to call; it "Obamacare". Don't worry, I'm sure that will be in half the posts anyway.
Australia (where I am)
Canada
The United Kingdom
Most of Europe, for that matter
South Africa
New Zealand
Singapore
Japan
And that's just off the top of my head, with a bit of googling to back it up. You know, basically every single first world country except the United States, who recently were in a massive recession and are looking to head that way again.
Check out my sci-fi book "Lacuna" at http://goo.gl/MVxX8
Would people really feel "forced" if there was a tax financed single payer system financed by taxes? Does someone feel "forced" to pay for police and other services with taxes? Would anyone rather have a private company to call in case of fire, than pay tax money for that service? Am I making a weird extrapolation between police and healthcare?
The Nordic states are doing pretty well, and they all have universal socialised healthcare. The Netherlands claims it has privatised healthcare, and the best service in the world, but in fact 75%+ of the cost is transparently covered by the taxpayer, and poor people do get free healthcare.
In AU everybody is covered by public health care, if you earn more than $72K Aus (current ~$75k US) you pay an extra 1% tax.
This equates to about $700 a year which (I am sure not by coincidence) is about the starting point for a single non-smoker private health cover. If you do take out private cover and earn > $72k you don't pay the extra tax.
All up I feel its a fair system
I don't know why people don't get it. The "free market" people out there love to say "government shouldn't mess with it" and usually, I agree except when government has no choice.
Any time there is an unlimited supply, the government needs to help. Such cases include matters like "copyright" and "patent protection." The supply is unlimited and therefore must be enforced by government to use other means to get people to pay for something with an unlimited supply.
Any time there is an unlimited demandm the government needs to help. Such cases include matters like healthcare, water and electrical service. People need what they need and it has little to do with market conditions. Often is is "use or die." Government needs to ensure that needs of the people are met before suppliers are allowed to exploit the need to gain unlimited profits.
It's interesting and amusing to me that many such free market proponents are great with government enforced or assisted items like copyright but not with health and power regulation. "Only when it serves their interests." So it's selfish humanity as usual... and in the end, that's why we have law in the first place -- to help us to act against our own nature.
Yes they say the words that make you happy... do they actually deliver?
Still trolling? Let me repeat his statements for you, in a new wording
- All of the "first world" economies, except the US, pretty much have universal socialized health care.
- The systems are popular in these countries (they are all democracies, so they would have to be quite popular to remain).
- All of these economies are of course facing more or less rough times at the moment, but their economies would still be regarded as "healthy" on a global scale or seen over a few decades.
Does someone feel "forced" to pay for police and other services with taxes?
Yes, many libertarians.
Would anyone rather have a private company to call in case of fire, than pay tax money for that service?
Yes, many libertarians.
Am I making a weird extrapolation between police and healthcare?
Yes, many people don't see the connection between public safety and public health. And most of them are libertarians.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
... nothing. President Lawnchair signed the massive bailout for the health insurance companies (which was conveniently disguised as "health care reform") which ultimately left us with the same broken system, but with people now forced to buy into it. We still have no standard of care, and nothing that actually resembled universal coverage.
And now to further accentuate how ridiculous that is, the Mexican government just beat us to health care reform as well. A significant portion of their country is embattled in violent conflict in the drug war, yet they can pass health care reform. Up here, we can't pass it because of a collection of idiots who are afraid of (their own lack of understanding of) "socialism".
Yeah, go ahead. Mod me down. I can take it. At least I said my piece.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
The United States relies upon private health insurance to provide much of the financing for medical costs. This is unusual: in Britain, Canada, and Spain, for example, health-care costs are largely paid for by the government. In Austria, Belgium, France, Germany, and the Netherlands, medical costs are paid for by a system of "social insurance": it is compulsory for most people to buy insurance, but insurance premiums are tied by law to income rather than to the risk of a claim.
The United States system makes it voluntary to buy insurance, and premiums are linked to risk, not to income. But these market-based premiums, beloved of many Americans, do not seem to be delivering health care that makes them happy. A recent survey revealed that only 17 percent of respondents in the United States were content with the health-care system and thought no substantial reforms were necessary. Why the discontent?
