Conservatives and the Swiss Healthcare System

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I guess some conservs are fond of the Swiss system. The 1st article shows why they favor it and the 2nd responds and shows how it really compares to Obamacare.

http://blogs.reuters.com/great-debate/2013/02/20/the-future-of-free-market-healthcare/

I don’t think the Swiss health care system is what they think it is

Posted: 20 Feb 2013 10:07 AM PST

"Yglesias praises Douglas Holtz-Eakin and Avik Roy, and notes that their continued call for a more-Swiss like health care system is a “surrender” to Obamacare. I’ll leave that political nuance to him. But I have got to point out that while Switzerland seems to be some “holy grail” to many conservatives, with respect to a health care system, I’m not sure they know what it really is.

For instance:

While most Americans view their healthcare system as “free-market,” Switzerland actually has the most market-oriented healthcare system in the West. It translates into universal coverage and low entitlement costs. Swiss government entities spent about 3.5 percent of gross domestic product on healthcare in 2010, compared to 8.5 percent in the United States. That’s a difference of more than $5 trillion over 10 years: real money, especially relative to our $16 trillion debt.

The reasons other countries spend less are not because they are “free market”. Why not cite how much less the UK spends? Or Canada? Or pretty much any other country in the world? The reason they spend less is because everything (including drugs, physicians, etc.) costs less there.

There is no “public option” in Switzerland. Instead, citizens qualify for means-tested, sliding-scale subsidies and choose among a variety of regulated, private-sector insurance products. The Swiss have the freedom to choose their own doctors, as Americans do, and access to the latest medical technologies. They also have short waiting times for appointments.

There is no “public option” here. What are they talking about? But more importantly – do they know that the Swiss health care system forces every insurance company to offer a non-profit product to everyone, which is closer to a “public option” than anything we have?

More of their ideas:

The first is to replace or reform Obamacare’s exchanges, which are larded with costly mandates and regulations. These drive up the price of insurance, while limiting insurers’ ability to come up with more innovative, cost-efficient products.

Do they know that the Swiss health care system has an individual mandate? Do they know that the Swiss health care system has arguably more regulations, such that they can’t even charge a 25 year old and an 80 year old a different price (like you can in Obamacare)? Do they know that the Swiss health care system regulates drug prices and fees for lab tests and medical devices? Do they know the most someone can pay for insurance in Switzerland is 8% of income (which is less than Obamacare allows)?

“Community rating,” for example, will dramatically increase premiums for young people, a counterproductive approach when one considers that most uninsured Americans are in their 20s and 30s. States should build free-market exchanges with affordable health plans — as Utah has done — and demonstrate their superiority to Obamacare’s costlier approach.

Do they know that the Swiss health care system employs community ratings?

Fourth is to gradually shift the remainder of Medicaid’s low-income enrollees into the exchanges. Today, Medicaid recipients face a strong disincentive to seek work, because entry-level jobs can force them to give up their health coverage in exchange for modestly higher income. The exchanges would allow these workers to climb up the income ladder while maintaining their insurance.

Do they not know that this will be more expensive than giving them Medicaid? Do they not know that’s why Congress didn’t do it?

Look, I get that they’re trying to make a political point, and I applaud the fact that they’re trying to make conservative changes to Obamacare to make it more palatable to their goals and ideology. But it’s just hard to look at the rest of the world and argue other countries make the point Roy and Holtz-Eakin assert."

DynoDon
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Jun. 29, 2012 10:24 am

Comments

I am a fiscal conservative and social liveral, used to be a Democrat until the party was taken over by progressives. Now I am Libertarian. I like Dr. Benjamin Carson's plan. Health care should never have been tied to a jonly no one should come between the patient and the doctor-not insurance companies or the government. If we all had HSA accounts to manage, we would be more thoughtful in our choices...and probably more frugal.

SaltoftheEarth
Joined:
Apr. 25, 2011 6:01 pm

In Switzerland it was a national referendum that forced insurance companies to go non-profit. Maybe California could do such a thing as they seem to run their state government by referendum.

Of course, the unbridled free marketeers always look for market solutions to health care because, uh well, they're more efficient maybe. Aren't all things market oriented more efficient? In fact, no they aren't. If you're in the market for a new blender or toaster, it's great. Lots of choices and lots of different prices. In fact you can do without if you want to. That's called "elasticity of demand."

So let's translate that to healthcare. You're in a hospital bed with an IV in your arm and the doctor says, "We need to operate right away to save your life." How likely are you to say, "I need to shop around," or "No, I don't want any." That's called " inelastic demand." Doesn't quite fit the free market religion.

