Myth 23. Private insurance and self-payment are relics of an oppressive past, confined to the United States and backwater, poorly developed nations.
Sunday, October 11, 2009 at 11:08PM We constantly hear that the United States is the only nation in the “developed,” or “industrialized” world (we no longer say “civilized” world or “free” world) that doesn’t have taxpayer-funded medical care for all.
It is therefore past time for the U.S. to relinquish the traditional idea that “the voluntary way is the American way” and join the “progressive” march to coercive, state-funded and state-directed medicine—as instituted by Chancellor Otto von Bismarck in Germany in 1884. These days, the state-owned variant, adopted by Britain in 1948 based on a model developed by Lenin in 1911, is considered “politically unfeasible” in America.
We need to give up our own perception of having the best medical care the world has ever known (in the eyes of individual American citizens and foreign visitors) and aspire to move from the 37th position closer to the 1st position held by France in 2000 (in the eyes of the World Health Organization, which prefers equal misery to unequal blessings)—or so say advocates of “reform.”
Meanwhile, countries outside the U.S. are moving away from failing single-payer systems. “Health insurers worldwide added over 100 million covered lives in 2008 in one of the strongest markets since health insurance was invented in 1880s, according to official government statistics” (HealthPlanWire 8/24/09). The number is projected to exceed 1 billion by 2012.
Single-payer systems are declining because they are based in countries with static or declining populations—many of which are also adopting market-based reforms. Private insurance is growing rapidly in countries with the fastest growing populations. Building a health financing system for the first time, countries on five continents are choosing the private way. Examples include China, South Africa, Mexico, India, Australia, and most of eastern Europe. But in at least 25 of the 125 nations with national health systems, private insurance is growing faster than the government-run system (ibid.).
Democrat-proposed reform plans would restrict out-of-pocket payment for “covered” services—while U.S. patients already have the lowest out-of-pocket costs (OOP) as a percentage of total national health spending of any developed country except France, Luxembourg, the Czech Republic, and Ireland. They are even lower than in Canada. OOP spending in the U.S. represented about 60% of real per-capita spending on medical care in the U.S. in 1960, and dropped to 10% by 2002. This surely has a lot to do with escalating costs. But Democrat reformers would eschew financial incentives to patients in favor of “health information tools” enabling payment denials right in the doctor’s office (Scott Gottlieb, Wall St J 8/15-16/09).
A few facts about private insurance and self payment in nations with national health systems (Gregory Dattilo and Dave Racer, Your Health Matters, Alethos Press; 2006):
- Health Canada pays about $1 billion for services purchased in the U.S. because of a shortage of facilities in the country. It is not known how much Canadians spend abroad beyond this amount.
- In the UK, 13% of its residents own private insurance, enabling them to bypass waiting lists.
- The Japanese face a coinsurance cost of up to 30%, and pay an average of 44% of employer-based premiums. Childbirth, check-ups, vaccines, and prosthetics are not covered. The maximum OOP for a Japanese worker, if copied in the U.S., would expose the average worker to a potential health cost exceeding 50% of his disposable income. Japan relies largely on market forces to restrain expenditures.
- About 85% of French citizens buy private supplemental insurance. Because of escalating costs, the government increased copayments to as much as 30% to 40%.
- Germany is the only [European] country where high-income people, self-employed, and civil servants may opt out of the compulsory social security system and join private health insurance. (See comments by German physicians, with English subtitles, and Myth 20.)
- Per capita spending rates are increasing as fast in most national health systems as in the U.S. Increases between 1990 and 2003 were: U.S., 28%; Germany, 30.5%; France, 17.4%; Canada, 10%; Japan, 33%; and England, 28%.
The French system, held up as the example now that Canada and Britain have lost appeal, is also in trouble. “Citizens must pay more and doctors must alter their behaviour” said a government-commissioned report (BBC News 1/23/04). In 2009, the total cost of the system, from employee and employer combined, is more than half the worker’s wages (Investors Business Daily 8/26/09).
“In France, the supply of doctors is so limited that during an August 2003 heat wave when many doctors were on vacation and hospitals were stretched beyond capacity—15,000 elderly citizens died,” wrote David Gratzer (ibid.).
While upcoming nations are choosing the private, voluntary path, American “reformers” are pushing for a regression to 19th century, consistently failed systems of centrally planned coercion.
Additional information:
- “Financing Free-Market Medicine, presented by Ralph Weber, C.L.U., at AAPS annual meeting 2008.
