Thursday, January 20, 2011

Health care: I pay for insurance

Fair warning: this is another "political" post. I just can't seem to stay out of this.

A friend of mine, Damian Gryski, sent me a fascinating link comparing the US and Netherlands in several key areas that you would want to know about if you lived here. I found the following bit particularly interesting:

spend 48.19% less money on health care
Per capita public and private health expenditures combined in Netherlands are $3,481 USD while The United States spends $6,719 USD
This entry contains the per capita public and private health expenditure at purchase power parity using US Dollars. This figure combines government, personal, and employer spending on health care
Source: World Health Organization
A right or a privilege?
Photo by edenpictures
Please note that "per capita" spending doesn't mean what you and I pay, it's what is paid overall and the US is paying around twice the amount as the Netherlands. So while the US is has the most expensive health care system in the world, one which operates fabulously if and only if you have the money to participate in it, my wife and I spend only €220 a month on our health insurance. That's a bit higher than normal, but only because we spent a extra to cover any issues she might have with her pregnancy.

And the US? Back in 2009, US households were spending an average of $13,000 per year for health care. Your out-of-pocket health care costs in the Netherlands more than make up for an apparent 15% drop in income (naturally, the situation is far more complex than this facile analysis).

During the recent US debate about health care — well, no, I have to stop already. There was no "debate" in the US. There was idiocy everywhere as politicians and media were busy supporting their team rather than the American people. One argument I kept hearing over and over again was what a disaster "socialized" medicine has been for Europe. And yes, you can find individuals for whom it's been a disaster, just as you can find individuals for whom the US system has been a disaster. However, you can't look at individuals to tell if a system works or not. You have to look at the system. You have to look at its aggregate outcomes and in Europe, it's indisputable that our aggregate outcomes generally involve a better quality, coverage and cost of health care.

But do we really have socialized medicine over here? What we have varies from country to country. In the UK, there was definitely what one would call "socialized" medicine and that served the vast majority of people very well. Sometimes people would buy supplementary insurance to handle issues which the National Health Service was less likely to cover, but all in all, the health care in the UK was free and excellent.

Here in the Netherlands the health care system is different. I am required by law to have insurance. No insurance company may turn me down if I apply and they must charge me a flat rate. Children are free. Actual health care costs are subsidized by the government. Despite the widely held US belief that government intervention always makes things worse¹, the Dutch government has clearly done a better job than the US government. Of course, the same is true for most European governments in this regard.

Soldiers receive treatment for IED injuries
Enjoying socialized medicine
while defending your freedom.
Photo by the US Army
Ironically, when I was a child my health care was free because I was a military dependent and the US military enjoys the finest in socialized medicine while fighting to keep our country free of socialism. I never could figure that one out. Some have been offended by my characterization of the US military's doctors, government-paid and operated hospitals and complete "cradle to grave" free health care for military personnel and dependants as "socialized", but I honestly can find no definition of socialism which doesn't cover this situation (lest anyone forget, the US military is a branch of the US government). Mind you, this is not a criticism of the excellent health care the US military provided for me and my family. I'm just pointing out that sometimes we need to step back and put things in perspective.

Compare the Dutch "everyone must have insurance" system to the mess in the United States. They have so many problems with their health care that the government has tons of public programs to try and plug the gaps:

  • Medicare, generally covering citizens and long-term residents 65 years and older and the disabled.
  • Medicaid, generally covering low income people in certain categories, including children, pregnant women, and the disabled. (Administered by the states.)
  • State Children's Health Insurance Program, which provides health insurance for low-income children who do not qualify for Medicaid. (Administered by the states, with matching state funds.)
  • Various programs for federal employees, including TRICARE for military personnel (for use in civilian facilities)
  • The Veterans Administration, which provides care to veterans, their families, and survivors through medical centers and clinics.[66][67]
  • National Institutes of Health treats patients who enroll in research for free.
  • Government run community clinics
  • Medical Corps of various branches of the military.
  • Certain county and state hospitals

Before you think about moving abroad, check out the health care system of your target country, its costs (always lower than the US) and its outcomes (usually better than the US). And stop getting your news through profit-driven corporate media and find out the truth for yourself.

1. This is a naïvety which is breathtaking, to say the least, but one which is enshrined not only in US political thought, but in astoundingly popular, yet foolish, economic theory (why the hell hasn't the Chilean disaster and the Soviet transition to "capitalism" put the lie to the Chicago School fanatics?)