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Combad57
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May. 29, 2012 12:50 pm

Health care must be non-profit, and I would include the supply train of pharm, med tech and other facilities. We should end employment tied insurance and go with a general citizen universal risk pool approach to get the best cost/benefit results for all. It also ends both the problem for employers and the bind on employees related to health insurance. Health is not a product, and the insurance is a universal hedge against largely unpredictable health issues over a lifetime. Some people have bad genes and others have bad habits, but neither is likely to be influenced by consumer choices in health insurance. Holding people accountable to bad insurance choices is nasty. Back to the rationing problem.

Making the insurance companies go non-profit robs them of any larger reason to be. Why not just absorb them into one network so there is less confusion about various plans and coverages for patients to skirt in the course of making medical decisions with their doctors? If it makes sense for different expertise to be applied to different needs and coverages, you can either have it be civil service or to have these private non-profits possess some real value-adding competence that fits what the society needs. Merely allowing private non-profits instead of state civil servants does not show any advantage to the system in the former. Maybe it had some political advantages by allowing some favored people to run the firms. I cannot see any theoretical advantage to the Swiss plan.

drc2
Joined:
Apr. 26, 2012 12:15 pm

But a Swiss type system may be the best we can get under our capitalist system.

DynoDon
Joined:
Jun. 29, 2012 10:24 am

It is basically "domesticated capitalsm" where the private firms act in place of civil servants. I am not sure what the benefits of ownership are there or what is extracted from the system in their scheme to reward stockholders or 'owners.' What I am sure about is that there is no real advantage to the private form of administration if the State is setting the standards and practices they must observe.

It may be the only way to insure that Darlin' and others like her do not die of apoplexy were we to have it be civil service and government instead of these Swiss style non-profits. If they don't think the government is taking over, we get to save on ER and Crisis Unit costs by not having to treat them.

drc2
Joined:
Apr. 26, 2012 12:15 pm

As a Swiss citizen, I know many American idealize our system, but there are many misconceptions about healthcare in Switzerland. "Competition" isn't exactly what's going on, as most providers keep prices high, in a sort of articificial monopolistic market. While the system also has its qualities, it's very important to keep possible pitfalls in mind. Student health Switzerland

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Benjamin222
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May. 17, 2013 7:16 am

But how does it compare to the current US system in regards to universal coverage and cost?

DynoDon
Joined:
Jun. 29, 2012 10:24 am
Quote Benjamin222:

As a Swiss citizen, I know many American idealize our system, but there are many misconceptions about healthcare in Switzerland. "Competition" isn't exactly what's going on, as most providers keep prices high, in a sort of articificial monopolistic market. While the system also has its qualities, it's very important to keep possible pitfalls in mind. Student health Switzerland

In the U.S., health care insurers are the only industry legally allowed to collude with one another in setting services/prices. However, we call a manipulated market by collusion a "free market". LOL

Retired Monk - "Ideology is a disease"

polycarp2
Joined:
Jul. 31, 2007 4:01 pm
Quote SaltoftheEarth:

I am a fiscal conservative and social liveral, used to be a Democrat until the party was taken over by progressives. Now I am Libertarian. I like Dr. Benjamin Carson's plan. Health care should never have been tied to a jonly no one should come between the patient and the doctor-not insurance companies or the government. If we all had HSA accounts to manage, we would be more thoughtful in our choices...and probably more frugal.

Show me a progressive Democrat that I'm eligible to vote for, and I'll vote for him/her. They are rare birds. Most Dems are neo-liberal twits just like the Repugnants. They just use different rhetoric. LIbertarianism works really well in a reciprocal economic system. In a market economic system, it isn't viable

Reciprocal economic systems were violently overthrown by those having the economic/political/military clout to do so. A few very small remnants of reciprocal economic systems still remain.

Functioning liberarianism within a reciprocal economic system. Example (video):

http://thoughtmaybe.com/ancient-futures-learning-from-ladakh/

Retired Monk - "Ideology is a disease"

polycarp2
Joined:
Jul. 31, 2007 4:01 pm

"

None of the 36 countries which have better health care systems than the USA have followed the money to build their health care system. For the very good reason given above: money does not care.

Once care has been made the master motivation of its own house, health care, care can dictate lots of behaviors which enhance care and that the search for profit cannot dictate.

For example most forms of advertizing by private health care companies is unlawful in Europe (and European authorities are suggesting to crack down on more subtle forms of lobbying). In the USA, lobbying and advertizing has become more costly than research and development, explaining, at least partly, why the development of new drugs and cures has stagnated in recent years." from

http://patriceayme.wordpress.com/2012/03/19/money-does-not-care/

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pshakkottai
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