Universal Health Care - Been There, Done That
06/10/09 - InsureBlog by Bob Vineyard
Cristina Folchitto reports her experience.
[edited] As an Italian citizen, I have experienced the “Utopia” of universal health care. It is a noble and ethically good idea, but it simply does not work.
It is not free. Every month a percent of your salary is taken out of your paycheck. You have no control of that money, you have no freedom to choose whether to have health care coverage or not. The more money you make, the more you pay, which is not fair nor directly linked to your health status or habits.
Hospitals are overcrowded, understaffed, mostly old buildings and infrastructure, without enough physicians or resources. You might have to wait several months to get a sonogram or an MRI. For a surgical procedure, you are put on a waiting list. You could be called months later at any time, any day to have the procedure.
If you cannot afford private care, after going through the painful process of public infrastructure, you still pay a co-pay according to the treatment you receive.
Private health care guarantees competition between doctors and medical institutions. The monetary gain stimulates a higher level of care and professionalism. This does not apply to the public system that often cannot afford to pay adequate wages to doctors, lowering the quality of medical service and almost eliminating research projects.
The psychological comfort of having health care “paid by the government” lowers the awareness and responsibility that people have towards their own health. It is easier for them to rely on future care instead of making the best lifestyle choices to stay healthy and in shape.
Having lived under both systems, I appreciate the freedom of choice that is given to me by a private health care system.
Political control of healthcare promises and payments has a sad history. Delaying payments has the same effect as reducing payments, since the state doesn’t catch up for a long time. The payment delays ensure that providers need to hold a big “rainy day” fund, since their employees want to be paid cash rather than IOU’s.
Medical providers can do little except complain to their local legislators. They can’t sue the State to speed up payments, and if they did, the state wouldn't care. Unlike insurance, which may be popularly perceived as unfair, there are no avenues of appeal if you feel the state is killing your business.
Natasha Richardson died from a ski accident due to a delay in treatment. Montreal does not have fast transportation to a full-service hospital, even near a ski area. Why not? Patients are a cost to the system.
The bureaucracy sees you as a cost, especially if you have already paid. All people and organizations seek income and avoid costs. Socialized or centralized healthcare is paid up-front and delivers services after the fact.
How hard will a system work to earn the money that they have already been paid? This is something that everyone can understand in their gut. A customer is lost without competition for his dollar.