An interesting Wall Street Journal article on Singpore's excellent healthcare system...
"What Singapore Can Teach the White House"
William McGurn of the Wall Street Journal
Its health care is first class, cheap and market-driven.
Critics of this island-nation often have fun referring to it as the "nanny state" for its laws against spitting, littering, or leaving behind an unflushed loo.
When it comes to health care, however, Uncle Sam has better claim to the nanny title. From our federal price "negotiations" and state regulations to discrimination in the tax code, government distortions prop up a system that puts key health-care decisions in the hands of everyone but the patient. Each new government intrusion, moreover, begets only higher costs—and a call for more intervention to fix the problem.
In Singapore, by contrast, they already have universal coverage. They also have world-class quality care at world-competitive prices. And in a week when White House chief of staff Rahm Emanuel is meeting behind closed doors with Senate Majority Leader Harry Reid, Singapore's example might have something to teach them about the kind of reform Americans really need.
"When I'm asked to describe the differences between the U.S. and Singapore systems, my one-word answer is 'complexity,'" says Dr. Jason Yap, director of marketing for Raffles Hospital, a leading private care facility in downtown Singapore. "There are so many parties in the American system that do not really contribute to care."
Dr. Yap is referring to the higher costs that come from an American system that depends on regulation and oversight to accomplish what Singapore tries to do with competition and choice. At the Raffles lounge for international patients, he shows me an example of the latter. It's a one-page, easy-to-read list of fees.
At the high end of accommodation, a patient can choose the Raffles/Victory suite for about $1,438 per night. That price includes a 24-hour private nurse, a refrigerator stocked with drinks, and an adjoining living room to entertain. At the other end of the scale, a bed in a six-person room goes for just $99.
As Dr. Yap points out, the actual care is the same whether a patient decides to stay in a deluxe suite or a dormitory-style room. But the choice is the patient's; the financial incentives encourage the patient to think about those choices; and the low-priced options help keep the overall costs down.
This is no accident. Like ours, Singapore's system is a mix of public and private care and financing. Unlike ours, Singapore's system is anchored, as the Ministry of Health puts it, "on the twin philosophies of individual responsibility and affordable health care for all."
"Individual responsibility" is not just a buzzword. All but the abjectly poor have to pay for some of their care, another downward pressure on prices. Perhaps most important, almost all working Singaporeans are required to put money in a medical savings account that they use for out of pocket expenses. It's their money, and they control it. As a result, they are careful about spending it.
"In Singapore almost everyone has to pay something for their care," says Dr. Yap. "When it's your money, you really ask yourself: Do I really need this?"
It seems to be working. According to a Raffles Hospital official, a knee replacement surgery runs between U.S. $12,000 and $14,000. Spinal fusion runs between $10,500 and $14,000, and a heart bypass (coronary artery bypass graft) from $23,000 to $26,500. Conservatively speaking, these prices are less than a third of what the same procedure would cost in the U.S.—that is, when you can even get the price.
As any American who has ever tried to make sense of a hospital bill or haggled with his insurance company over a payment can tell you, even for those who have decent coverage our system can be a bureaucratic nightmare. Singapore's system isn't perfect. It does suggest, however, that the Average Joe stands more to gain from a system where hospitals and doctors compete for patients, where patients have different price options for their hospital stays and appointments, and where they pay for some of it out of pocket.
Yes, a city-state with three million citizens has some advantages over a nation of more than 300 million people in 50 states. Yes, health care in Singapore is hardly the laissez-faire ideal. Still, there's intervention and there's intervention: What makes Singapore's health care work is that it is designed to swim with the market and not against it.
In macro terms, that means Singaporeans spend only about 4% of GDP on health care—against 17% for the United States. At the same time, Singapore scores better than the U.S. on life expectancy, infant mortality, and other key international measures.
In his address to Congress last month, President Obama complained that "we spend one and a half times more per person on health care than any other country, but we aren't any healthier for it." That's a good point. And the lessons Singapore has to offer suggests that what Americans need most in Washington today are fewer closed-door meetings and more open minds.
Wall Street Journal Website:
http://online.wsj.com/
Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts
Tuesday, October 20, 2009
Friday, September 11, 2009
"Really, Joe Wilson? Really?"
Calling a politician a liar is NOT a capital offense. Saying that a politician is a liar is like saying that the sky is blue. It is however highly inappropriate for a Congressman to yell “You lie!” at the President of the United States while he is formally addressing a joint session of Congress as well as the American public. The incident was just plain disrespectful; Joe Wilson is from South Carolina – a southerner should have better manners than that.
