Korean Job Discussion Forums

[Big_Bird]

Anyone feeling cynical about the place of 'market forces' in public health care...?

This great free-market experiment is more like a corporate welfare scheme

[thepeel]

I don't see how the "free-market" has anything to do with this. My reading of the article, and I have no knowledge of this issue beyond this article, is that this is a solidly neo-corporatist situation that was very poorly implemented.

I'm also not sure what "neo-liberal" is, but a market solution would not involve the government in the way, and to the extent, that does this situation.

The author does expose his misunderstanding of economics in this sentence:

[ontheway]

The biggest problem in the example above is that the government was the owner of the hospitals that needed renovating. It is up to the owner to provide the equity for expansion or renovation. The owner can attract investors as partners, sell stock or borrow money.

The NHS was the owner, but acted like a welfare queen. They didn't act like a responsible owner who looks after his investment, his business and seeks to improve it rationally. The NHS said, "Please, someone come and bail me out." That is always expensive.

The free market solution would be to abolish the NHS. This would have led to the provision of the best health care at the lowest possible price. An owner would find a way to renovate his hospital(s), unless it was more efficient (lower cost coupled with a better quality of service) to replace them.

The reason socialists are socialists is that they haven't got a clue about math, accounting, engineering, physical science, psychology, ecology, the environment, finance, nor the science of liberty.

[mack4289]

France is reputed to have the best health care in the world. They have a large private insurance sector and no physician is compelled to be a part of the government system. At the same time, the government provides free medical schooling and keeps their liability costs down. So, unsurprisingly, it's a mix of public and private measures.

http://www.iht.com/articles/2007/08/13/opinion/eddutton.php

"That's because the French share Americans' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." Virtually all physicians in France participate in the nation's public health insurance, S�curit� Sociale.

Their freedoms of diagnosis and therapy are protected in ways that would make their managed-care-controlled U.S. counterparts envious. However, the average American physician earns more than five times the average U.S. wage while the average French physician makes only about two times the average earnings of his or her compatriots. But the lower income of French physicians is allayed by two factors. Practice liability is greatly diminished by a tort-averse legal system, and medical schools, although extremely competitive to enter, are tuition-free. Thus, French physicians enter their careers with little if any debt and pay much lower malpractice insurance premiums.

Nor do France's doctors face the high nonmedical personnel payroll expenses that burden American physicians. S�curit� Sociale has created a standardized and speedy system for physician billing and patient reimbursement using electronic funds.

It's not uncommon to visit a French medical office and see no nonmedical personnel. What a concept: no back office army of billing specialists who do daily battle with insurers' arcane and constantly changing rules of payment.

Moreover, in contrast to Canada and Britain, there are no waiting lists for elective procedures and patients need not seek pre-authorizations. In other words, like in the United States, "rationing" is not a word that leaves the lips of hopeful politicians. How might the French case inform the U.S. debate over health care reform?

National health insurance in France stands upon two grand historical bargains - the first with doctors and a second with insurers.

Doctors only agreed to participate in compulsory health insurance if the law protected a patient's choice of practitioner and guaranteed physicians' control over medical decision-making. Given their current frustrations, America's doctors might finally be convinced to throw their support behind universal health insurance if it protected their professional judgment and created a sane system of billing and reimbursement.

French legislators also overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new health care funds. Private health insurers are also central to the system as supplemental insurers who cover patient expenses that are not paid for by S�curit� Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market."