How did the French manage to achieve a system that has the advantages that American love but still gives everyone coverage?
The French legislature realized that they would need the cooperation of 2 groups if they were to get the kind of national health insurance they wanted. First they needed the doctors; second they needed the private insurance companies.
French doctors only agreed to participate in a compulsory health insurance program only if
* A patient's free choice of their doctors was protected by law
* Doctor's maintained control over medical decisions
Next the French legislators overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new healthcare funds. France's comprehensive health insurance provides coverage for all or part of the following healthcare categories:
* Hospitalization
* Non-Hospitalization Benefits
* Prescription Drugs & Medical Equipment
* Medical Evacuation & Repatriation
* Dental & Optical Cover
* Emergency Healthcare is provided to everyone
But the Sécurité Sociale's health insurance plan covers only about 70% of actual medical fees. The balance of the bill is paid for through private insurance called assurance complémentaire.
Private health insurers are central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.
Working with these 2 groups, France developed a program of universal health care that demonstrates that it is possible to achieve universal coverage without a "single-payer" system.
Why isn't Washington looking at the French system as a model? The concepts and the execution would be far easier to implement in the U.S. then moving to a Canadian or British system. The end result would be universal healthcare that would effectively marry the desires of both the public and private sector.
Monday 10 January 2011
Tale of Two Healthcare Systems
With all the hoopla over the healthcare debate in this country I thought it about time I share my experience that was up close and personal. In the summer of 2008 I was enjoying a little relaxation with friends at our cottage on the French River, just south of Sudbury, Ontario, Canada. Now as I share this let me make it clear, we've been going to Canada for five decades and personally I love the place and the people. The healthcare on the other hand, not so much.
One evening one of the ladies visiting made her 'to die for' roast beef dinner and I nearly did. On the second bite mine got stuck in my throat and I was in for a long, painful and at times, downright terrifying night. I began choking about 4PM and it was weird, it would come and go in five minute cycles. I gutted it out for an hour thinking I could dislodge the blockage myself. Then another episode made me think I might check out right there in the north woods. My wife called 911.
The Regional Medical Center was over 80 miles away so it wasn't going to be a quick fix. Inside the ambulance and on the way I had my worst episode of the day. I thought I was a goner, hacking into a little pale while the EMT sat quietly looking at paperwork. The whole time the computer I was hooked to was saying over and over again 'check the patient - check the patient'.
When my episode was over I said to the EMT, "Aren't you going to do something?" He was a nice young fellow who promptly said, "No sir that's why we're taking you to someone who makes a lot more than us to fix you". It was then I realized my wife could have driven me up with our own pale and saved what turned out to be a $650 taxi ride.
When we arrived at the Regional Medical Center in Sudbury, a city of over 100,000, they whisked me into emergency where I would hack for the next 9, yes that is 9 hours. They gave me a pan and told my wife to call if I got worse. Well, I can't make sounds on the computer but my wife says I sounded like a moose bellowing in mating season. And it hurt. After one episode about 3AM I once again thought I was going to check out for sure. My wife retrieved a nurse who brought with him a young lady, an intern.
The Intern told me to take a sip of water. It was about 7 hours into the process and I had tried that before. It sent me into a coughing, hacking tailspin. She insisted, annoyed at her inability to listen I chugged the water she held as she stood silently for the next five minutes, looking quite embarrassed as I hacked my guts out.
She apologized and then decided to put a scope down my nose to insure I didn't have a wind pipe blockage. Now I know little about these kinds of things but I knew I didn't have a wind pipe blockage or I'd already be dead. She insisted so I relented between episodes as she stuck the instrument in my nose, down my throat and then said, "Oops". It seems the batteries were dead! She quickly left and came back with a couple double A's and proceeded again. To only her surprise, I didn't have a wind pipe blockage; it was apparently an esophageal blockage.
