Blogging on health care

Belated kudos to the superb series by Ezra Klein comparing the health care systems in various other countries, including Canada, Britain, France, Germany and Japan.
Klein’s serices brings clarity to a subject that is usually treated with a mix of ideology, and mind-numbing, detail-encrusted jargon.
The analysis shows that the US is getting a bad deal with our current health care system. The US spends more than $5,000 per person on health care, despite not covering 43 million citizens. Japan covers all of its citizens for $2,000 per person. Germany covers 90% of citizens through its public program for $2,817 per person. Canada covers all of its citizens for administrative costs that are 1/3 of the US costs per capita. The higher costs in the US don’t buy better health. The US comes out worse in measures of preventable premature death.
The systems are structured differently: France has three programs for different occupational groups. Japan has three programs for big business, small businesses, and the retired or self-employed. The programs in Britain and Canada are separate from employment. They also treat private insurance differently. Britain, France, and Germany allow supplementary private insurance, while Canada prohibits it.
They differ in the level of choice: Britain and Canada use a gatekeeper system, where a patient needs to first go to a general practitioner and get a recommendation to a specialist. Japan does not limit hospital or physician choice, and in most cases does require a gatekeeper. Neither does France, although they are moving to a primary doctor system.
The ill-fated Clinton plan was based on the German system. German health care is funded through employer contributions, with half the money coming from the employeer and half from the employee. Germany has different “sickness funds”, specializing by region and occupation, which compete for members. Germany spends $2,817 on health care for its citizens compared to $5,267 for the US.
When the Clinton plan was up for debate, I looked unsucessfully for a clear explanation of how health care systems worked. Ezra Klein has done an amazing job showing the structure of health care systems. And he links to his primary sources, so the diligent can check the facts.
If you want to grok health care in a few short posts, check out Health of Nations.

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