This is another piece that takes a bite out of the ideas of writer Atul Gawande. One thing we haven’t looked at are the diverse systems that can be found internationally that seem to work. The British system uses a purely governmental-run healthcare system called the National Health System.
The interesting part is a lot of these systems seem to work, and a very fair question is – can these systems work in the
Again, just like last time with the Two Towns posting, this will be a slight summary of Dr. Gawande’s main points, so I highly encourage you to read the source article to help formulate your own opinion.
Back in the 1940s, the British system consisted of a variety of hospitals and health insurance systems.
The French system developed in a different way. Before the war, large manufacturers and unions had organized insurance cooperatives through a payroll tax. By the time
The other example that Dr. Gawande presents is the Swedish system. Because they chose to be neutral, it was not ravaged by the war the way the rest of
I know this concept doesn’t make a whole lot of intellectual sense. If a system is bad to begin with, why don’t we scrap it and go with something else that is better? Atul Gawande goes on to describe a few more examples of this “path-dependence” including VHS vs. beta-max (a superior technology to VHS), the telephone system, the gasoline-based transportation network. Sometimes nations are too far down one path to turn it around, and any such upheaval of the existing system can pose serious risks (like Mao’s Great Leap Forward).
Our country is built on a patch-work of 1) the employer-paid piece, 2) the government-paid piece for seniors (Medicare), 3) government-run piece for veterans (Veterans Administration), and 4) the federal/state government-paid piece for the poor (Medicaid). Any realistic/pragmatic expansion would build on these already-existing programs. Indeed, just earlier this morning, the Senate is pushing a package through that will expand Medicaid and establish a new health insurance exchange that will help solve the broken individual market. They are building on what already exists; not by intellectual choice, but by practical necessity.