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."
Re:Like everywhere else it's been tried... (Score:5, Interesting)
We were only discussing whether a public universal healthcare system automatically tanks the economy. Whether this system provides better or worse care, or does it for ore tax money than would otherwise be spent in private insurance is a completely separate discussion.
(but as a clue, I have seen lots of studies saying that for example the US healthcare system provides about half as much "care per dollar" than most single payer systems. A lot of this is of course due to legal and bureaucratic overhead).
Re:Like everywhere else it's been tried... (Score:3, Interesting)
You display the ignorance that indicates that you are a drone repeating the mantra instilled in you by propaganda. There are plenty of countries doing very well with universal healthcare. The majority of them also offer private health care for the rich who think they can buy their way to better health with additional insurance.
Re:Like everywhere else it's been tried... (Score:5, Interesting)
Yes they say the words that make you happy... do they actually deliver?
Still trolling? Let me repeat his statements for you, in a new wording
- All of the "first world" economies, except the US, pretty much have universal socialized health care.
- The systems are popular in these countries (they are all democracies, so they would have to be quite popular to remain).
- All of these economies are of course facing more or less rough times at the moment, but their economies would still be regarded as "healthy" on a global scale or seen over a few decades.
Re:Like everywhere else it's been tried... (Score:2, Interesting)
no, healthcare tanks the economy when hospitals are forced to provide healthcare to the uninsured. if some freeloading hick with no healthcare gets hit by a bus the local hospital will be forced to treat him even though it will cost hundreds of thousands of dollars that he will obviously never pay. the only option is either force people to contribute to healthcare through taxes or let hospitals refuse treatments...forcing hospitals to treat people who are too irresponsible to get insurance is a moral hazard and raises the cost for everyone else.
Re:Cost? (Score:3, Interesting)
Singapore (Score:5, Interesting)
The United States relies upon private health insurance to provide much of the financing for medical costs. This is unusual: in Britain, Canada, and Spain, for example, health-care costs are largely paid for by the government. In Austria, Belgium, France, Germany, and the Netherlands, medical costs are paid for by a system of "social insurance": it is compulsory for most people to buy insurance, but insurance premiums are tied by law to income rather than to the risk of a claim.
The United States system makes it voluntary to buy insurance, and premiums are linked to risk, not to income. But these market-based premiums, beloved of many Americans, do not seem to be delivering health care that makes them happy. A recent survey revealed that only 17 percent of respondents in the United States were content with the health-care system and thought no substantial reforms were necessary. Why the discontent?
The superficial reasons are simple enough to describe: the system is hugely expensive, very bureaucratic, and extremely patchy. The expense first: US health cares costs a third more, per person, than that of the closest rival, super-rich Switzerland, and twice what many European countries spend. The United States government alone spends more per person than the combination of public and private expenditure in Britain, despite the fact that the British government provides free health care for all residents, while the American government spending program covers only the elderly (Medicare) and some of the marginalized (Medicaid). Most Americans worry about health-care costs and would be stunned to discovered that the British government spends less per person than the American government but still manages to provide free health care for everyone. In fact, if you figure in the costs of providing health insurance to government employees and providing tax breaks to encourage private health care, the US government spending on health care, per person, is the highest in the world.
Bureaucracy next. Researchers at the Harvard Medical School found that the administrative costs of the US system, public and private, exceed $1,000 per persons. In other words, when you count all the taxes, premiums, and out-of-pocket expenses, the typical American spends as much on doctor's receptionists and the like as citizens of Singapore and the Czech Republic spend on their entire medical care. Both places are countries with health outcomes very similar to those in the United States: life expectancy and “healthy life” expectancy (a statistic that distinguishes a long healthy life and a long life plagued by years of severe disability) are a shade lower in the Czech Republic than in the United States; and in Singapore they are a little higher than in the United States. The costs of US bureaucracy is also more than three times the $307 cost per person for the administration of the Canadian health system, whic
Re:Like everywhere else it's been tried... (Score:4, Interesting)
Germany.
Re:Like everywhere else it's been tried... (Score:5, Interesting)
The evidence is that the amount of money that can be saved by various tort reform laws is approximately 2%:
http://www.nber.org/bah/2009no3/w15371.html [nber.org]
Now, that's not nothing, but it's not even close to explaining why US health care costs 3.5 times that of the UK. Some things that are more likely to make a difference:
1. Most health care in the US is fee-for-service, so doctors get paid more if they do more procedures, no matter how useful those procedures are. Solution: put doctors on salary.
2. The US spends a lot of money keeping people alive as basically a vegetable in a hospital during the last year of their life. Solution: end-of-life counseling and legalizing euthanasia.
3. A significant portion of health care costs are insurance companies, hospitals, individuals, and government each haggling to try to make the other parties pay for the cost of care. Solution: Single payer and single provider, so there's nobody else to haggle with.
4. Another significant problem is that people without insurance and money to pay for care tend to seek care at emergency rooms, which both makes it harder for ERs to handle real emergencies and means we spend easily 5 times what we would have spent to treat the same condition in a doctor's office. Solution: Cover everybody.
In other words, you get pretty close to what every other country in the world is doing, and it gets a lot cheaper to provide health care.
Re:Like everywhere else it's been tried... (Score:5, Interesting)
Let me put it this way, 10 years ago a little over half of the costs in my dad's practice were billing insurance. Its now over 75%. That right there should tell you a lot about how a single payer system could save money.
