Near-universal Mexican Healthcare Coverage Results From Science-informed Changes 732
ananyo writes about improvement to Mexico's healthcare system. From the article: "A revamp of Mexico's beleaguered health-care system is proving to be a runaway success and offers a model for other nations seeking to reform their own systems, according to a review published this week in The Lancet (abstract). The key to the scheme's success is the way in which it has modified its reforms in response to scientific assessments of their effectiveness, the authors say. Launched in a law in 2003, the Mexican scheme was designed to sort out widespread inefficiencies and inconsistencies in the country's health-care system. Some 50 million Mexicans — nearly half the country's population — who previously were not covered by health insurance are now enrolled, leading the scheme's architects to claim that the country has near-universal health-care coverage. As well as the increased coverage, the scheme has seen the number of conditions treated under Mexican public health insurance nearly quintuple. Admittedly, the former health minister Julio Frenk, now dean of the Harvard School of Public Health, is a co-author on the paper."
Shocking (Score:5, Informative)
You mean, using someone who actually understands the field he's working in instead of a politician with little or no qualifications, actually gives better results? OMFG this is revolutionary!
Re:Like everywhere else it's been tried... (Score:5, Informative)
Seguro Popular -- it's not universal (Score:5, Informative)
Yes, the claim that Mexico has near universal coverage is accurate, but Mexico's health care is not a US or Canadian (-provincial) style. This Wikipedia article is pretty accurate: http://en.wikipedia.org/wiki/Health_care_in_Mexico [wikipedia.org] about how it works.
Ex-President Fox's Seguro Popular is mostly what the article talks about, and that's what (properly) gives Mexico the right to say that it has nearly 100% coverage. And it's a good program -- my mother-in-law's maid's kid received a kidney transplant under the program.
It's important to distinguish, though, that you're not forced into this system. You can still buy private insurance, or pay cash. (Last time I had to go to a hospital in Mexico, they simply wanted my credit card).
tl;dr: the Mexican government hasn't taken away choice.
Re:Like everywhere else it's been tried... (Score:5, Informative)
Australia (where I am)
Canada
The United Kingdom
Most of Europe, for that matter
South Africa
New Zealand
Singapore
Japan
And that's just off the top of my head, with a bit of googling to back it up. You know, basically every single first world country except the United States, who recently were in a massive recession and are looking to head that way again.
Re:Like everywhere else it's been tried... (Score:5, Informative)
The Nordic states are doing pretty well, and they all have universal socialised healthcare. The Netherlands claims it has privatised healthcare, and the best service in the world, but in fact 75%+ of the cost is transparently covered by the taxpayer, and poor people do get free healthcare.
Re:Like everywhere else it's been tried... (Score:5, Informative)
In AU everybody is covered by public health care, if you earn more than $72K Aus (current ~$75k US) you pay an extra 1% tax.
This equates to about $700 a year which (I am sure not by coincidence) is about the starting point for a single non-smoker private health cover. If you do take out private cover and earn > $72k you don't pay the extra tax.
All up I feel its a fair system
Re:Like everywhere else it's been tried... (Score:4, Informative)
lol.. isn't Australia a duel health care country consisting of private and public system like England? I'm pretty sure I was going to have to buy insurance when I was thinking of moving there.
Is the NHS in the UK inadequate these days? I don't live there but I'm quite sure I'd be happy with "just" the NHS if I lived there. Having other insurances to cover e.g. loss of income from illness is one thing. I wouldn't have to have private insurance to cover transplants or cancer treatment, nor would be in a better situation to get such treatment than my poorer neighbor, and thats the important bit.
Re:Like everywhere else it's been tried... (Score:5, Informative)
I don't know where I said that paying for public healthcare leads to a collapse.
I was thinking of this: "Like everywhere else it's been tried...let's watch the mexican economy tank in 3...2...1..."
The current method of providing healthcare is basically stealing from future generations (which will eventually lead to collapse), if you think about how it works (at least in the US) it is a big ponzi scheme. Every generation needs to convince the ones after them to buy in to the insurance/Social Security scam. Please explain how else it could work.
I don't know what you mean by "stealing from future generations". If you have a budget neutral (i.e. not deficit spending) based, tax financed, public healthcare system, how will that be problematic? Look at Sweden for example. There is a single payer universal healthcare system paid for by taxes, at the same time there is a budget surplus and the national debt has been quite rapidly reduced in the last decade. Are the current generation of swedes "stealing" from the next generation of swedes?
Re:Like everywhere else it's been tried... (Score:5, Informative)
Re:Like everywhere else it's been tried... (Score:5, Informative)
When I select HEALTH index (only) the United States ranks #38. The United States is trailing the industrial powerhouses of Cuba and Costa Rica.
Build your own index using UN data:
http://hdr.undp.org/en/data/build/ [undp.org]
Re:Like everywhere else it's been tried... (Score:3, Informative)
By looking at basic economic figures, such as Gross National Product, National debt, poverty percentages, unemployment rates, education levels etc. And yes, get over it: almost all of the countries in question are doing much better in those areas than the USA.
