Wednesday, May 06, 2009

What are other Countries doing about Health Care?

I've been slowly but surely immersing myself in the current debate over healthcare reform in this country. It's is believed that this is the year that a serious step is going to be taken towards this end, that being of providing adequate healthcare for everyone in society regardless of their ability to pay. Obama and the recently elected Democratic majority are seen by some pundits as getting ready to muster the political will accomplish that very goal before the end of 2009. Will it be enough?

Some are not conviced that it will be enough. Too little support has been given to bringing Single Payer Health Insurace
, the system currently used by Canada, to be implemented in the United States. People of this group note that President Obama took Single-Payer Health Insurance off the table in the 2008 campaign. Recently he met with leaders of the health insurance industry, but denied an opening for single-payer advocates to speak. He has done nothing to push forward H.R. 676, the current bill before the house which would bring Single Payer to the U.S.

One individual who I was debating this topic with on the Sojourners blog asked me the following: "How can you guarantee health care for everyone? Political
will cannot defy the laws of supply/demand and the reality of scarcity." To respond, I have to explain that personally, I believe that leaving everything to those laws is a basic evil that we need to cure. I agree with James Galbraith, who says we should work on a "Planned Economy." If I understand him correctly, then applying this to healthcare means we would simply "plan" for there to be healthcare for all. So we would provide health insurance for everyone though the single payer method, and move to build more medical facilities and educate more medical personnel through planning.

Check out this video in support of the Single Payer System
by Portland, OR talk show host Tom Hartman:

Think market-based solutions are the way to go? Check out this .pdf file on how Japan got ahead in the auto-indsutry through marekt controls. For heady economics buffs only:

But to get away from debates, I thought it might be a bit enlightening and refreshing to see what other places in the world are doing for their citizens as far as the health care system goes. I'm tired of talking about Canada, Sweden, Denmark & The U.K. Although I believe all those nations have good healthcare systems in place, and that much of the criticism comes from one-sided reporting intended to confuse the debate rather than enlighten it. But maybe they have been overdone? I chose 4 nations who have been recently mentioned in the news over the past couple of years and model economies for one reason or another, and simply Googled up something pertinent to how they provide care for their citizens. I skipped China because what I found out is that they are growing and changing way too fast to really even have a health care system in place. I picked 4 countries that have been mentioned din the news at one time or another for something positive we should be looking into. As an example, The Netherlands was cited as a model for building bulwarks against the threat of hurricanes.

I find it amazing that government controls or provision of such care is characterized as dangerous an inadequate, and yet almost every industrialized nation in the world seems to have implemented some form of it or another. And they have a public health insurance system, which is similar to what Single Payer is about (except that in Single Payer Health Insurance, only public insurance is allowed for basic care.)

Here's some of the results of what I did find:


On January 1, 1995, the National Health Insurance Law went into effect. The law sets forth the state's responsibility to provide health services for all residents of the country (not including tourists.) The law stipulates that a standardized
basket of medical services, including hospitalization, will continue to be supplied by the sick funds. Sources for funding of health costs include progressive health insurance premiums paid by each resident, employers' health tax payments, National Insurance Institute funds, funds from the Ministry of Health budget and consumer participation payments. The insurance premiums are collected by the National Insurance Institute.

The law provides that:

*Every resident must register as a member with one of the four sick funds.

*The sick funds may not bar applicants on any grounds, including age and state of health.

*Equal status is accorded to all four sick funds.


In the Japanese health care system, healthcare services, including free screening examinations for particular diseases, prenatal care, and infectious disease control, are provided by national and local governments. Payment for personal medical services is offered through a universal health care insurance system that provides relative equality of access, with fees set by a government
committee. People without insurance through employers can participate in a national health insurance program administered by local governments. Since 1973, all elderly persons have been covered by government-sponsored insurance. Patients are free to select physicians or facilities of their choice.


The Brazilian health system is composed of a large public, government managed system, the SUS (Sistema Único de Saúde) , which serves the majority of the population, and a private sector, managed by health insurance funds and private entrepreneurs.

The public health system, SUS, was established in 1988 by the Brazilian Constitution, and sits on 3 basic principles of universality, comprehensiveness and equity. Universality states that all citizens must have access to health care services, without any form of discrimination, regarding skin color, income, social status, gender or any other variable.

The Netherlands

“Long-term treatments, especially those which involve (semi-)permanent hospitalization, and also disability costs such as wheelchairs, are covered by a a state-run mandatory insurance. This is laid down in the Algemene Wet Bijzondere Ziektekosten (AWBZ, see article in the Dutch Wikipedia), "general law on exceptional healthcare costs" which first came into effect in 1968.

For all regular (short-term) medical treatment, there is a system of obligatory health insurance, with private health insurance companies. These insurance companies are obliged to provide a package with a defined set of insured treatments .

“This system came into effect in January 2006. For those who would otherwise have insufficient income, an extra government allowance is paid to make sure everyone can pay for their health care insurance. People are free to purchase additional packages from the insurance companies to cover additional treatments such as dental procedures and physiotherapy. These additional packages are optional.

“A key feature of the Dutch system is that premiums are set at a flat rate for all purchasers regardless of health status or age. Risk variances between funds due to the different risks presented by individual policy holders are compensated through risk equalization and a common risk pool which makes it more attractive for insurers to attract risky clients. Funding for all short term health care is 50% from employers, and 45 percent from the insured person and 5% by the government. Children until age 18 are covered for free. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are about 100 € per month (about US$145 in Jan 2008) with variation of about 5% between the various competing insurers.”


Still not convinced? Check out this data from Business Week magazine, which shows the US as last in healthcare when compared with 6 other nations:

Why do we have such a problem realizing we need serious change?

Where to find info on the campaign for Single-Payer:

Definition of Single-Payer:

Physicians for a National Health Program:

Rep. John Conyers' website:


SIngle Payer Action:

Citizens Alliance For Antional Health Insurace:

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