I’m going to tell just this one story about my experience as an American expat with the health care system here in Germany.
One night a few months ago I had sharp stomach pains that got worse and worse and kept me from sleeping. This had never happened before, and it was a little scary.
At 3am, after hemming and hawing, I finally gave in and took a taxi to the emergency room at one of the hospitals here in Munich.
At first I thought the place was closed, because there was just a receptionist on duty behind plexiglas. No one rushing around, and it was a bit dark. She was reading a novel.
I told her about my stomach, and she buzzed me into a room with three hospital beds and some nurses and doctors. An old woman was lying on the far bed near the window, her husband seated in the chair next to her. A nurse told me to take the bed nearest the door. The middle bed was empty. There were no other patients.
Two nurses hooked me up to an EKG immediately. One brought the printout to a doctor while the other took my blood. These are the admittance exams they give everyone who comes to the emergency room — it’s automatic.
Somewhere in the middle of this experience, I realized that I’d shown up at an emergency room in the middle of the night, and I’d been seen immediately.
I hadn’t been asked to sit in a waiting room for 8 hours like the time I had a concussion in Boston.
A few hours later, after my abdominal ultrasound was clear, I poked around the hallway near the main entrance just to confirm what I’d been wondering about.
There was no waiting room.
There were a few chairs in the hallway — six or eight, all empty — but nothing like the hospital waiting rooms I knew from the US.
How was this possible?
A week later the bill for my ER visit arrived. I have no German health insurance so I pay all my health care costs out of pocket. In theory I can send these to my US insurer to get reimbursed but so far that hasn’t worked out very well.
I opened the envelope nervously, and there it was in black and white: 264 euros. The total cost of the best emergency room visit I’ve experienced in my life.
Health care in Germany is not a single-payer model. There’s a public insurance option which is more affordable for families and a private insurance option which offers better care. Some doctors only accept the private insurance because they make more money from it. Poor people get government subsidies to cover their health insurance and preventative care.
The result is that everyone has health coverage, and my uneducated guess is that this is why there was no waiting room at the hospital I visited. In the US the ER is a service provider of last resort for people who have no other option for routine care. And a lot of routine and preventative care is delayed until the issue becomes acute, triggering even more ER visits.
So another system is possible. And the people debating the health care system in the US who have never experienced another system don’t have the whole picture.
(By the way, the routine blood test they did during my admission picked up a previously undiagnosed Thyroid condition called Hashimoto’s Thyroiditis, which I am treating with a daily pill.)
Posted on 8 December 2009
- Leave a comment
- Subscribe with Google Reader
- Follow me on Twitter
Did you like this article?
-
“264 euros” = $391
That’s actually quite expensive for an uninsured emergency room visit at many hospitals in the U.S and obviously more expensive than an insured copay.
I can’t really comment on waiting room time, other than to say it varies greatly by the specific hospital. Some hospitals almost never have waits and other hospitals always have people waiting. I don’t think waiting is endemic to the U.S. healthcare system.
-
Well, according to newchoicehealth.com, an abdominal ultrasound in a major American city costs $340 on average at the cheapest service providers. At hospitals it’s much more expensive – $1350 at the Massachusetts General Hospital.
And that’s just the ultrasound — without the ER fees, the blood tests, the surgeon consultation, etc, that I also received in Munich. So I think 265 euros is extremely cheap.
Average ER waiting time in the US is 3 hours and 42 minutes according to a 2006 Press Ganey study, see these articles:
http://www.msnbc.msn.com/id/15817906/ns/nightly_news_with_brian_williams/
http://www.chicagonow.com/blogs/doctors-next-door/2009/09/the-emergency-room-a-misused-portal-of-entry.html-
America and Germany is fucked. Here in Lithuania it would cost $5 – $10.
-
-
You haven’t been to an emergency room in a while, have you?
Insured, I paid well over $500 for my sons infected finger. No tests, just slice, drain, and he was done. It was also at least a 6 hour ordeal.