The superficial reasons are simple enough to describe: the system is hugely expensive, very bureaucratic, and extremely patchy. The expense first: US health cares costs a third more, per person, than that of the closest rival, super-rich Switzerland, and twice what many European countries spend. The United States government alone spends more per person than the combination of public and private expenditure in Britain, despite the fact that the British government provides free health care for all residents, while the American government spending program covers only the elderly (Medicare) and some of the marginalized (Medicaid). Most Americans worry about health-care costs and would be stunned to discovered that the British government spends less per person than the American government but still manages to provide free health care for everyone. In fact, if you figure in the costs of providing health insurance to government employees and providing tax breaks to encourage private health care, the US government spending on health care, per person, is the highest in the world.
Bureaucracy next. Researchers at the Harvard Medical School found that the administrative costs of the US system, public and private, exceed $1,000 per persons. In other words, when you count all the taxes, premiums, and out-of-pocket expenses, the typical American spends as much on doctor's receptionists and the like as citizens of Singapore and the Czech Republic spend on their entire medical care. Both places are countries with health outcomes very similar to those in the United States: life expectancy and “healthy life” expectancy (a statistic that distinguishes a long healthy life and a long life plagued by years of severe disability) are a shade lower in the Czech Republic than in the United States; and in Singapore they are a little higher than in the United States. The costs of US bureaucracy is also more than three times the $307 cost per person for the administration of the Canadian health system, whic
I suppose it's easy to believe this doesn't happen in the US if you've lived somewhere urban your whole life. But out here in rural America, it's not uncommon to have to travel two or three hours to get treatment. There's a local clinic in the town that I live in, but if you need anything more complicated than having a broken bone set or some penicillin, you're going to have to travel to the nearest town an hour and a half away. If you have something serious like cancer then it might be time to look into relocating. Rural areas always have a more difficult time getting to medical care, especially with a country as spread out as the United States. It has nothing to do with universal health care or our privatized system and wouldn't necessarily become better or worse if we changed.
Seriously? You're seriously asking that question?
In the civilised world, we view people who refuse to help the sick and injured as evil scum. In your country you may be happy with people dying, untreated, on the streets. YMMV.
I posted this elsewhere, but its entirely relevant to most discussions on here -
In 2010 (year picked because figures are unlikely to be revised), the UK spent £118.2Billion on the NHS, for a population of about 63Million persons.
Thats a per population head equivalent of £1906 or $2954.
In that same year, the US spent about $381Billion on Medicaid and about $509Billion on Medicare - both of which highly intersect with what the NHS provides, for a population of about 311.5Million persons.
Thats a per population head equivalent of $2858.
Except the US Medicare and Medicaid programmes don't cover 311.5Million persons - Medicaid covers roughly 50Million persons, and Medicare covers roughly the same number - theres about a 6Million person intersection between the two (persons that are enrolled in both), so, again roughly, the total number of beneficiaries for these federal and state programmes is around 94Million.
That makes it a per eligible head equivilent of $9469.
And you know which system I would rather have? The one I currently use - the NHS at $2954.
The US system is just very very badly run.
Sources:
http://www.gao.gov/highrisk/risks/insurance/medicaid_program.php
http://www.gao.gov/highrisk/agency/hhs/reforming-medicare-payments.php
http://www.kff.org/medicare/upload/7305-05.pdf
http://en.wikipedia.org/wiki/Medicaid
http://en.wikipedia.org/wiki/Medicare_(United_States)
Every generation needs to convince the ones after them to buy in to the insurance/Social Security scam. Please explain how else it could work.
Simple: the population of people requiring healthcare treatment at any given moment, even at 0 population growth, is always going to be much smaller then the population who are able-bodied and working. Across the volume of that total population, if everyone kicks in a small amount of money, then we can ensure that there's cash available for all of them when they themselves need medical treatment.
Also, since insurance gets more efficient as you dilute the risk pool, expanding it up to the size of the entire country's population has enormous benefits - as well we follow on ones such as providing for government collective bargaining on the cost and purchase volumes of pharmaceuticals (the government is the largest possible purchaser, ordering the largest possible volumes, which means it'll always be able to negotiate a good deal).
Social Security (in the US) is not a scam, incidentally. It only becomes a scam if the American populace let that happen, which will be if they allow the government (screw it - allow the current batch of GOP politicians) to reduce SS benefits to future generations. The scheme has been enormously well-funded, and is owed billions by the US government, which has avoided raising taxes by "borrowing" against SS savings. It's alleged bankruptcy is due to the fact that that money was never paid back, because it was never used for anything profit earning in the long-run: it was wasted away as tax cuts to the rich, and still is.
