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In Answer To A Question

Posted elsewhere, in response to a question on how America can "fix healthcare."

This really isn't rocket science. Most of the rest of the world has figured it out years ago. The solution, in broad strokes, is:

1) Get everybody to pay into the healthcare system, whether via taxes or private insurance. Actually, taxes are cheaper because private insurance has marketing and profit overheads. But everybody is important, in that you don't want some freeloader rolling into an emergency room, especially for something that could have been managed cheaply had they been able to see a doctor sooner.

1a) Everybody in is also important in that, just like auto insurance or homeowner insurance, those that don't file a claim subsidize those that do.

2) Allow the large payers (in our case Medicare / Medicaid) to negotiate pricing. In every other country, they do so, and get meds and equipment at a fraction of the cost. For example, in Belgium, if you need an artificial hip joint, you get the same one you do in the US (both made in a factory in Indiana) but the Belgium one cost $800 and the US one costs $20,000.

3) Pay doctors on performance, not activity. Right now, my doc has every financial incentive to order every test I'll take. Penalize hospitals for things like hospital-based infections. Again, the financial incentive of a hospital is to keep you in. These changes will force the health-care system to get more efficient.

Most of the rest of the world accomplishes this by having a government paid-for (Canada) or government-ran (UK) system that relies on private insurance for supplementary things, like private rooms or other upgrades. In fact, in Canada, they call it Medicare and it works like US medicare except you buy in at birth. I'll say it because somebody will comment on it, but even when Canada has to ship somebody to the US (which they do, at government cost, because it's cheaper than having Canadian specialists) they deliver quality health care at a fraction of the cost.

This entry was originally posted at http://chris-gerrib.dreamwidth.org/676932.html. Please comment there using OpenID.

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This is the personal blog of Chris Gerrib, and all opinions expressed here are solely his own. Commenters are welcome; however please be polite to me and my other readers. I reserve the right to delete comments that are rude, inappropriate or otherwise objectionable at my sole discretion. The opinions expressed in a comment are not necessarily mine, and if I do not delete a comment that should not be construed as my agreement with the commenter.

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