As President Obama unveiled his version of a health care plan on Monday, February 22, 2010, it remains to be seen if the Republicans and Democrats will ever agree enough to enact any type of legislation that won’t bankrupt the country but will stem the rising tide of everyday Americans who either can’t get health insurance, because of pre-existing conditions, or whose coverage has become so inflated that they can no longer afford it.  No doubt, the “devil is in the details” and as the bickering continues, each day that passes we are hearing more and more stories of ordinary people who are losing their healthcare coverage or in danger of losing it because of premium increases and/or loss of eligibility if they lose their job.

Perhaps only a coincidence but I am struck by the irony of this because today, February 22, 2010 is also the day that the new credit card laws take effect. And these laws were intended by our government to “protect” the consumer, but as the last nine months have shown, instead of helping consumers in an already tight credit market, card issuers closed accounts, raised rates, and squeezed even highly responsible credit holders into positions where there FICO scores dropped and interest rates increased even though their credit risk remained the same.  The very laws that were intended to “help” ended up having the exact opposite effect. So it is these “unintended consequences” that perhaps we should look at before jumping into a health care plan just for the sake of passing it.  Can you imagine if we give insurers and health care companies 10 years to “prepare” for the changes, similar to what was done in the credit card legislation?

Most everyone agrees on the following: In the United States we absolutely need some safeguards in place that would grant coverage and the ability to purchase coverage for everyone regardless of pre-existing conditions.  Even if our legislators could do that one simple step, eliminate the barriers to insurance for those with pre-existing conditions, we would be moving in a positive direction.

Perhaps it would be helpful to our legislators and  all Americans if we would re-examine a healthcare system that functions well for it’s people! One that provides care and coverage to all of it’s citizens.  Here’s an article that was graciously shared  from Dr. Steve Blevins’s blog, professor of medicine at the University of Oklahoma, that portrays A Look Inside Switzerland’s Health Care System.  What could we learn from the Swiss?

The Following is a reprint of Dr. Steve Blevins’s  Article.

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Is it any surprise that Switzerland has, arguably, the world’s finest health care system? Would you expect any less from a nation where the air is crisp, the streets are clean, and the trains run on time?

Consider the achievements of the Swiss system:

  • Everyone is covered

  • Health outcomes are excellent

  • Health costs are reasonable

  • Patient satisfaction is high

What’s especially remarkable about the Swiss system is that it is admired by both liberals and conservatives. Liberals like it because it guarantees universal coverage and conservatives like it because there’s no burden on business. 

Although more expensive than the British and French systems, the Swiss system is much less expensive than the American system. Mortality rates are lower, waiting times are shorter, and technology is advanced. Not surpris-ingly, patient satisfaction is among the highest in Europe.

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There are four major health care systems: the British system, in which the government employs doctors and runs hospitals; the French system, which is largely financed, but not run, by government; the Swiss system, which is financed through a tightly regulated insurance industry; and the American system.

As Paul Krugman points out in his outstanding New York Times piece, the American system has British, French, and Swiss elements. The Veterans Administration system follows the British model, Medicare follows the French model, and the Massachusetts Health Plan follows the Swiss model. 

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Most Americans rely on an unregulated insurance industry, which fails on most counts: costs are exorbitant, outcomes are poor, coverage is restricted, and patient satisfaction is low. The major European systems – British, French, and Swiss – produce better results. The British system is the least expensive, but access to care, patient satisfaction, and technological innovation lag behind the Swiss.

 

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The Swiss system works by regulating commercial insurance. People buy insurance directly from insurance companies, so businesses are out of the loop. Everyone must carry insurance, and those who don’t pay a penalty.

The government subsidizes the cost of insurance for low-income individuals (about one-third of the population). The affluent are not subsidized. (Contrast that with Medicare, which covers everyone over the age of 65, including wealthy people who don’t need government assistance.)

In Switzerland, insurance companies must provide basic insurance to all recipients and cannot deny coverage on the basis of poor health. Premiums are not affected by health status. "Basic insurance" is defined by government, which decides which drugs, lab tests, and devices will be covered. Deductibles and premiums are tightly regulated and cannot exceed certain limits. Insur-ance companies cannot profit from the basic plan, though they may profit from supplemental insurance.

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The Swiss health care system costs 40% less than the American system (on a per capita basis). Health care costs rise at a slower rate than in America. Healthy lifestyles (e.g. not smoking) translate into lower premiums, and people keep their coverage when they change or lose jobs.

The Swiss system has been criticized by right-wingers, who hate government, and by left-wingers, who hate insurance companies. But facts are facts, and results are results. By any standard, the system delivers. And the result is a nation of healthy, satisfied people.

sunshinevalleysswiss

So why aren’t Americans talking about the Swiss system?

Well, actually we are. The Swiss system is the crux of the Obama plan. Specifically, it meets Obama’s goals:

  • Reduce growth of health care costs for businesses and government

  • Protect families from bankruptcy or debt from health care costs

  • Guarantee choice of doctors and health plans

  • Invest in prevention and wellness

  • Improve patient safety and quality of care

  • Assure affordable, quality health coverage for all Americans

  • Maintain coverage when changing or losing a job

  • End barriers to coverage for people with pre-existing medical conditions

mountains2swiss

So before we get too upset about single-payer and other details in the emerging health plan, let’s remember that the Swiss are masters of efficiency and proficiency. They are long-lived, cost-conscious, and technologically advanced.

If Obama takes us as far as Switzerland, he will have done us all  an incalculable service.

 

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*I am indebted to Paul Krugman for his indispensable analysis of the American and European health care systems.

*** END of Dr. Steve Blevins’s  Article ****

 

I would like to thank Dr. Steve Blevins for his graciousness in sharing his overview of the Swiss HealthCare System. 

As the debate on healthcare continues, it will indeed be a balancing act in trying to bring the Democrats and Republicans together. Some who believe that the Obama plan is the way to go, whereas others thinking that some of the ideas are solid, but it is the “details” like the credit card legislation that could cause many unintended consequences. What do you think?