The evidence is that the amount of money that can be saved by various tort reform laws is approximately 2%:
http://www.nber.org/bah/2009no3/w15371.html
Now, that's not nothing, but it's not even close to explaining why US health care costs 3.5 times that of the UK. Some things that are more likely to make a difference:
1. Most health care in the US is fee-for-service, so doctors get paid more if they do more procedures, no matter how useful those procedures are. Solution: put doctors on salary.
2. The US spends a lot of money keeping people alive as basically a vegetable in a hospital during the last year of their life. Solution: end-of-life counseling and legalizing euthanasia.
3. A significant portion of health care costs are insurance companies, hospitals, individuals, and government each haggling to try to make the other parties pay for the cost of care. Solution: Single payer and single provider, so there's nobody else to haggle with.
4. Another significant problem is that people without insurance and money to pay for care tend to seek care at emergency rooms, which both makes it harder for ERs to handle real emergencies and means we spend easily 5 times what we would have spent to treat the same condition in a doctor's office. Solution: Cover everybody.
In other words, you get pretty close to what every other country in the world is doing, and it gets a lot cheaper to provide health care.
I am officially gone from
Let me put it this way, 10 years ago a little over half of the costs in my dad's practice were billing insurance. Its now over 75%. That right there should tell you a lot about how a single payer system could save money.
The next largest cost is malpractice insurance; when about half the doctor's lost their malpractice insurance so they closed up shop, the state stepped in, but its still a big problem.
Finally a single payer system consolidates information about what a doctor does. In other systems, like the VA, they're using that to shape doctor's practices. Basically they get the leaders in the field together to try and figure out an ideal process (e.g. weighing the risks and costs of a test to see when you should jump to the most accurate test vs using less accurate but less costly or more safe screening). Any doctor can go outside the reccomendation; all they need to do is basically check a box. If more than a certain percent of a doctors patients go outside the expected range, they then review the cases. There may be other mitigating circumstances, so they are reviewed by doctors and that feedback is used to refine the reccomendations or to consult with the doctor about how to be more cost-effective. This system shapes doctors behaviors toward providing proper medical care at a minimal cost, without ever preventing a patient from receiving the care their doctors feels is appropriate.
Keep in mind, for many people the government already provides care. If you don't have insurance and its life-threatening, the poor, veterans, etc. Before we were married, my wife worked as a pharmacy teach and she would see all these people getting pills on the government's dime and then selling them in the parking lot, yet the government wouldn't cover her and private insurance was more than she made, so she couldn't afford her bi-polar medicine. If she quit, the government would cover her, but she's the type of person who likes to pull her own weight so she went without. How much sense does that make?
Until the Mexican government builds a massive electrified fence all the way across the northern border to stop impoverished US immigrants from stealing their jobs.
Recognizing this reference probably means you're already flashing.
And that point is insignificant with universal coverage because the option to get luxury health care wouldn't exist either.
The far right keeps saying this, but it's simply not true. In England, everyone is covered by universal coverage. But many people buy supplemental health insurance because they want more of a premium plan with extra coverage/benefits. You can still have all the luxury health care you want. You are just going to have to pay extra for the luxury bits. Which all sounds quite reasonable. Stop spreading FUD.
>of course employers would NOT pay for healthcare
Just a minor correction, although I agree with your post. I live in a country where there is such a system, and employers DO pay for healthcare if there are on-the-job injuries, indeed it's illegal to claim those from private insurance - it MUST be paid by the employer (who is free to take out insurance against such events but not forced to - they can cover accidents out of pocket if they prefer - at least for smaller companies this is often viable).
The reason has nothing to do with healthcare cost however, it's one of the more efficient and effective ways to regulate work-place safety. If the employer is automatically liable for the cost of on-the-job injuries (however minor or major) without litigation or such ever entering into it - a guilty-by-default status, then they have every possible incentive to make the workplace as safe as possible.
Frankly if you pay for every skull fracture caused by slippery floors, it's no longer economic to save money on slip-proof mats now is it ? Ultimately this may increase the cost of doing business but I would argue it only increases it to what it OUGHT to be in the first place. Skimping on worker-safety is not a saving, it's basically murder-for-money.