The next largest cost is malpractice insurance; when about half the doctor's lost their malpractice insurance so they closed up shop, the state stepped in, but its still a big problem.
Finally a single payer system consolidates information about what a doctor does. In other systems, like the VA, they're using that to shape doctor's practices. Basically they get the leaders in the field together to try and figure out an ideal process (e.g. weighing the risks and costs of a test to see when you should jump to the most accurate test vs using less accurate but less costly or more safe screening). Any doctor can go outside the reccomendation; all they need to do is basically check a box. If more than a certain percent of a doctors patients go outside the expected range, they then review the cases. There may be other mitigating circumstances, so they are reviewed by doctors and that feedback is used to refine the reccomendations or to consult with the doctor about how to be more cost-effective. This system shapes doctors behaviors toward providing proper medical care at a minimal cost, without ever preventing a patient from receiving the care their doctors feels is appropriate.
Keep in mind, for many people the government already provides care. If you don't have insurance and its life-threatening, the poor, veterans, etc. Before we were married, my wife worked as a pharmacy teach and she would see all these people getting pills on the government's dime and then selling them in the parking lot, yet the government wouldn't cover her and private insurance was more than she made, so she couldn't afford her bi-polar medicine. If she quit, the government would cover her, but she's the type of person who likes to pull her own weight so she went without. How much sense does that make?
Re:Scientific assessment of effectiveness? (Score:5, Interesting)
Translation: "We did some things we thought would work, and then later we stopped doing the things that weren't working and did more of the things that were." In an ideal world, governments behaving sensibly wouldn't make headlines.
You'd be surprised to know how much of the real world operates on things they believe to work rather than having any proof that it's effective. For example I remember one person telling me about this new program they created to work with young criminals. He had suggested they give it to 50% of them, using the other as a control group. That was shot down in flames, of course this worked and no juvenile should go without such a program from now on. Did it work? Is this well spent money or a waste of resources? Who the fuck knows, since society changes so you can't say shit comparing old statistics to new statistics. The irony was they said this was "too important" to not provide help, while health care that deal with real life and death situations would never use medication they had no clue if worked or not.
It's a little better on the private side but there's a helluva lot of things that are done on pure belief, you may have had some very persuasive business cases and PowerPoint presentations at the start of the project but very rarely is it properly followed up at the end of the project if the goals were actually achieved - if they were even properly defined, quantifiable and measurable to begin with. Of course sometimes projects go wrong for reasons that were impossible to predict when the project was started, but most often not. Most companies just want to bury the failed project and not try deconstructing why they started a project with such flawed plans, requirements and goals. Usually because it'll reflect poorly on some executive who authorized it.
Just got back from Mexico dentist... to Canada! (Score:3, Interesting)
Well, I'm here in Edmonton, Canada and I just recently got back from visiting a dentist in Puerto Vallarta, Mexico. Sure glad I went! Gotta do your research though!
Alberta dentist's have raised their prices in many cases to more than triple what they were 6 years ago. I even would've saved money by going to the States!
I feel bad for families who can't fly to Mexico on short notice... or me if I get stuck timewise next incident.
Re:Seguro Popular -- it's not universal (Score:5, Interesting)
>of course employers would NOT pay for healthcare
Just a minor correction, although I agree with your post. I live in a country where there is such a system, and employers DO pay for healthcare if there are on-the-job injuries, indeed it's illegal to claim those from private insurance - it MUST be paid by the employer (who is free to take out insurance against such events but not forced to - they can cover accidents out of pocket if they prefer - at least for smaller companies this is often viable).
The reason has nothing to do with healthcare cost however, it's one of the more efficient and effective ways to regulate work-place safety. If the employer is automatically liable for the cost of on-the-job injuries (however minor or major) without litigation or such ever entering into it - a guilty-by-default status, then they have every possible incentive to make the workplace as safe as possible.
Frankly if you pay for every skull fracture caused by slippery floors, it's no longer economic to save money on slip-proof mats now is it ? Ultimately this may increase the cost of doing business but I would argue it only increases it to what it OUGHT to be in the first place. Skimping on worker-safety is not a saving, it's basically murder-for-money.
Re:Like everywhere else it's been tried... (Score:4, Interesting)
So Mexico gets their act together on health care (Score:5, Interesting)
Leaving the United States as the largest third world country without universal health care.
We're getting beat by Mexico while Congress is fighting over funding for Planned Parenthood by people who want to turn Medicare into a discount coupon program.
Re:who cares about free healthcare in a civil war? (Score:4, Interesting)
All financed by American prohibition. When you see all the cash they find in a drug lord's mansion, do you see pesos, or dollars?
Re:Here I come. (Score:4, Interesting)
It's a supply-and-demand problem.
Canada and Mexico healthcare is basically "free" so demand is high, while supply is limited. Naturally standard of care goes down in order to increase supply. It's also why you get waiting lists and all that.
US healthcare is expensive, and supply is high, but demand is low (as fewer can afford it, though I thought Obamacare was supposed to fix that). Hence lots of money to spend on shiny new toys to fix people, and no waiting lists. (Of course, there are other costs as well - like people delaying trips to the doctor so they can get more ailments before seeking treatment...).
Unfortunately, I don't think anyone's figured out where the curves meet, probably because it's considered a basic necessity for a functioning society