A couple hours later a Surgeon came to get me, yes he wheeled me to the operating room himself. He said if he had to wait on an orderly he'd be there another two hours. Once inside I started having an episode on the operating table. The Anesthesiologist insisted I lie down. I told her I needed a bucket to cough into and she said, quite irritated at my lack of cooperation, "This is an operating room and we don't have buckets!" I barfed into a towel and turned to the Surgeon and said, "You got five minutes."
That's pretty much the end of the Canadian story. The Surgeon told my wife he'd 'pushed' the food through and indeed it was an esophageal blockage, meaning it was below the wind pipe. They sent me on my way and other than sore ribs I seemed none the worse for the wear of the 13 hour ordeal. I was thinking the whole time 'where is Michael Moore when I need him?'
Fast forward six weeks and I'm in Decatur, Illinois having lunch with a friend of mine. At this point I'd become a vegetarian like my youngest daughter just on the chance this might happen to me again. But as time moved on I'm in the Mexican restaurant for lunch the chicken taco's I love got the best of me. I thought 'what the heck' and made one, took one bite and was hacking within seconds, I'd done it again.
The only advantage this time was to know the fix I was in. My wife and I took a quick trip to Decatur Memorial Hospital, one of two in this city of just over 100,000 people. It was a Friday so we expected a wait. We walked in as I hacked every five minutes. A nurse took me right in to emergency and was immediately joined by a Doctor and another nurse. The Doctor said, "You have an esophageal blockage. We get four a week, tow real and two imagined". He then gave me a shot and said, "This will stop you from hacking until we can get our Surgeon to you".
Wow! It worked and after about a 45 minute wait the Surgeon walked in, smiled as he was making a motion as if he was reeling in a fish and said, "I hear I get to go fishing?" We talked about my history and what had recently taken place in Canada. He asked me whether they had enlarged my esophagus while they were in there. I told him if they did they didn't tell me. He explained how easy it was to do since he'd already be in there anyway. An hour later I was on my way with before and after pictures of my esophagus and feeling great. The Surgeon told me it was good for 18 months to 2 years.
I know this is just one example of many but we have to be careful what we wish for because we just might get it. That same summer a good friend of ours from Canada had been waiting for gall bladder surgery, she waited a year. Another friend of ours up there in his 70's had cancer and couldn't eat. He waited upwards of two weeks for surgery.
With all the debate raging about our healthcare crisis in America we need to take a chill pill. We don't have a crisis of healthcare; we have a crisis of the cost and coverage of healthcare. I don't think anyone disagrees that we should have coverage for everyone in this country. But there is something badly wrong with a plan that is now before Congress that 'saves' all this money and increases the cost of those on Medicaid now. That's just a red flag as to where these Bozo's in DC are leading us.
I consulted in business for years, with large companies. The first thing you do is identify the problem you're trying to solve. I don't believe Congress is doing that. I believe they're playing to the new President's agenda supported by a few nut cases already in place, namely Reid and Pelosi. The real healthcare crisis is centered on three things:
1. Cost not Quality:
Our outrageous costs are getting worse. Why, because of all the lawyers and greedy drug companies, period. Do you think we can change that? No! Because Congress is made up of 98% lawyers and they take big money from the drug company lobby.
2. Coverage:
The problem in America is not the poor, they have coverage now. I know people in that category and they just go to the emergency room and everything is covered. The problem with coverage is the middle and they have no voice America anymore.
3. Inequality:
I'm not talking racial inequality but the inequality of our leaders and their privileges versus ours as a people. I believe that every single law they vote for us, from healthcare to pensions must apply to them. And their raises... put it on the ballot for all of America to vote. And while you're at it place term limits of two terms for every elected position.
We're rushing into this thing way too fast. It should be a priority but at what expense. If you keep doing the same thing you'll certainly get the same result. Why will this quick hit initiative be any more successful than Social Security which Congress has robbed and is bankrupt? Will it be any better than Medicaid and Medicare now in place? If you think so, why would it? And we know this type of program can be done well. I have a friend in England who swears by their coverage and has given me example after example of how even I as an American would go to England, have the problem I had in Canada and not pay a dime. Now that is something to think about - how did they do that?