Despite what a majority of Americans believe, politics is not 100% disrespectful. It’s not all about negative campaigning, name calling, and pouting like toddlers. There are actually legislators who are friendly towards their colleagues from the other side of the aisle – YES, it is allowed! It’s too bad the late Ted Kennedy is no longer with us; he could teach some of these ideologues how to work closely with and be friendly towards others of differing viewpoints.
Before people accuse me of being ideologically biased, I have to say Democrats are just as guilty as Republicans when it comes to unwillingness to compromise. Nancy Pelosi deserves her own blog of criticism, but I don’t even want to open that can of Botox.
Back to the Wilson debacle: nothing like that has ever happened to any other President, at least not in such a grand and formal setting.
In the immortal words of Bon Qui Qui: “…rude.”
It is the job of Congress to hold the President accountable, but it is not the job of one embittered Congressman to disrupt a Presidential address in such a way.
On the topic of political compromise and the reduction of bitterness among congressional colleagues, I would like to share an essay that I have written on the book First Person Political. The author, Grant Reeher, is Associate Professor of Political Science at Syracuse University’s Maxwell School of Citizenship and Public Affairs. Reeher also co-authored Click on Democracy: The Internet’s Power to Change Political Apathy into Civil Action.
“Up Close and Personal”
In First Person Political, Grant Reeher strives to provide the reader with deep insight into the more private aspects of state and local legislators. As citizens, we tend to have a negative, untrustworthy view of elected officials. Reeher refutes this common opinion through a series of interviews with legislators of Connecticut, New York, and Vermont; which expose politicians as complex human beings who have a true love for public service and the betterment of society.
Reeher’s main question that he seeks to answer through his research is that of motivation. Several factors create difficulty for politicians to run for, win, and continue to hold legislative office. Through his series of in-depth interviews with several state legislators, Reeher uncovers the reasons why they subject themselves to the hardships that accompany life in the public sphere.
Reeher wants us to understand that the vast majority of people who run for elected office do so to serve the will of the people and to improve the well-being of society. The legislators that he interviewed often spoke of the improvements they wanted to make for the people of their communities and states. In order to set their positive ideas in motion, there are many difficulties that legislators must overcome. Simply winning a position in a legislature is often extremely costly and time-consuming. Also, the legislative salary can sometimes – as in the case of Connecticut and Vermont – be insufficient. This typically requires elected officials to have a second job that provides them with adequate funds to live and campaign. It seems irrational for politicians to seek office solely for the sake of fame and power, when there are much easier and more cost-effective venues in the private sector to do so. While the desire for notoriety may be a common factor in the quest for political office, clearly one must also have a very intense desire to serve society in order to push through the barriers facing public servants.
Reeher concludes through his interviews that legislators must gain a great deal of satisfaction from their jobs, otherwise the struggle to attain and hold these jobs would prove fruitless. Sources of job satisfaction for legislators often come from a sense of personal efficacy, legislative accomplishments, and camaraderie with other legislators. However, he also claims that negative experiences of political office can be quite profound. Overextension of time and resources result in emotional stress and strain on several aspects of life: family, secondary career, and public image. Life in the public eye can result in a psychological toll, especially when elected officials are repeatedly criticized by media and constituents.
In my opinion, the most striking segment of Reeher’s collection of interviews is the section discussing Ralph Wright – a House Speaker of Vermont. This section gives the reader insight to the inner workings of a skilled politician who has made a career of public service. Wright wielded a great deal of political power, and used that power (along with a Democratic majority) to stack important committees and push through legislation. Such a forceful use of command caused several Vermont legislators to feel alienated from the political process. At the same time, however, Wright was able to enact a great deal of policy that benefitted the state. Opinions on Wright varied depending on the legislator being interviewed, but his mastery of the political process was evident throughout.
It was surprising to see the nature of the relationships among members of the legislature. The conversations that are recounted by Wright and others indicate that the Vermont legislature is – foremost – a workplace like any other. Rather than two sides of enemy ideology, it seemed more like a cooperative group of people with differing opinions. Indeed there were heated disagreements and political dealings, but primarily the Vermont legislature was remarkably connected to the needs of the state and its citizens.
