The American health care system is the best in the world, although patients and providers alike bitterly complain about the increasing rigmarole involved in receiving adequate care and compensation. Everyone agrees: Something must be done.
But what? Several presidential candidates are trying to convince voters that a government-run, universal health care system is needed. But this solution requires the electorate to believe that the government can and will fix what it helped to break.
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The pitfalls of centralized control are obvious north of the border.
The Canadian government is working on a National Wait Times Strategy in five priority areas — diagnostic testing, cancer treatment, cardiac treatment, joint replacements and cataract surgery — because sick people are being forced to wait for treatment — four and a half months on average.
Two years ago, Canada’s Supreme Court struck down a Quebec law that prohibited Canadians from buying private insurance for procedures covered under the public system, archly noting that “access to a waiting list is not access to health care.”
So policy-makers’ attention has turned to other models. Earlier this month, Health and Human Services Secretary Michael Leavitt visited Switzerland and the Netherlands, two countries that have adopted a hybrid approach that requires universal insurance coverage, but within a privately run health care system.
Sixty percent of Americans are covered under employer-selected plans because health benefits were one of the few ways to circumvent government-imposed wage and price controls during the 1940s. But Swiss and Dutch workers are required to buy their own insurance.
The Swiss mostly pay for it themselves; a higher percentage of the Dutch get government subsidies. In both cases, however, individuals select policies that best meet their needs from among hundreds of competing plans — the antithesis of central planning.
President Bush’s version would extend the same tax incentives that employers now receive to individuals who purchase their own insurance coverage, augmented by private medical savings accounts. That would force insurers to offer more individualized and consumer-friendly plans.
Harvard business professor Regina Herzlinger says competitive, consumer-driven health care coverage also costs about a third less than what Americans typically pay, even though government meddling in Switzerland (where government dictates prices for medical procedures) and the Netherlands (where it sets premiums) still cause medical market distortions.
Even so, it’s much better than hoping you’re still alive when the bureaucrats finally get around to scheduling your bypass surgery.
