"If it ain't broke, don't fix it." Really?

"If it ain't broke, don't fix it." Really? Jason Chen yadayada@gmail.com Both Israel and Taiwan passed the legislation to implement universal health care in the mid 90’s. At the time Israel started universal coverage; it already had 90% of the population insured. But when Taiwan started, only 57% were insured. Taiwan did not have the powerful health insurance industry. It adopted a single payer (government) system. Israel adopted a system that is hybrid of public and private system. 15 years later, let’s see how they compare to the US in terms of quality of health care and cost containment. The following charts are infant mortality rate in 1000th from 2000 to 2008. The red line represents the US, the blue is for Taiwan, and the green is for Israel. In all three countries, the infant mortality rate decreases over this period. But the US started out with the lowest infant mortality rate became the highest among the three by the end of the period. Both Israel and Taiwan decreased at a faster rate than the US. (Source of data http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate) <img src="http://www.freeimagehosting.net/uploads/3f9bc3fb44.gif" height="289" alt="" width="482" /> <img src="http://www.freeimagehosting.net/uploads/4f8a9d2789.gif" height="289" alt="" width="482" /> In terms of life expectancy, the ranking has not changed in the 9-year period: led by Israel, followed by the US and Taiwan. But upon closer look, you should be able to see that both Israel and Taiwan improve faster than the US. The lead Israel over the US is increasing and the gap between Taiwan and the US is reducing. <img src="http://www.freeimagehosting.net/uploads/6eaae5b6b3.gif" height="289" alt=" " width="482" /> <img src="http://www.freeimagehosting.net/uploads/f264eb80f3.gif" height="289" alt="" width="482" /> Yet, the US not only has the highest health care expenses in terms percent of its GDP at 15.2% by 2005, it has been steadily increasing from 13% in 1999. While Israel maintained the rate around 8% and Taiwan maintains a level between 6% and 6.3%. This is a very amazing number considering only 57% of the population was insured at the beginning of the universal health insurance policy. <a href="http://content.healthaffairs.org/cgi/content/full/22/3/77">This article</a> provides some interesting analysis of Taiwan’s success as well as the problem with the government managed single payer system. However you dice it, the American people are paying the highest cost for health care (directly to the health care industry or indirectly through tax) and get back the least value in terms of quantifiable results among all the industrialized counties. In fact, the US is only on par with Cuba in terms of infant mortality and life expectancy per latest data. Worse yet, the American health care cost is a runaway train and more and more people will be dropped out the system. The longer we wait, the deeper the hole we are in and the more people will be exposed. There is no system that is perfect. You can always pick an issue from any system and argue against the system if the purpose is to defeat any change. For 85%+ of the Americans who currently have health coverage either under the employer benefits or government plans, you may feel that the status quo appears OK, at least for the short term. But if you look at macro perspective and historical perspective, you should see that the so call "status quo" is not really "status quo." The cost continues to rise and coverage continues to shrink. If nothing is done, the health care will consume 20% of our GDP by 2017, and Medicare will go broke even before that. Therefore, there are really two priorities in the health care reform: universal coverage and cost management. By now, you probably heard about the health care bill from Sen. Baucus. If you want to find out all the detail, there is the <a href="http://www.docstoc.com/docs/11382446/Baucus-Health-Care-Bill---Full-Text">link</a> for the 220 pages text. One central element in the Baucus bill is the idea of health care Co-Ops. Given where Sen. Baucus comes from, it is not a stretch to figure out how this idea was inspired. But this is probably the dumbest idea in the whole bill. Unlike establishing a farmer’s market co-op, a health care co-op would required a lot of work before its operations to recruit service providers in terms of doctors, hospitals, test labs, pharmaceutical companies, and many equipment and devices suppliers. This requires very specific knowledge and will cost a lot of money for consultants. It is likely that all 50 states will need to go through the same thing. They will also need to set up an operations organization to process claims and reimburse provider. Where are you going to find the executive offers and experienced works to get it off the ground? By the way, that is for 50 states too. If Sen. Baucus gets his way, we will not see universal health care for the next 10 years because the co-op will become a project like IRS information system upgrade: a financial black hole and eternal delay. The alternative way is to outsource all operations to a company with operational experience, such as an, cough cough, insurance company. If that is the way to go, why not bypass the whole co-op thing and contract an insurance company to begin with? Although they will charge you a lot, at least they know what they are doing. Finally, here is the touchy part. What about the "public option?" (to be continued) public true 0.00 0 Betsy Markey false CO-04 markey 4800.00 242393.87 3671 http://markeyforcongress.com/ https://secure.actblue.com/contribute/entity/18134 0.00 0