I'm no longer against healthcare reform but I'm solidly for solving the correct problem. And I don't think we're about to do that. Einstein said, "You can't solve a problem with the same level of thinking that got you into it." I think we need new thinking, not just change. I decided we really should Go Green in 2010 and recycle Congress!
One evening one of the ladies visiting made her 'to die for' roast beef dinner and I nearly did. On the second bite mine got stuck in my throat and I was in for a long, painful and at times, downright terrifying night. I began choking about 4PM and it was weird, it would come and go in five minute cycles. I gutted it out for an hour thinking I could dislodge the blockage myself. Then another episode made me think I might check out right there in the north woods. My wife called 911.
The Regional Medical Center was over 80 miles away so it wasn't going to be a quick fix. Inside the ambulance and on the way I had my worst episode of the day. I thought I was a goner, hacking into a little pale while the EMT sat quietly looking at paperwork. The whole time the computer I was hooked to was saying over and over again 'check the patient - check the patient'.
When my episode was over I said to the EMT, "Aren't you going to do something?" He was a nice young fellow who promptly said, "No sir that's why we're taking you to someone who makes a lot more than us to fix you". It was then I realized my wife could have driven me up with our own pale and saved what turned out to be a $650 taxi ride.
When we arrived at the Regional Medical Center in Sudbury, a city of over 100,000, they whisked me into emergency where I would hack for the next 9, yes that is 9 hours. They gave me a pan and told my wife to call if I got worse. Well, I can't make sounds on the computer but my wife says I sounded like a moose bellowing in mating season. And it hurt. After one episode about 3AM I once again thought I was going to check out for sure. My wife retrieved a nurse who brought with him a young lady, an intern.
The Intern told me to take a sip of water. It was about 7 hours into the process and I had tried that before. It sent me into a coughing, hacking tailspin. She insisted, annoyed at her inability to listen I chugged the water she held as she stood silently for the next five minutes, looking quite embarrassed as I hacked my guts out.
She apologized and then decided to put a scope down my nose to insure I didn't have a wind pipe blockage. Now I know little about these kinds of things but I knew I didn't have a wind pipe blockage or I'd already be dead. She insisted so I relented between episodes as she stuck the instrument in my nose, down my throat and then said, "Oops". It seems the batteries were dead! She quickly left and came back with a couple double A's and proceeded again. To only her surprise, I didn't have a wind pipe blockage; it was apparently an esophageal blockage.
A couple hours later a Surgeon came to get me, yes he wheeled me to the operating room himself. He said if he had to wait on an orderly he'd be there another two hours. Once inside I started having an episode on the operating table. The Anesthesiologist insisted I lie down. I told her I needed a bucket to cough into and she said, quite irritated at my lack of cooperation, "This is an operating room and we don't have buckets!" I barfed into a towel and turned to the Surgeon and said, "You got five minutes."
That's pretty much the end of the Canadian story. The Surgeon told my wife he'd 'pushed' the food through and indeed it was an esophageal blockage, meaning it was below the wind pipe. They sent me on my way and other than sore ribs I seemed none the worse for the wear of the 13 hour ordeal. I was thinking the whole time 'where is Michael Moore when I need him?'
Fast forward six weeks and I'm in Decatur, Illinois having lunch with a friend of mine. At this point I'd become a vegetarian like my youngest daughter just on the chance this might happen to me again. But as time moved on I'm in the Mexican restaurant for lunch the chicken taco's I love got the best of me. I thought 'what the heck' and made one, took one bite and was hacking within seconds, I'd done it again.