President Obama's 9/9/09 address to Congress in its entirety:
http://www.youtube.com/watch?v=U1YNF9I25yU
Joe Wilson's big moment:
http://www.cnn.com/video/#/video/politics/2009/09/09/obama.heckled.cnn?iref=videosearch
Bon Qui Qui:
http://www.youtube.com/watch?v=jZkdcYlOn5M
http://www.youtube.com/watch?v=t1wpEAlneHA
Despite what a majority of Americans believe, politics is not 100% disrespectful. It’s not all about negative campaigning, name calling, and pouting like toddlers. There are actually legislators who are friendly towards their colleagues from the other side of the aisle – YES, it is allowed! It’s too bad the late Ted Kennedy is no longer with us; he could teach some of these ideologues how to work closely with and be friendly towards others of differing viewpoints.
Before people accuse me of being ideologically biased, I have to say Democrats are just as guilty as Republicans when it comes to unwillingness to compromise. Nancy Pelosi deserves her own blog of criticism, but I don’t even want to open that can of Botox.
Back to the Wilson debacle: nothing like that has ever happened to any other President, at least not in such a grand and formal setting.
In the immortal words of Bon Qui Qui: “…rude.”
It is the job of Congress to hold the President accountable, but it is not the job of one embittered Congressman to disrupt a Presidential address in such a way.
On the topic of political compromise and the reduction of bitterness among congressional colleagues, I would like to share an essay that I have written on the book First Person Political. The author, Grant Reeher, is Associate Professor of Political Science at Syracuse University’s Maxwell School of Citizenship and Public Affairs. Reeher also co-authored Click on Democracy: The Internet’s Power to Change Political Apathy into Civil Action.
“Up Close and Personal”
In First Person Political, Grant Reeher strives to provide the reader with deep insight into the more private aspects of state and local legislators. As citizens, we tend to have a negative, untrustworthy view of elected officials. Reeher refutes this common opinion through a series of interviews with legislators of Connecticut, New York, and Vermont; which expose politicians as complex human beings who have a true love for public service and the betterment of society.
Reeher’s main question that he seeks to answer through his research is that of motivation. Several factors create difficulty for politicians to run for, win, and continue to hold legislative office. Through his series of in-depth interviews with several state legislators, Reeher uncovers the reasons why they subject themselves to the hardships that accompany life in the public sphere.
Reeher wants us to understand that the vast majority of people who run for elected office do so to serve the will of the people and to improve the well-being of society. The legislators that he interviewed often spoke of the improvements they wanted to make for the people of their communities and states. In order to set their positive ideas in motion, there are many difficulties that legislators must overcome. Simply winning a position in a legislature is often extremely costly and time-consuming. Also, the legislative salary can sometimes – as in the case of Connecticut and Vermont – be insufficient. This typically requires elected officials to have a second job that provides them with adequate funds to live and campaign. It seems irrational for politicians to seek office solely for the sake of fame and power, when there are much easier and more cost-effective venues in the private sector to do so. While the desire for notoriety may be a common factor in the quest for political office, clearly one must also have a very intense desire to serve society in order to push through the barriers facing public servants.
Reeher concludes through his interviews that legislators must gain a great deal of satisfaction from their jobs, otherwise the struggle to attain and hold these jobs would prove fruitless. Sources of job satisfaction for legislators often come from a sense of personal efficacy, legislative accomplishments, and camaraderie with other legislators. However, he also claims that negative experiences of political office can be quite profound. Overextension of time and resources result in emotional stress and strain on several aspects of life: family, secondary career, and public image. Life in the public eye can result in a psychological toll, especially when elected officials are repeatedly criticized by media and constituents.
In my opinion, the most striking segment of Reeher’s collection of interviews is the section discussing Ralph Wright – a House Speaker of Vermont. This section gives the reader insight to the inner workings of a skilled politician who has made a career of public service. Wright wielded a great deal of political power, and used that power (along with a Democratic majority) to stack important committees and push through legislation. Such a forceful use of command caused several Vermont legislators to feel alienated from the political process. At the same time, however, Wright was able to enact a great deal of policy that benefitted the state. Opinions on Wright varied depending on the legislator being interviewed, but his mastery of the political process was evident throughout.
It was surprising to see the nature of the relationships among members of the legislature. The conversations that are recounted by Wright and others indicate that the Vermont legislature is – foremost – a workplace like any other. Rather than two sides of enemy ideology, it seemed more like a cooperative group of people with differing opinions. Indeed there were heated disagreements and political dealings, but primarily the Vermont legislature was remarkably connected to the needs of the state and its citizens.
