Sunday, 1 November 2009

On the healthcare insurance debate...

I would like to add a few notes.All of the Eastern European countries under communist rule till 1989, when the wall and system collapsed had socialised medicine.One would expect that, like many other inefficient, corrupt social programs "universal" healthcare would have been changed to an efficient,patient centered program. In fact, remember that Americans, none of these countries have been able to get rid of socialized medicare to date. Many reasons for this. First it has been free for all pensioners. Those who are employed pay a small amount, employers pay a big chunk. None of the contributions, and they have been steadily rising, cover the need, so all healthcare budgets spend over budget. There has never been enough money to cover expenditure, and hc is the biggest contributor to the overall deficits of all these countries.
The biggest political fights in every election and in every budget debate is over the cost of national hc. There are center left and right parties. Which party would you guess is for privatizing (improving) socialized hc? Here is the paradox: socialists and liberals want to get rid of socialized medicine and centre right parties agitate for retaining socialized medicine!
Just a word about socalized hc. Almost from thee beginning, if you wanted the best medical and medicinal help you'd better have the money for it. Whether it was a choice of doctor or medicine,a treatment, a hospital stay, an operation those with cash always had the best available service and product. To this day corruption, paying under the table is the EXPECTED way to get the best treatment. Budgets have been so overspent that in Hungary today,when you go in the hospital you better take your towel,spoon, soap, and medicine as you may not get any of those things. Choice of surgeon will depend on the money you come up with. Of course you will always get some treatment. But you will be at the end of the line. And you better reward the nurses who look after you, as their pay is so low they need money from the patients to live. Most medicines are available, but for the best ones you will pay a high co-pay. It is not unusual for a pensioner to make choices from the various drugs that he is prescribed and get only one or two as the monthly total maybe more than his pension.
Dental care is "free" on paper, in fact most dental treatments are performed by private practitioners or those employed by the state, but you still pay them.
Since the iron curtain came down, socialized medicine is still around, even if it had improved from before 1989.
Changing that system for private insurers is a politically daunting exercise.
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