Every so often, a visitor from afar (usually from Canada or Great Britain) will comment on the plight of the American health care system and the advantages of their “nationalized” health service. Yes, we certainly have our share of troubles here in the US. And if the current news is any indication, the upcoming election is shaping up to bring more uncertainties for the medical profession – regardless of which political party we are talking about.
A recent blog on ZDNet mentions a survey of Dutch citizens who are generally happy with their form of health care, which is primarily a government-sponsored system with some private carriers (similar to the system implemented in Massachusetts). All people are required to carry insurance, in some cases with government subsidies, relieving employers of the burden of insuring their employees. This is paid in large part by higher taxes, which are skewed more towards the wealthier citizens (read owners of same businesses).
The term “socialized medicine” has a relatively negative connotation among physicians here, although many experts will note that Medicare is just that – and in most cases, it is the best-paying insurance carrier. Some doctors are dropping managed care plans altogether and accepting only Medicare. They find that the initial drop in revenue is followed by increased profitability (less staff needed for pre-authorization) and decreased stress levels.
Meanwhile, the total U.S. expenditure on health care last year was $2.3 trillion. By the way, about 1/1000 of that goes to pay the salaries of the top ten insurance carriers’ CEOs – yes, ten individuals (from the 2007 New York State Ophthalmological Society Meeting).
How long can the system continue on its present course? As we see the government trying to parse out coverage to middleman entities (Medicare advantage plans, etc), who probably are going to “save” money by squeezing physicians, it gives us cause for being wary. On the flip side, we need only look across the Atlantic to see what true socialized medicine can become.