Here’s some interesting views on healthcare reform, which I think provide a helpful perspective on the current U.S. debate.
The first is from a November 2007 article by Maggie Mahar (hat tip to Matthew Holt at TheHealthcareBlog), which talks about how the Swiss have achieved a workable universal healthcare system involving private insurance.
Writes Mahar: “Swiss patients have relatively little say over either the cost or the quality of the care they receive. Prices are regulated by the government, which also tries to make sure that consumers are getting value for their health care dollars by selecting which drugs, devices and tests insurance will cover. In fact, it is the very visible hand of a smart, largely efficient government that accounts for Switzerland’s relative success.”
She goes onto cite research from Ewe Reinhardt, suggesting that “Because insurers are so strictly regulated, consumers have fewer options. They can’t pick a bargain-basement plan that is less than comprehensive; it doesn’t exist. Cheap plans with a $10,000 deductible per family member also are not available; the government sets a mandated minimum and ceiling for deductibles. And households cannot choose between plans that offer high co-pays or no co-pays.”
The second is from a recent research note by Leerink Swan equity analyst Jason Gurda, which talks about the effects of healthcare reform in The Netherlands in 2006.
Writes Gurda: “The introduction of universal coverage in the Netherlands has been a negative for the health insurance industry thus far. Standardized benefits and the inability to reject applicants left premium pricing as the primary means of insurer competition. A grab for market share led to below cost premium pricing and operating losses for insurers, although consolidation appears to be leading to improvement.
“Under the old system, the Dutch health insurance system consisted primarily of two groups: 1) a socialized health insurance system for people in lower income brackets; and 2) voluntary private health insurance for people with higher incomes.
“Beginning in 2006, all Dutch citizens have been required to buy standardized individual health insurance coverage from a private insurer.
“Individuals can shop for insurance using a government web site which compares health insurers with respect to price, services, consumer satisfaction, supplemental insurance, and available hospitals. Individuals may also pay extra for supplemental insurance for benefits that are not included in the mandatory basic insurance package, such as dental care, physiotherapy, eyeglasses, alternative medicine, and cosmetic surgery.”
In lieu of going single-payer or totally free market, a reformed U.S. system will for now have to cope with striking a precarious balance between the two. And when you come right down it it, that’s really not news.
Subscribe in RSS Reader
