Last evening, Occupy Greenville sponsored a Teach-In featuring a showing of Sick Around the World, followed by a spirited and lively discussion. There were maybe a dozen of us in attendance. This follows our showing of Sick Around America last week--both shows produced by PBS Frontline.
It's a depressing situation: how did this country's health care system get so messed up? Can we fix it? Will 'Obamacare' make it better or stretch our existing makeshift solutions to the breaking point?
Sick Around the World profiled five rich, capitalist, Western countries, and how they have managed health care for their citizens: Taiwan, Switzerland, Germany, Japan, and the UK. All systems are far superior to ours, and running on less.
From the transcript of "Sick Around the World"--some highlights:
T.R. REID: [voice-over] Here's something else that's different. Japanese patients have much longer hospital stays than Americans, and they love technology, like scans. They have nearly twice as many MRIs per capita as Americans, eight times as many as the Brits.The whole show was like this, a series of PRICE REGULATING realizations that blew my little mind. (Why do we accept the AMA's flimsy-ass excuses for everything?)
So how do they keep costs under control? Well, it turns out the Japanese health ministry tightly controls the price of health care, right down to the smallest detail. Every two years, the physicians and the health ministry negotiate a fixed price for every single procedure and drug. Like the items in this sushi bar, everything from open heart surgery to a routine check-up has a standard price, and this price is the same everywhere in Japan.
If a doctor tries to boost his income by increasing the number of procedures, well, then, guess what? At the next negotiation, the government lowers the price. That's what happened with MRIs, which are incredibly cheap in Japan. I asked the country's top health economist, Professor Naoki Ikegami, to tell us how that happened.
[on camera] In Denver, where I live, if you get an MRI of your neck region, it's $1,200, and the doctor we visited in Japan says he gets $98 for an MRI. So how do you do that?
Prof. NAOKI IKEGAMI, School of Medicine, Keio Univ.: Well, in 2002, the government says that the MRIs, "We are paying too much. So in order to be within the total budget, we will cut them by 35 percent."
T.R. REID: So, if I'm a doctor, why don't I say, "Well, I'm not going to do them, then. It's not enough money"?
Prof. NAOKI IKEGAMI: You forgot that we have only one payment system. So if you want to do your MRIs, unless you can get private-pay patients, which is almost impossible in Japan, you go out of business.
T.R. REID: [voice-over] So that shafts the medical device makers and must limit innovation, right? Well, no. Japanese manufacturers of scanning equipment, like Toshiba, found ways to make inexpensive machines they could sell to doctors. And guess what? Now they're exporting those machines all over the world.
In Taiwan, everybody must opt into the system, and they issue a standard government health care card that you just pop into a slot, like paying to park: Zip. All I could think, watching them flip that wonderful little card in and out of various slots, was how these rabidly-anti-government guys around here (waves to my radio-show callers!) would never go along with something like that: galdurnit, I won't get a guvmint ID card! I can hear it now--echoes of last week's Ron Paul rally dancing in my head.
What is interesting is that once they finally get it established, even conservatives in these countries appreciate (and want to continue) universal health care for all of their citizens. And at that point, it becomes another political football, as liberal politicians threaten the populace that conservatives want to cut benefits. (Could that actually happen here?)
In Switzerland, their system was a wreck as late as 1994. It took a lot of political will to change it. Their administrative costs are now 5% of their medical budget, compared to our whopping 22%. From the transcript:
[on camera] One of the problems we have in America is that many people -- it's a huge number of people -- go bankrupt because of medical bills. Some studies say 700,000 people a year. How many people in Switzerland go bankrupt because of medical bills?In conclusion, there appears to be three major factors to make universal health care work:
President PASCAL COUCHEPIN: Nobody. It doesn't happen. It would be a huge scandal if it happens.
T.R. REID: [voice-over] But here's Switzerland's challenge. Having achieved universal health care, it has to decide how much citizens are willing to pay. Today, an average monthly premium for a Swiss family is about $750. But there's pressure to raise the premiums. And it's already the second most expensive health care system in the world, although still much cheaper than ours.
What's interesting about Switzerland is that after LAMal's success, people in this proud capitalist country see limits now to the free market.
[on camera] Could a 100 percent free market system work in health care?
Pres. PASCAL COUCHEPIN: No, I don't think that. If you do that, you will lose solidarity and equal access for everybody.
These capitalist countries don't trust health care entirely to the free market. They all impose limits.I'll repeat the question here: Can Americans accept these ideas, do you think?
There are three big ones. First, insurance companies must accept everyone and can't make a profit on basic care. Second, everybody's mandated to buy insurance, and the government pays the premium for the poor. Third, doctors and hospitals have to accept one standard set of fixed prices.
Can Americans accept ideas like that?
Well, the fact is these foreign health care ideas aren't really so foreign to us. For American veterans, health care is just like Britain's NHS. For seniors on Medicare, we're Taiwan. For working Americans with insurance, we're Germany. And for the tens of million without health insurance, we're just another poor country.
But almost all of us can agree that this fragmented health care mess cannot be ignored. The longer we leave it, the sicker it becomes, and the more expensive the cure.
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Update: Walkupy's recent bust in Madison County, Georgia, did not dim the hardy spirits of our Occupiers! We tweeted news of the arrest to the world and the Madison County Sheriff's Office was bombarded with phone calls from all manner of lefty busybodies such as your humble narrator. The Powers-That-Be responded by setting them free with all charges dropped--WOOT! Very happy about that, as one of our local Greenville Occupiers has joined up with Walkupy for a stint. (We love you, Lynne!)
From the Anderson Independent Mail, here are some very nice pictures of Walkupy on the roads.
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At left: Daisy and the dangerous sign-carrier. (Would this man hit anybody with a sign?)Speaking of busts, the official consiglieri/producer of the DAISY DEADHEAD SHOW, Gregg Jocoy, was cited for having a sign that was TOO BIG, outside the federal courthouse last week, during the Occupy the Courts action. Yes, there is some dopey Greenville County ordinance about the size of signs.
And what about Newt's enormous signs all over the county (that still haven't been taken down by his lazy supporters)? Well, they don't count, since it's a PICKETING ordinance! Big signs are okay, but not if you are walking around with it... I guess he might hit somebody with it? He'll poke his eye out!
So, an expensive citation, which I suspect was really because he was out there yelling about the courts. Occupy the Courts was a national succcess, if (as usual) receiving little media coverage.
I love seeing the Occupy movement stretch out in all directions!