The Commonwealth Fund's newly released study of health care effectiveness clearly demonstrates only half the job is done following the passage of the American Recovery and Reinvestment Act.
Ranking seven industrialized nations (Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States) health care systems, the study found the United States ranked last overall on "dimensions of access, patient safety, coordination, efficiency, and equity."
From the study:
The six other nations have universal health care as a mandate, something the U.S. won't implement until 2014. That mandate will address the access and equity issues, but the U.S. also fares poorly when it comes to the quality of the care received.
Interestingly, this is the first time the number one ranked Netherlands has been included in the survey. The Dutch revamped their health care system in 2006. All residents are required to purchase health insurance through highly regulated for profit or non-profit private insurers. In other words, no Medicare or Medicaid. No one can be refused coverage and the government provides subsidies to insurers to compensate for sicker, or chronically ill participants. There are some differences however:
The required standard insurance is financed by a mixture of income-related contributions and flat premiums. The individual contribution is set at 6.5 percent of income, which is contributed by employers if the patient is enrolled through their job or by the patient if they are self-employed or unemployed. The insured also pay a flat-rate premium to their insurer for a policy. (Link)
It would likely be every Republican's wet dream to fantasize about a health system completely managed by private insurers. What would likely kill the mood would be an obvious, clear requirement for a system that includes both highly regulated insurers and providers.
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