The only advantage this time was to know the fix I was in. My wife and I took a quick trip to Decatur Memorial Hospital, one of two in this city of just over 100,000 people. It was a Friday so we expected a wait. We walked in as I hacked every five minutes. A nurse took me right in to emergency and was immediately joined by a Doctor and another nurse. The Doctor said, "You have an esophageal blockage. We get four a week, tow real and two imagined". He then gave me a shot and said, "This will stop you from hacking until we can get our Surgeon to you".
Wow! It worked and after about a 45 minute wait the Surgeon walked in, smiled as he was making a motion as if he was reeling in a fish and said, "I hear I get to go fishing?" We talked about my history and what had recently taken place in Canada. He asked me whether they had enlarged my esophagus while they were in there. I told him if they did they didn't tell me. He explained how easy it was to do since he'd already be in there anyway. An hour later I was on my way with before and after pictures of my esophagus and feeling great. The Surgeon told me it was good for 18 months to 2 years.
I know this is just one example of many but we have to be careful what we wish for because we just might get it. That same summer a good friend of ours from Canada had been waiting for gall bladder surgery, she waited a year. Another friend of ours up there in his 70's had cancer and couldn't eat. He waited upwards of two weeks for surgery.
With all the debate raging about our healthcare crisis in America we need to take a chill pill. We don't have a crisis of healthcare; we have a crisis of the cost and coverage of healthcare. I don't think anyone disagrees that we should have coverage for everyone in this country. But there is something badly wrong with a plan that is now before Congress that 'saves' all this money and increases the cost of those on Medicaid now. That's just a red flag as to where these Bozo's in DC are leading us.
I consulted in business for years, with large companies. The first thing you do is identify the problem you're trying to solve. I don't believe Congress is doing that. I believe they're playing to the new President's agenda supported by a few nut cases already in place, namely Reid and Pelosi. The real healthcare crisis is centered on three things:
1. Cost not Quality:
Our outrageous costs are getting worse. Why, because of all the lawyers and greedy drug companies, period. Do you think we can change that? No! Because Congress is made up of 98% lawyers and they take big money from the drug company lobby.
2. Coverage:
The problem in America is not the poor, they have coverage now. I know people in that category and they just go to the emergency room and everything is covered. The problem with coverage is the middle and they have no voice America anymore.
3. Inequality:
I'm not talking racial inequality but the inequality of our leaders and their privileges versus ours as a people. I believe that every single law they vote for us, from healthcare to pensions must apply to them. And their raises... put it on the ballot for all of America to vote. And while you're at it place term limits of two terms for every elected position.
We're rushing into this thing way too fast. It should be a priority but at what expense. If you keep doing the same thing you'll certainly get the same result. Why will this quick hit initiative be any more successful than Social Security which Congress has robbed and is bankrupt? Will it be any better than Medicaid and Medicare now in place? If you think so, why would it? And we know this type of program can be done well. I have a friend in England who swears by their coverage and has given me example after example of how even I as an American would go to England, have the problem I had in Canada and not pay a dime. Now that is something to think about - how did they do that?
I'm no longer against healthcare reform but I'm solidly for solving the correct problem. And I don't think we're about to do that. Einstein said, "You can't solve a problem with the same level of thinking that got you into it." I think we need new thinking, not just change. I decided we really should Go Green in 2010 and recycle Congress!
Saturday 1 January 2011
Healthcare Systems and Their Structure
Constantly under review and scrutiny, the issues on healthcare Systems have become international.
Made up mainly of organizations and individuals, these healthcare structural systems are designed to meet a target population's need for health care. On an international level, there is a diverse variety of health care systems. In some countries the planning of the health care systems are market driven and participated in by the private sector. In other countries the systems are composed of government and non-government entities such as religious groups, trade unions charities and or other coordinative bodies that are centrally run and planned, to enable the delivery of healthcare services to the populations they target. In other words, health care planning has evolved.
