Jane Sarasohn-Kahn, a health economist and management consultant (and blogger) had this in her status bar:
In London meetings all day with UK and US colleagues, arguing about whose health system is worse. It's a draw: it you don't have health insurance or a medical home in the US, then the UK system looks awful great. If you're in the UK and have access/rationing/queueing challenges, the US looks great.
This drew a response from Matthew Holt, of The Health Care Blog fame:
I am prepared to bet you a nickel Jane that every one of your UK colleagues has private health insurance and doesn't have to worry about said rationing, but no poor Brit goes bankrupt because they're in hospital.
A long time ago, I wrote about how the US and European health systems will eventually converge.
The health systems in these countries are owned and financed by the government and are often appropriately cited for the quality of care offered to the public. Indeed, in debates here in the US, they are often called out as examples of what we might strive for in terms of universal coverage and a greater emphasis on primary care than we have.
[In a nationalized health system, the] appropriation by the parliament is a politically derived decision, just as it would be for any appropriation for a program of important national priority, and it therefore competes with other worthy national programs for resources....
In the face of inevitable limitations on the ability of the national hospital system to offer all services demanded by the public, a growing parallel system is emerging, in which private practitioners offer elective therapies and procedures outside of those supported by the national system.
As I note above, I am not saying one is better than the other. Just different. I predict, though, that the systems will start to look more and more alike over time. Pressure in the US for a more nationally-determined approach. Pressure in Europe for more of a private market approach. It shouldn't surprise us to see this convergence. After all, the countries are dealing with the same organisms, both biologically and politically.
A final note from the Facebook back-and-forth:
Neil Versel asks,
What about cost and quality?
Liz Scherer replies,
One word: oy.
A long time ago, I wrote about how the US and European health systems will eventually converge.
The health systems in these countries are owned and financed by the government and are often appropriately cited for the quality of care offered to the public. Indeed, in debates here in the US, they are often called out as examples of what we might strive for in terms of universal coverage and a greater emphasis on primary care than we have.
[In a nationalized health system, the] appropriation by the parliament is a politically derived decision, just as it would be for any appropriation for a program of important national priority, and it therefore competes with other worthy national programs for resources....
In the face of inevitable limitations on the ability of the national hospital system to offer all services demanded by the public, a growing parallel system is emerging, in which private practitioners offer elective therapies and procedures outside of those supported by the national system.
As I note above, I am not saying one is better than the other. Just different. I predict, though, that the systems will start to look more and more alike over time. Pressure in the US for a more nationally-determined approach. Pressure in Europe for more of a private market approach. It shouldn't surprise us to see this convergence. After all, the countries are dealing with the same organisms, both biologically and politically.
A final note from the Facebook back-and-forth:
Neil Versel asks,
What about cost and quality?
Liz Scherer replies,
One word: oy.
Suggesting that -- in all systems -- a concerted focus on quality, safety, transparency, and process improvement would be well worthwhile.
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