Tuesday, April 15, 2008

Healthcare-Around the World.

I saw this really interesting documentary on PBS on how some of the richest nations in the world handle healthcare for their citizens. And it wasn't surprising that the US ranked the last among them in terms of cost, service and efficiency.
These are some of the points that I gathered from the documentary. If I had enough time, I would have probably organized it a little better.

Looking at the countries that were covered in the program: Great Britain, Japan, Germany, Taiwan and Switzerland, this was the common traits that the healthcare system all possesed:
1) Insurance Companies have to accept everyone and they cannot make profit from basic services.
2) Everyone needs to buy insurance, either through their employee or through the government and the unemployed get free insurance.
3) All the Doctors and hospital have fixed prices for everything, 1 hospital can't charge a different amount for the same procedure compared to other hospitals.
4) Nobody goes bankrupt from paying their hospital bills compared to about 700,000 people in the US.
5) There are no gatekeepers, which means you don't have to see your GP(general practitioner) before you can see your cardiologist or gastroentrologist.
6) The downside, well if you can call that, is doctors and hospitals don't make much money as compared to the US.
7) The insurance providers strived to keep their operating costs down, for all the countries it was in the low single digits whereas in the US, it is around 22 %.
8) The proportion of GDP follows the same script as well, it was in the single digit for all these countries whereas in the US it was almost double at 16%.

Now the features of the healthcare systems in each of this countries:-

1) Great Britain- You get no bill from the doctor/hospital. Everything is covered by taxes. They focus more on preventive medicines since there's no ulterior motive to make money from you when you are sick.

2)Japan- The government sets the prices of all the treatments thus maintaining control over the healthcare costs. Everyone is covered by insurance, either by work insurance or community insurance. They have the longest life expectancy and the lowest infant mortality rate.

3) Germany :- Everyone is offered healthcare and while the 90% of the population choose the national system, the rich get to opt out and can pay their bills on their own. The insurance pays for everything even for spas and ballet dancing :)
The waiting time to see a doctor or getting a procedure done is faster than Britain but slower than Japan. Pregnant women pay nothing and copay is about 10 euros every 3 months. Medical providers and sickness funds negotiate to keep the prices down. Drugs are cheap since they negotiate as a single entity thus reducing the scope of negotiations.

4) Taiwan:- They turned out to be the smartest of the whole bunch and compared the healthcare policies of all the good systems and took the best policies out of each. Every citizen has a smart card which contains all the health records(If you visit more than 15 times, you are audited) and all the medical bill goes to the national insurer.

5) Switzerland:- They had a system very similar to the US but in 1994 they held a referendum to change their system which passed by a wafer-thin majority.(lucky them!!).The insurance providers cannot pick and choose on whom they provide insurance to. The providers make their profits by trying to keep their operating costs down and trying to attract new customers.

I am going to end this by quoting what one of my friend told me the first time I was in the US and when I was planning to visit a Doctor for a slight fever, which is sad but true. "Don't go to the doctor or the hospital unless you really feel if you are going to die'.