According to a World Health Organization report in 2000, the main goals of health systems are the ability to provide a responsive health service alongside considerations of fair financial contributions. In order to appraise overall health care systems, a proposed two-dimensional approach was conceived. The first dimension consists of equity and the second is composed of efficiency, quality and acceptability.
Several proposals have come from the Senate in the United States and the White House. Health care system issues according to President Obama are issues that should be addressed immediately and placed them on a top priority list. A universal health care system does not exist or is practiced in the United States. Some countries subsidize their universal healthcare directly from government coffers. This kind of universal healthcare is called socialized medicine, which is a combination of private and public delivery systems, with most countries spending public funds for this service delivery. Government taxes plays the role of funding this system supplemented and strengthened with private payments.
The World Health Organization (WHO) report of 2000 ranks each member country's health care system. Discussions on the positive and negative aspects of replacing health care systems with insurance systems use this report's quotation. However, the WHO has remarked that as ranking healthcare systems is a complex task, these ranking tables will no longer be produced. Infant mortality and life expectancy are two main variables that are used in the ranking. Out of 198 countries, Canada ranks thirtieth and the US ranks thirty seventh. The World Health Organization ranks France, San Marino, Italy, Andorra, Singapore, Malta, Spain, Austria, Oman and Japan as the world's top ten.
With the founding of the UN (United Nations), there was planning and discussion on the need for a single entity to serve, observe and assess global health care system trends. Thus the World Health Organization was formed in 1948 on April 7th with headquarters based in Geneva, Switzerland. Annually the WHO is recognized by the celebration of a World Health Day. The WHO is the coordinative and directive authority for United Nations' member countries individual health systems. Member countries of the United Nations are allowed WHO membership through the acceptance of the WHO constitution. To date there are a total of 198 member nations participating in WHO programs.
Made up mainly of organizations and individuals, these healthcare structural systems are designed to meet a target population's need for health care. On an international level, there is a diverse variety of health care systems. In some countries the planning of the health care systems are market driven and participated in by the private sector. In other countries the systems are composed of government and non-government entities such as religious groups, trade unions charities and or other coordinative bodies that are centrally run and planned, to enable the delivery of healthcare services to the populations they target. In other words, health care planning has evolved.
According to a World Health Organization report in 2000, the main goals of health systems are the ability to provide a responsive health service alongside considerations of fair financial contributions. In order to appraise overall health care systems, a proposed two-dimensional approach was conceived. The first dimension consists of equity and the second is composed of efficiency, quality and acceptability.
Several proposals have come from the Senate in the United States and the White House. Health care system issues according to President Obama are issues that should be addressed immediately and placed them on a top priority list. A universal health care system does not exist or is practiced in the United States. Some countries subsidize their universal healthcare directly from government coffers. This kind of universal healthcare is called socialized medicine, which is a combination of private and public delivery systems, with most countries spending public funds for this service delivery. Government taxes plays the role of funding this system supplemented and strengthened with private payments.
The World Health Organization (WHO) report of 2000 ranks each member country's health care system. Discussions on the positive and negative aspects of replacing health care systems with insurance systems use this report's quotation. However, the WHO has remarked that as ranking healthcare systems is a complex task, these ranking tables will no longer be produced. Infant mortality and life expectancy are two main variables that are used in the ranking. Out of 198 countries, Canada ranks thirtieth and the US ranks thirty seventh. The World Health Organization ranks France, San Marino, Italy, Andorra, Singapore, Malta, Spain, Austria, Oman and Japan as the world's top ten.
With the founding of the UN (United Nations), there was planning and discussion on the need for a single entity to serve, observe and assess global health care system trends. Thus the World Health Organization was formed in 1948 on April 7th with headquarters based in Geneva, Switzerland. Annually the WHO is recognized by the celebration of a World Health Day. The WHO is the coordinative and directive authority for United Nations' member countries individual health systems. Member countries of the United Nations are allowed WHO membership through the acceptance of the WHO constitution. To date there are a total of 198 member nations participating in WHO programs.
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