Re:NYT had an interesting write-up. . . (Score:5, Informative)
Re:Like everywhere else it's been tried... (Score:5, Informative)
I posted this elsewhere, but its entirely relevant to most discussions on here -
In 2010 (year picked because figures are unlikely to be revised), the UK spent £118.2Billion on the NHS, for a population of about 63Million persons.
Thats a per population head equivalent of £1906 or $2954.
In that same year, the US spent about $381Billion on Medicaid and about $509Billion on Medicare - both of which highly intersect with what the NHS provides, for a population of about 311.5Million persons.
Thats a per population head equivalent of $2858.
Except the US Medicare and Medicaid programmes don't cover 311.5Million persons - Medicaid covers roughly 50Million persons, and Medicare covers roughly the same number - theres about a 6Million person intersection between the two (persons that are enrolled in both), so, again roughly, the total number of beneficiaries for these federal and state programmes is around 94Million.
That makes it a per eligible head equivilent of $9469.
And you know which system I would rather have? The one I currently use - the NHS at $2954.
The US system is just very very badly run.
Sources:
http://www.gao.gov/highrisk/risks/insurance/medicaid_program.php [gao.gov]
http://www.gao.gov/highrisk/agency/hhs/reforming-medicare-payments.php [gao.gov]
http://www.kff.org/medicare/upload/7305-05.pdf [kff.org]
http://en.wikipedia.org/wiki/Medicaid [wikipedia.org]
http://en.wikipedia.org/wiki/Medicare_(United_States) [wikipedia.org]
Re:Like everywhere else it's been tried... (Score:5, Informative)
Every generation needs to convince the ones after them to buy in to the insurance/Social Security scam. Please explain how else it could work.
Simple: the population of people requiring healthcare treatment at any given moment, even at 0 population growth, is always going to be much smaller then the population who are able-bodied and working. Across the volume of that total population, if everyone kicks in a small amount of money, then we can ensure that there's cash available for all of them when they themselves need medical treatment.
Also, since insurance gets more efficient as you dilute the risk pool, expanding it up to the size of the entire country's population has enormous benefits - as well we follow on ones such as providing for government collective bargaining on the cost and purchase volumes of pharmaceuticals (the government is the largest possible purchaser, ordering the largest possible volumes, which means it'll always be able to negotiate a good deal).
Social Security (in the US) is not a scam, incidentally. It only becomes a scam if the American populace let that happen, which will be if they allow the government (screw it - allow the current batch of GOP politicians) to reduce SS benefits to future generations. The scheme has been enormously well-funded, and is owed billions by the US government, which has avoided raising taxes by "borrowing" against SS savings. It's alleged bankruptcy is due to the fact that that money was never paid back, because it was never used for anything profit earning in the long-run: it was wasted away as tax cuts to the rich, and still is.
Re:Seguro Popular -- it's not universal (Score:5, Informative)
And that point is insignificant with universal coverage because the option to get luxury health care wouldn't exist either.
The far right keeps saying this, but it's simply not true. In England, everyone is covered by universal coverage. But many people buy supplemental health insurance because they want more of a premium plan with extra coverage/benefits. You can still have all the luxury health care you want. You are just going to have to pay extra for the luxury bits. Which all sounds quite reasonable. Stop spreading FUD.
According to the Chart... (Score:5, Informative)
From National Geographic Magazine:
http://blogs.ngm.com/.a/6a00e0098226918833012876a6070f970c-800wi
Guess who gets the least bang for their buck in Healthcare?
Re:Like everywhere else it's been tried... (Score:4, Informative)
Even that article doesn't quantify the costs caused by what it calls "defensive medicine". These are tests and procedures done a doctor covering his ass rather than trying to diagnose and treat evident conditions.
Re:Like everywhere else it's been tried... (Score:5, Informative)
Investors. The country with the highest tax burden in the world right now, Denmark, is at the moment loaning money at an interest of -0.25%..
YES, that means rich people, very rich people, and investors in general, believe the Danish economy is so healthy they are willing to loan them money at negative interest, just so that Denmark can protect they money for them.
Re:Like everywhere else it's been tried... (Score:5, Informative)
Popular? In Canada any hint of weakening the public health care system is met with outrage. It's one of the few things you can guarantee will upset Canadians, and get your government booted. I suspect the same is probably true in other countries that have them.
Re:Like everywhere else it's been tried... (Score:4, Informative)
I thought that there were states in which various flavors of tort reform were instituted, and the reform was NOT followed by interesting savings. I think Texas is one example. (I'm doing this all from memory; yeah, Wikipedia says insurance companies saved money, not sure any else did, or that it was big money. Shaving 2% off costs and dumping it entirely into the lap of the insurance companies would be a big win for them, that's for sure. http://en.wikipedia.org/wiki/Tort_reform [wikipedia.org] )
Re:Like everywhere else it's been tried... (Score:5, Informative)
Who's giving anything out for free? Public health care systems simply involve one not for profit entity, the government, paying.