- “Socialized Medicine,” by Dan Smoot, originally published in The Freeman, April 1960.
Reader Comments (8)
There was a time about 220 years ago, when we were the only country in the "western" world that did not live under a monarchy. We were very proud of that distinction. When I was in school, my mother used to tell me that just because all the other kids were jumping off a cliff that I didn't need to follow them.
MOST PEOPLE DON'T WANT GOVERNMENT RUN HEALTH CARE, PLAIN AND SIMPLE. WE ARE NOT A SOCIALISTIC COUNTRY, AND WHY DOES OBAMA WANT TO TAKE US DOWN THAT ROAD, THE ANSWER IS SIMPLE, HE WANTS POWER AND THIS CONGRESS IS WILLING TO GIVE HIM THAT POWER. WE ALL NEED TO PROTEST THIS ACTION, WRITE YOUR LOCAL STATE AND FEDERAL GOVERNMENT OFFICIALS AND TELL THEM THAT THE TAX PAYERS WON'T STAND FOR THIS BEHAVIOR AND IF THEY DON'T LISTEN, TELL THEM YOU WON'T VOTE THEM BACK INTO OFFICE IN THE NEXT ELECTIONS. AND THEN DO IT.
It is essential for us to let the Obama Pelosi Reid lapdog politians know that if they go along with this plan we will vote them out. Don't rely on others to do this sent them your own e mail so they get the message.
We need to put term limits for all these jerks ASAP.
My wife and I took part in the "912 Project" in Washington as well as the smaller, though no less dedicated, Tea Party in New Lennox in September. The country is being stolen from us through the dishonesty of the legitimized thugs in Washington. The healthcare legislation, the "cap and trade" malarkie and all the other liberal falsehood has nothing to do with anything but control of the hearts and minds of the uninformed American.
If we lose the control of our healthcare, freedom and decision-making is at an end in this great country. Obama is not what he appeared to be to those ignnorant and frustrated voters who put him and the Chicago gangsters in office. Lies can only be obscured for so long and theirs are finally coming to light.
Is it too late? Our destiny and that of the Great Experiment is up for grabs.
I really don't understand why we need to change our insurance. I have private insurance along with Tricare which is government, because my husband is retired military. This works for me.
Obama is trying to get power over the United States. I have contacted my officials in my state and one of them (which is Democrat) knows that she will not have a job if she does not do the right thing. My official is actually not sticking with the Democrats, but more with the Republican side, but I feel she could be easily influenced by Obama's thugs.
I have written my officials several letters and emails. Believe it or not, if you write them a letter and send it through the US mail, they will write you back. However, if you send them an email - they do nothing. This has been my experience in the past.
National Health care will lead to the ruination of American medicine. It will lead to a reduction in the money spent on pharmacologic research; a reduction in the money spent on medical technological research; a reduction in the money spent on improvements in surgical technology, radiological technology , and technological improvements in all medical speciaties. This will lead to a loss of the best and brightest to other professions, people who would have gone into the medical and surgical specialties and into primary care. In other words, the collapse of medical and surgical care in the United States because of a House of Representatives, a Senate, a political party (need I say Democrat) and a president who either do not have the faintest idea what they are about to do, do not care what they are about to do or both!
Knowing both systems the US and the French I can tell you that I prefer the French
Doctors make house calls the same day of the call
Hospitals are state of the art and there is virtually no paperwork or wait
An American friend of mine now living in France was butchered by an othopedic surgeon in the US after a grave accident resulting in double amputation above the knees,
The cost of rehab and prosthesis in the US $ 750.000 with no guarantee of success
In France where he got his prosthesis under $ 100.000 with a guarantee that he would be mobile again and he is as much as one can be in those circumstances
Private insurance can be OK but needs to be strongly regulated as it is in Switzerland where i lived too
The public option is the best way to keep the insurance companies working for the patients and prevent abuses and excesses
In a modern society where we live in close quarters national health needs to be considered as a national asset and not just an other consumer product
If my neighbor has TB and no health care coverage I shall be exposed too
Gagted communities mean nothing to germs and viruses
Again, get your facts straight.
Very, very few countries are actually "single-payer," to the exclusion of private insurance completely.
Most, including Canada, the UK, Australia, Germany, Switzerland, New Zealand, etc. have a mix of private and public operations - but no-one is left out.
A big problem here is "screw you Jack, I'm alright, I've got what I want, the heck with you, go ahead and get bankrupted," and the eternal "Red Scare" argument of "socialism." Straw man at best, red herring at worst.