President Obama's 9/9/09 address to Congress in its entirety:
http://www.youtube.com/watch?v=U1YNF9I25yU
Joe Wilson's big moment:
http://www.cnn.com/video/#/video/politics/2009/09/09/obama.heckled.cnn?iref=videosearch
Bon Qui Qui:
http://www.youtube.com/watch?v=jZkdcYlOn5M
http://www.youtube.com/watch?v=t1wpEAlneHA
Sunday, August 16, 2009
"Universal Health-Scare"
A new week, a new day, a new school, a new blog being sent out into the internet void. I have been wondering what would be the best way to start a political blog. Then I realized there are about two people who will read this – so who gives a damn. So what better way to begin sharpening my political prowess by diving headfirst into the quagmire that is the healthcare system? Cable news is inundated with health care reporting – interviews and debates between congressmen and congresswomen, ardent anti-government protesting, those painful town hall meeting question/answer sessions, and the occasional corn-fed redneck calling President Obama an illegal alien communist dictator. It’s enough to make you want to punch your television, until you realize that Wolf Blitzer is on, and he’s awesome (really, I mean, his name is Wolf … that’s BA). So who should we troubled masses believe? The proponents, the opponents, the vacillating crowd who isn’t quite satisfied but appreciates the main objective?
For me, it’s a big question of “Ifs”. I would support the health care reform if it turns out how it has been advertized by the President and Left-leaning members of Congress. Government sponsored healthcare as an option seems perfectly acceptable. As long as private insurance coverage can still exist, the government should make an effort to fill in the gaps left by capitalistic insurance companies. Many people believe that a government agency in charge of healthcare will run all private companies out of business. This fear is understandable, since the government healthcare administrators will not have to worry about making a profit the way that private companies do. Theoretically, the government health care “company” would be able to spend massive amounts of taxpayer money without having to balance its checkbook. However, today I heard President Obama refer to the Post Office – which as most of you know, is knee deep in the red right now. UPS and FedEx do quite well in the face of the government agency that is the postal service – maybe private insurance companies will do the same. Introducing a new competitor for insurance customers to subscribe to, may force private companies to be more competitive in the marketplace, i.e. cheaper and more user-friendly. Seems legit to me.
On the other hand, if private health care is done away with, competition (which is ONLY the backbone of our economy) flies out the window. With it goes our right to choose our coverage and ultimately the quality of coverage. It’s really as simple as that.
It seems to me that people who believe that there should only be private coverage do not realize that there will inevitably be uninsured and underinsured people out there. I wonder what they expect people who cannot afford an insurance plan to do. If a single parent who can only afford one insurance plan pays for insurance coverage for his child instead of paying for his own, and is then diagnosed with cancer, what does he do? Roll up into a ball and die? If he cannot afford the treatment bills and has no insurance of his own, what else is he supposed to do? He has his child insured while sacrificing his own security, and then he could potentially die, leaving his medical debts to his family.
In short - like most things in life, moderation seems to apply well to healthcare.
For me, it’s a big question of “Ifs”. I would support the health care reform if it turns out how it has been advertized by the President and Left-leaning members of Congress. Government sponsored healthcare as an option seems perfectly acceptable. As long as private insurance coverage can still exist, the government should make an effort to fill in the gaps left by capitalistic insurance companies. Many people believe that a government agency in charge of healthcare will run all private companies out of business. This fear is understandable, since the government healthcare administrators will not have to worry about making a profit the way that private companies do. Theoretically, the government health care “company” would be able to spend massive amounts of taxpayer money without having to balance its checkbook. However, today I heard President Obama refer to the Post Office – which as most of you know, is knee deep in the red right now. UPS and FedEx do quite well in the face of the government agency that is the postal service – maybe private insurance companies will do the same. Introducing a new competitor for insurance customers to subscribe to, may force private companies to be more competitive in the marketplace, i.e. cheaper and more user-friendly. Seems legit to me.
On the other hand, if private health care is done away with, competition (which is ONLY the backbone of our economy) flies out the window. With it goes our right to choose our coverage and ultimately the quality of coverage. It’s really as simple as that.
It seems to me that people who believe that there should only be private coverage do not realize that there will inevitably be uninsured and underinsured people out there. I wonder what they expect people who cannot afford an insurance plan to do. If a single parent who can only afford one insurance plan pays for insurance coverage for his child instead of paying for his own, and is then diagnosed with cancer, what does he do? Roll up into a ball and die? If he cannot afford the treatment bills and has no insurance of his own, what else is he supposed to do? He has his child insured while sacrificing his own security, and then he could potentially die, leaving his medical debts to his family.
In short - like most things in life, moderation seems to apply well to healthcare.
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