Speaking as someone who actually does medical research, in Canada, drug companies do and fund plenty of research here. We have excellent, unified records for epidemiological studies and a comparatively simple, consistent system with little risk of frivolous lawsuits.
Re:Like everywhere else it's been tried... (Score:5, Informative)
You seem to be confusing taxes to fund universal health care with social security, which is a large confusion. Health care insurance is pretty much pay as you go, and though there is a skew in costs to the elderly, young people are somewhat aware of reasons they might need it (pregnancy and delivery, usually routine, sometimes not; random medical horribleness, that sort of thing).
Social security is mostly a young-to-old transfer, but it is hardly a Ponzi scheme; there are projections for costs and projections for benefits, and it does not have Ponzi characteristics; people get their money out regularly (unlike a Ponzi scheme). If we accept the usually conservative projections of future SS budgets, then the money set aside in the SSTF will not be adequate starting sometime around 2035 -- but that is not an inherent Ponzi problem, that is something instituted in the 80s to help manage the retirement of the baby boom. Benefits won't stop; they'll just be smaller. We can fix that with relatively minor tweaks to funding or retirement age, and these fixes do not have the "then-another-fix, and another, and another" nature, at least not according to the usually conservative projections; you have to bring the system into demographic balance, and then you're done. The baby boom is one heck of a pig in the snake, and that's what causes a lot of the "problems" of SS.
A second important part of SS that you are ignoring is Survivor's Disability Insurance. When we went out to buy healthy insurance on our own (one of the joys of working for a startup), the initial estimates of the policy size were enormous. The sales-ish person we talked to helpfully pointing out that SDI takes care of a huge chunk of that. If it were not for the SDI part of SS, I would have been sending larger checks to the life insurance company for the last 15 years.
Re:Like everywhere else it's been tried... (Score:4, Informative)
Lawsuits only make up about 1-2% of the health care costs.
It's not the lawsuits. It's the insurance doctors (and now some nurses and PAs) are required to get to insure you against those lawsuits. This can be north of $100k/yr and in some cases (depending on the state) close to a quarter million a year for a surgeon.
Re:Like everywhere else it's been tried... (Score:4, Informative)
The hospital I work at would probably not charge for the Q-tip itself, but add the fully burdened cost to the service provided.
Follow through, though. I'll try to make it easy for you.
The Q-tip was purchased and probably has an acquisition cost of $.01.
It was stocked by a nurse who needed to track inventory to maintain a non-profit status ($35/hr). 30 seconds to place it in the correct position and check off that it is now in inventory. ($0.50)
It was housed in a rolling cabinet that cost $2K. (assume cost is amortized over several years) The cart is cleaned once a week. The Q-tip bucket's share of this cleaning is 30 seconds @ $20/hr. let's say it's $0.01
It was requested by a care provider and took 60 seconds to log the care request into the government mandated electronic medical records used for tracking and assuring proper follow up to care. Cost of 60 seconds of care from a family practice physician (assuming $120K/year) is $1.
The request was printed out at a nurse station and picked up by charge nurse. Evaluation: 15 seconds. Delegation of the service 10 second. For a nurse making $70K/year, that is approximately $0.24.
The CNA ($25/hr) will open up the cabinet, get the Q-tip, walk the Q-tip to the patient. (2 minutes) Cost: Approximately $0.25
CNA logs the patient ID band and confirms the service will be performed: 30 seconds. (approximately $.10)
Actual use of Q-tip by CNA: 1 minute, including disposal in approved container. (approximately $0.20)
Disposal of Q-tip by janatorial staff: $0.01.
If procedure is properly performed and there are no adverse issue, you have an OCOGS of over $2. And you think it should be free?
Re:Here I come. (Score:5, Informative)
Uh, by just about every objective standard the US is one of the lowest developed nation when it comes to healthcare outcomes is and absolutely the worst when it comes to outcome per dollar spent. How anyone who has ever been involved with the US system of healthcare providers and insurance companies could want to keep it is beyond me.
Re:NYT had an interesting write-up. . . (Score:4, Informative)
No one in the US has had to sell their house to get medical tests or treatment unless they were purposely trying to manipulate their income and assets to sneak into a government program and have the state pay for their health care.
Medical expenses are the majority cause of bankruptcy. And while you do not have to 'sell your [primary] house' to declare bankruptcy, the idea that _no one_ has sold their house for medical treatment is insane.
As is the idea that 'selling your house' is the problem. The problem is _losing_ it, and plenty of people do not own their home and miss mortgage payments or rent due to medical expenses. But I will take the premise at face value.
So, taking it at face value, let's google 'sell house for medical treatment'. And let's see what do we find...a bunch of home medical stuff...hey, look, the second damn page: http://www.prlog.org/11847260-selling-house-to-pay-for-medical-bills-leads-to-pillow-talk.html [prlog.org]
Please note this story is from 2001, when medical expenses were much lower. Also note that reason that story was reported was a weird human interest fact it turned out for the best...presumably, the ones that do not are not reported.