Unicode killed the ASCII-art *
From National Geographic Magazine:
http://blogs.ngm.com/.a/6a00e0098226918833012876a6070f970c-800wi
Guess who gets the least bang for their buck in Healthcare?
I suppose you consider fertility treatments to be frivolous.
I hate to say this, but they ARE frivolous, at least when compared to other things such as cancer treatment.
Not to mention, you COULD just adopt... or do as you did, and pay for private care.
-- Let us endeavor so to live that when we pass even the undertaker shall be sorry. -- M. Twain
Investors. The country with the highest tax burden in the world right now, Denmark, is at the moment loaning money at an interest of -0.25%..
YES, that means rich people, very rich people, and investors in general, believe the Danish economy is so healthy they are willing to loan them money at negative interest, just so that Denmark can protect they money for them.
I think we do have a right to healthcare, as well as food and housing, at least as long as the country can afford it. The wealthy already get to have luxuries because they're rich, why do they also get to have the necessities, like shelter, healthcare and food as well?
I also think we should cut our military budget by at least 90% before we start saying we can't afford to provide everyone with healthcare.
-- Let us endeavor so to live that when we pass even the undertaker shall be sorry. -- M. Twain
Word of mouth?
“He’s not deformed, he’s just drunk!”
There are death panels in both socialized medicine and private medicine with health insurance, the question is whether they're manned by government-employed medical professionals on a salary, or corporate-employed statisticians with a vested interest in your death.
"When information is power, privacy is freedom" - Jah-Wren Ryel
Medicare and SS spend more money than they take in, so to finance these pyramid schemes the gov't sells bonds.
SS takes in more than they make, you fucking moron. Which is where as these IOUs come from...the rest of the government borrows from them.
Jesus Christ on pogo stick, it's completely astonishing how many people are complete and total idiots.
Here, let me explain to you: You know how you don't have a job because you're too goddamn stupid to work a cash register? (And I also think it's unfair they fired you! Does it really matter if customers pay you or you pay them? Isn't it enough that money moves?) You know how you have to keep borrowing from your parents to pay off your credit cards? You know how they don't charge you interest?
They are, this analogy, social security, and you are the rest of the budget. And you are standing there arguing that they are borrowing too much and spending too much and will collapse, because look at all those IOUs they have from you! (IOUs are bad, right? So having IOUs must be bad, right?)
Hey, dumbass, it's you who have the problem, they're the people fucking bailing you out. The government has borrowed 2.7 trillion dollars from social security.
You get rid of social security, (even if we _don't_ pay it back, aka, we steal the 2.7 trillion dollars we've already borrowed, aka we default on US government securities), and in the future the rest of the budget is in a lot more trouble and has to borrow more, resulting in more interest. We borrowed $805 billion in 2011, so basically you're saying 'I wish we had to pay interest on an extra $805 billion each year!'.
And having stole 2.7 trillion dollars from our security holders (Even if said holders were ourselves), I can only imagine at what interest rate we'd have to offer on those added bonds. And our existing ones.
TL;DR: Conservatives think a place the government can, and has, borrowed money without interest (Instead of issuing bonds which do cost interest), is somehow causing the budget issues, and the fact that it has so much money is obvious proof that it is bankrupt.
(Medicare, OTOH, hovers on the line of taking in too much and too little, but is not separated out like social security and doesn't have a trust fund, so extra money just disappears into the general budget, and comes out another year, so it's harder to see that it's revenue neutral in general. People gasp and point out that it costs X billion dollars one year, and don't notice it made X billion dollars another. Right now, in a recession, yes, it's costing us.)
If corporations are people, aren't stockholders guilty of slavery?
The US fails, because it has a HUGE middle man bureaucracy that skims 20% off the top called Insurance. IF I got my "benefits" as salary, I could be much more efficient in my health care dollars than Insurance.
Case in point, I can get my meds via Insurance for $25 (co-pay) or I can go to Walmart and get them for $12 (which I do). I have insurance, but it is more expensive to use than paying cash. That is not efficient.
My daughter just spent 4 hours in Emergency, the Insurance paid (after discounts) 16,000. Four grand per hour?
Agent K: A *person* is smart. People are dumb, stupid, panicky animals, and you know it.