Uwe Reinhardt, Princeton’s healthcare economist who has previously been featured in this blog, has posted a very interesting article to his NY Times blog. In it, he dissects the various roles of the healthcare system, using the German model to explain how some roles can be performed by government and others by private health insurance companies. In the German system, everyone (90%) is covered, all workers and their employers contribute, and social goals are attained, at a cost less than half that in the US. Germans can choose from 200 different health insurance funds to get their health needs met.
Reinhardt has also started talking about one of the (cultural) elephants in the healthcare room. Must it take someone who hails from outside the US to explain to us our cultural biases? One recalls the success of DeToqueville in a similar arena.
Reinhardt spits it out: prevailing views of what our rights should be, vis a vis health care costs and entitlements, is inherently contradictory:
They [health plans in Germany, Netherlands, Switzerland] all rely on purely private, nonprofit or for-profit insurers that are goaded by tight regulation to work toward socially desired ends. And they do so at average per-capita health-care costs far below those of the United States — costs in Germany and the Netherlands are less than half of those here. . .
In Europe, as in Canada, that social ethic [guiding the payment for and provision of healthcare] is based on the principle of social solidarity. It means that health care should be financed by individuals on the basis of their ability to pay, but should be available to all who need it on roughly equal terms. The regulations imposed on health care in these countries are rooted in this overarching principle.
First, these countries all mandate the individual to be insured for a basic package of health care benefits.
Many Americans oppose such a mandate as an infringement of their personal rights, all the while believing that they have a perfect right to highly expensive, critically needed health care, even when they cannot pay for it. This immature, asocial mentality is rare in the rest of the world.
Read the full article, browse his other posts, and be grateful that a few pundits like Reinhardt are pointing to sensible solutions to the health care morass choking our nation.