HEALTH INSURANCE & HERE WE GO AGAIN...

HERE'S TO OUR HEALTH and, hopefully, our wealth as well. This is mainly directed to US readers of this blog; the rest of you can look on and jump in with comments if you wish.

Health Insurance is back in the Senate and everybody seems to agree that something has to be done to broaden coverage and reduce the cost of health care. This is something in which we all hold a vital interest so be sure you are all boned up and tuned in. I won't bore you with facts that you probably already have thrust at you and have mulled over many times. However, one might think it a curious matter indeed that the US, the richest country in the world, as we say, allocates double the percentage (17%) of Gross National Product (GDP) as do countries with universal health insurance and yet still manages to have 47 million of population uninsured.

Seeing Michael Moore's film, 'Sicko', has a few surprises and is good back grounding. Much easier to access are the PBS FRONTLINE documentaries, Sick Around the World and Sick in America. These are readily available online (just right click on the titles to open the relevant Websites). The first reviews health insurance and health care in five capitalist countries (The United Kingdom, Japan, France, Taiwan, and Germany) and gives some idea of the variations that are possible based on the model invented by Bismark in Germany in late 19th Century.

If you want to read up on the issues, try 'Social Security, the Phony Crisis' (by Dean Baker and Mark Weisbrot); these two economists are relatively easy to read and lay out the issues relating to 'saving' Medicare and Social Security Insurance really well.. They are also a good introduction to how economists think about these things. This was published in 1998 but issues have not changed significantly between then and now, putting aside the rapid increase in health care costs since then.

On a personal note, when I came to the US from Australia in 1995, I stepped out of having health insurance as a right into having none at all. I was self-employed for six months, living in Arizona, and could not afford health insurance. It was a more than a tad scary, to tell the truth, especially as I came down with a severe respiratory infection and avoided seeing a doctor on account of cost. How different from Australia where I could walk into any doctor's (or doctors') office with my little green Medicare card and be seen within the day, more often than not, within the hour.

This is not a time to be fooled by such slogans as 'socialized' medicine. With the exception of the UK system, in the capitalist counties touched on in these documentaries (plus Canada, Australia and New Zealand), all practitioners operate on a fee-for-service basis. The government does not tell them how to practice health care, as US health care insurers seem to be coming increasingly close to doing. Not insignificantly, no one is ever driven into bankruptcy by health care bills.

In health programs that follow Bismark's model, all persons are covered for health care and all covered persons have to purchase cover. A simple way of looking at this is to take the total cost of health care and divide this by the total number of purchasers to get the premium cost which, as it eventuates, is not a horrifying amount.

Apart from the obvious advantages of universal care, this spreads the risk of health care vertically over all ages and horizontally over all disorders providing the opportunity of the collection of broad data to give a picture of the total health task. In turn, this enables a progressive shift away from treating disorders when they get serious to a focus on how they can be prevented or made of less effect in the long term.Information from the broad health practice over the entire population can indicate which are the most effective treatments ('best practice"). However, this not different from from undergoing professional education and training, or later professional training courses. While this is a hope of health care planning, the general concern in most advanced health care systems is to free up practitioners to good practice while focusing on fraud and questionable or excessively costly practices.

Universal health systems are developing ways of limiting the cost of health care without compromising the health of their populations or imposing financial stress. You can find out about this in the documentaries mentioned above. Also, as in Taiwan, it is very possible to provide electronic health care histories on the entitlement card (a smart card). Is it possible to provide adequate health care for all at about 8% of GDP? Actually...Yes!

How likely is it that the US will go all the way to universal health care this time around? Not very...unless ordinary citizens take up the call for urgent and extensive change. Who, currently, gets the most benefit from the US health set up? For the answer, one would have to look at who has the strongest lobbies in Washington and that would be likely to be the health insurers and the drug companies. These provide huge sums toward politicians' 'soft money', so essential for successful electioneering here in the US. Nothing is more coveted by politicians than re-election which is why, up till now, they have the health system all should have and do not.

What are your concerns about health cover and health insurance? I'll see if I can point to answers.