Debunking Health Care Mythmaking with Healthcare Journalist J.R. Reid
MYTHS ARE an intriguing subject. Some are born of some long-ago purported truth that over time gets embellished as each subsequent truth-bearer who, by dint of philosophy, group affiliation or financial incentive, is compelled to thrust the Righteous Truth Banner higher and higher for all to see the resplendent truth mythologized.
Other myths are born complete with steroidal hormones and immediately grow tall (as in a “tall tale”) and sturdy. It takes no time at all to mythologize such a “truth”.
Want to see mythmaking in action? Gather some friends. Seven to ten would be good. Then quietly read a paragraph of something with a few facts and considerations into the ear of one person, and then ask for it to be repeated to the next person, and so on till the last has heard it from the next-to-last. Now, ask the last person to repeat it.
How close to the original statement do you think will be the last person’s interpretation? Most times, not even close, and particularly not close if time is inserted between the retelling, or people are injected into the process who have biases that slant the retelling.
Which brings us to the so-called Health Care Debate. If only it were. More like a shout-fest punctuated with what health care journalist and author J.R. Reid refers to as “myths”, and a recent Newsweek article claims as “lies”.
America has a huge, seemingly insurmountable health care problem that begs for fixing — one that has been fixed by other rich nations for their citizens — and yet we reduce the various efforts to revitalize our system to one-liners, like “pulling the plug on granny”, or “socialist health-care”, as if there isn’t enough real issues worthy of debate, such as cost, efficiency and health outcomes.
Mr. Reid, the health care journalist, writes in the August 23rd, 2009 edition of the Washington Post an article he entitles, 5 Myths About Health Care Around the World, where he implores us not to dismiss the health-care models of other industrialized nations as “socialist”, but rather to seek to understand the benefits each offers its citizens with the aim of adopting what works.
Simple conceptually, but, alas, if any change attempts to change an entrenched interest that’s doing just fine as it is… well… watch out. It’s mythmaking time.
Though I heartily encourage you to read the full version for greater understanding, here’s a summary of the Five Myths presented by Reid:
Myth # 1: It’s all socialized medicine out there.
Some are socialized, some are hybrid, some private — all work better than then America’s. Britain, New Zealand and Cuba provide health care in government hospitals and the government pays the bills. Canada and Taiwan rely on private-sector providers paid for by government-run insurance. Germany, the Netherlands, Japan and Switzerland provide universal coverage using private doctors, private hospitals and private insurance plans.
Myth # 2: Overseas, care is rationed through limited choices or long lines.
Generally, no. In some countries (Germany), citizens can select one of hundreds of private health plans with seamless transfer from one to another; others (France and Japan) mandate the one provider designated by employer or industry, but any doctor or hospital can be used. There can be waiting lists for non-emergency care in countries such as Great Britain and Canada, but in Japan waiting times are so short that most patients don’t bother to make an appointment.
Myth # 3: Foreign health-care systems are inefficient, bloated bureaucracies.
More so in the U.S. The free enterprise, for-profit health insurance may seem to be the most cost-effective way to pay for health care, but in fact, all the other payment systems are more efficient than America’s.
U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for non-medical costs, such as paperwork, reviewing claims and marketing.
In comparison: France covers everybody and spends about 4 percent on administration; Canada’s universal insurance system, run by government bureaucrats, spends 6 percent on administration; Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent.
Japan? It’s the world champion at controlling medical care. Even though the average person there goes to the doctor 15 times a year vs 5 times the U.S., Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
Myth # 4: Cost controls stifle innovation.
Nope. Hip and knee replacement innovations, depression treatments, and various ubiquitous drugs, like Viagra, were developed in other countries.
Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price, and still make a profit
Myth # 5: Health insurance has to be cruel.
Which system is more cruel?
In America, good luck if you have a “preexisting condition” and are seeking new insurance. And if a customer files a large medical claim, the insurer’s “rescission department” digs through the records looking for grounds to cancel the policy.
Foreign health insurance companies, in contrast, must accept all applicants, and they can’t cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital usually within tight time limits.
Mr. Reid goes on to write:
“In many ways, foreign health-care models are not really “foreign” to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we’re Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we’re Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we’re Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we’re Burundi or Burma: In the world’s poor nations, sick people pay out of pocket for medical care; those who can’t pay stay sick or die.”
In the U.S., then, this “crazy-quilt” health-care system results in Americans spending more than anybody else and yet the country has millions of citizens without heath insurance coverage. All the other developed countries have settled on one model for health-care delivery and finance; we’ve blended them all into a costly, confusing bureaucratic mess.
And this fact busts the biggest health care myth of all, of which the five above are merely subsets — America has “the finest health care” in the world.
It doesn’t. Nearly all advanced countries have better national health statistics than does the United States. Medical bankruptcy befalls 700,000 Americans each year. France, Britain, Japan and Germany all share the same number of medical bankruptcies each year: 0.
With all its medical assets — technology, education, people — the United States should have the best health-care in the world. Plainly, it doesn’t. Let’s learn from those who got it right.