Before reading the book The Healing of America by T. R. Reid, I was completely uneducated and unaware of the health care systems that other countries use all over the world. I had never really taken into consideration the millions of people in who have little or no health insurance at all and how much it effective them. Every country in the world devises its own set of arrangements for meeting the three basic goals of a health care system. These include keeping people healthy, treating the sick and protecting families against financial ruin from medical bills.
There are four main models of health care systems that Reid describes in the book that include, the Bismarck model, Beveridge model, National Health Insurance model and the Out-of-Pocket model. These models define and reflect each nation’s health care system throughout the world. It is fairly simple for Americans to understand these basic models because the United States has elements from each of them in our own health care system. The Bismark model is found in countries such as Germany, Japan, France, Belgium, Switzerland and somewhat in Latin America. This system dates back from the nineteenth century.
The Prussian Chancellor Otto von Bismarck invented this welfare state as part of the unification of Germany. In these countries, both health care payers and providers are private entities. This model insures everybody and does not make a profit. Instead, doctor’s offices and many hospitals are privately owned and operated. The insurers are called “sickness funds” which are usually financed jointly by employers and employees through payroll deduction. This tight regulation gives government much of the cost-control clout that the single-payer Beveridge Model provides.
The Beveridge model which muscled into existence over sixty years ago is still used today in countries including, Great Britain, Italy, Spain and most of Scandinavia. Lord Willaim Beveridge was an aristocratic social reformer who inspired Britain’s National Health Service. This arrangement gives universal coverage to everyone with no bills involved. The proposition is that they believe nobody should ever have to pay a medical bill. There is no insurance premium to pay, no co-payment with virtually no fee at all.
Whether one suffers from a mild cold or one receives a quadruple bypass from the nation’s top cardiac surgeon, there are still no fees involved. The doctor’s bills of every single person are paid by the government. People go literally their entire lives without ever having to pay a single doctor or hospital bill. Although this might sound like the perfect plan, in reality, people of this country are still paying these fees, for they pay through a series of network taxes that would essentially make Americans cringe. The sales tax in the United Kingdom runs from 15 to 17. 5 percent.
The citizens do not only have to pay a high sales tax, but also pay by waiting in lines for care. Reid mentions in the book how he sometimes would have to wait weeks to see specialists for specific injuries. My roommate’s father lived in Britain for 2 years and used this health care system. He suffered from major knee problems and was put on a waiting list for 6 whole months before he could receive the surgery he needed. Since I have had several surgeries here in the United States, I know that when the final decision of surgery is needed, it is very important to fix the problem before further complications can persist.
I would certainly not want to be in circuiting pain for 6 months until I could get the service I very much needed. Although there are still other private health insurance plans in the United Kingdom, most do not bother with them, for nine out of ten people use Britain’s National Health Care Services. This single national system provides minimal paperwork and no billing which has proven to be an unusually cost-efficient way of providing quality care to everybody. In chapter 7, Reid states that this particular system cares for “roughly one-fifth of the population of the United States but spends only one-fifteenth of the U.
S. health care bill. ” Yet the results are still favorable. Britain has lower child mortality, longer healthy life spans and better recovery rates from most major diseases than those in the United States. The next model Reid discusses is the National Health Insurance Model (NHI). This system uses elements of both the Bismark and Beveridge models. The NHI uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into. Since there’s no need for arketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style for-profit insurance. The countries of Canada, Taiwan and South Korea use this model. Some Provinces in Canada pay 100 percent of every doctor and hospital bill while patients are required to make a co-payment or pay a deductable before the government insurance takes effect, much like the United States. Most Canadians though do not pay any type of fee for health visits.
The problem persists that if one’s illness does not require immediate treatment; plan to be waiting a while before you can be seen. The waiting periods vary province to province and of course the treatment that you are waiting for. Mental health care is also commonly part of the package, but normal dental care is not covered, but dental surgery performed in a hospital is free. Most Canadians deal with waiting lists because statistics suggest that those who need care urgently can get it and those whose problems can wait, will wait.
Although most medical costs in Canada are covered by the governmental health insurance plan, most Canadians also have private health insurance. This private health insurance provider pays the tab for things that aren’t covered by the free health care system. This includes the coverage of prescription drugs, dental care, private hospital rooms, childbirth classes and so on. This helps people in most provinces of Canada since without a private insurer one has to pay for their drugs solely on their own, but Medicare picks up the drug bill for the poor, the elderly and people with chronic illness that need constant medication.
Canadians are also required to pay out of pocket for “lifestyle” drugs such as Viagra, botox, or other medications that are not a necessity. It is illegal for patients, or insurance plans, to pay privately for any medical service covered by the Medicare system. This avoids the threat of private health insurance businesses that could potentially turn more and more people to use private insurance instead of the provided Medicare. The last model described in the book is the Out of Pocket model. Reid describes this system, or nonsystem to be brutally simple to understand.
This model is used in many poor developing nations including much of Africa, South Africa, South Asia and India. Since there is little or no government money to pay for health care and there is no health insurance, only the rich, the military and sometimes other government employees get medical care. As for everybody else, they stay sick or even perish. In most African countries the bulk of public spending on health care whether foreign or domestic is aimed almost entirely at the lethal epidemic of HIV-AIDS.
This causes insufficient funds left over to pay for treatment of all other diseases and accidents. Thus people have to pay for treatment themselves. In countries where hundreds of millions of people live in rural areas, a simple necessity such as water can be difficult to encounter. If people cannot even accommodate for water it is almost non realistic to think that these people can pay for a medical bill. It is very normal for these people to go their whole lives without ever seeing a doctor or receiving any type of medical attention.
Most of these nations use traditional approached used by their ancestors, such as a local healer who might use herbal or spiritual techniques to cure someone. Patients usually pay by other services instead of currency that can include whatever he or she has of values. This can include crops, pottery, dairy products or even babysitting services. These medical implications unfortunately are the cause of millions of deaths per year. In 2002, the life expectancy at birth in Mozanbique was an estimated thirty-two years and in Zambia thirty five years.
This means I would have already lived over half of my life which is quite sorrowful to imagine. The United States does not follow any of these models entirely, for we are the only country that separates its health care systems by separate classes of people and relies very heavily on the profit of private insurance plans to pay the bills. Reid describes the elements of each model, as for different people are covered in different ways. For most people under the age of sixty-five the U. S. is much like the Bismark model, as the worker and the employer share the premiums for a health insurance policy.
For Native Americans, military personnel and veterans, the U. S. follows the Biveridge model, where these certain Americans never get a medical bill. For those over the age of sixty-five, U. S Medicare is much like the National Health Insurance scheme because of the low administrative costs that characterizes it. As for the rest of the 45 million Americans who are uninsured, the U. S. is much like that of the Out of Pocket model. These people have access to medical care if they can pay the bill out of pocket at the time of treatment, or if they are sick enough to be admitted to a hospital.
There is much debate on which health care system is essentially the “best in the world,” but it is not at all a simple thing to prove. There are many different studies that all produce different rankings which make the comparison of the different health care models used in different countries difficult to compare. Some countries excel in some areas and do less well in others. This makes comparing data difficult, as much of the data becomes a matter of opinion on which system is considered “better” because of the importance it relates to you.