-
No, it’s not expensive.
I have insurance. It pays 80% of emergency room visits.
I had to visit an American emergency room a few months ago. The doctor saw me for five minutes, total, after I waited for two and a half hours, I was billed something like $2000 (and received separate bills from the hospital and doctor, because that’s the way these things work) and my share, after insurance, was around $400.
-
I have health insurance coverage through my work, and an emergency room visit, regardless of the reason or final cost, will cost me $200 out of pocket (Note that this does not cover any actual procedures, tests are covered by insurance as being completely separate from the act of being admitted at the er. my $200 copay only gets me in the door, lets me lounge around for, oh, say 8 hours, then spend, if i’m really lucky, 10 minutes with a doctor). It’s safe to say that the same visit for me here in the states would have cost at least as much (in out of pocket expenses) as it did for our distinguished author.
I might consider hopping a last minute flight to Germany the next time I need to visit the emergency room…
-
-
Hey Nat (we met shortly at the Novell office in Nürnberg a while ago
) Arguably, the German health care system is somewhat going down the drain, specifically because it has that schizophrenic approach of public and private insurance. Costs are quite high, and the quality of services varies a _lot_ between those two options.
Here in Belgium (*), we only have the public option, and the system is less expensive. But most importantly, it is fair, a lot more so than in Germany. There are no “better treatments” as in .de, there is just the better treatment for everyone. And there is no waiting room at the emergency either.
(*) I work in Germany and pay my health care tax there, but I live in .be and always go to the doc or clinic in .be — simple system, my Belgian health fund pays the bills and then gets the money back from my German health fund, totally transparent to me
Of course, the German health care system is a lot better than in the US, but it is on the slippery slope of having been liberalized, clearly not for the better. And definitely not for the better of the less wealthy.
Your blog post remains true nonetheless, but having _only_ the public option is an even better system. It is less expensive (in .be it’s 13.7% of your salary, in .de it’s ~21%), it is fair, and is at least equally as good as the German private insurance level from a quality perspective. Note that “only the public option” does not mean that you do not have a choice: you can get additional coverage at one of the many public health funds or from a private insurance (not that the latter is better), and there are quite a few public health funds to choose from. All the health care taxes paid by people working in Belgium are put together and then distributed across those public funds, proportionally to the number of people they are insuring. People without a job are covered too, to no expense. And insuring my children (aged 4 and 1.5) costs me ~100 EUR per year, including additional services such as covering single bed room and such.
So much for a public option being worse I’ve been following some of the debate in the US through The Daily Show, and I just couldn’t stop shaking my head. Socialist here, socialist there. Well… yes, western Europe countries have those systems because they have a socialist government or had so in the past. And I wouldn’t want to give that up, definitely not for more money on my bank account but less fortunate people having awful health care or even dying because they couldn’t afford it. A lot of people have suffered and fought to have those systems in place and to keep them there. It’s also quite funny from the perspective of history, as those things were put into place to appease the people as most western Europe countries were on the verge of becoming communist after WW2. Seems like we kept the good parts, even though it’s hardly communist since quite a long time
-
Hey, good to hear from you Pascal.
Interesting to hear the intra-European perspective. I think it’s important to note that your criticisms of the German system are relative. It’s still a lot cheaper than the US system, see these charts from the International Federation of Health Plans:
http://montclairsoci.blogspot.com/2009/11/top-of-charts.html
Also the German system does not take 21% of your salary. It’s a cost determined based on your age/etc so it doesn’t scale up if you get a raise. So 21% must be an average (but where did you get that number?).
Thanks for your thoughtful comment Pascal!
-
It’s definitely not 21%, but the monthly amount you pay does scale up with wage increases. My public plan costs 15% of my salary, for example, but Novell pays for half of that.
-
Ah, ok. I believe the private insurance is an actuarial rate, no salary scaling.
-
-
-
-
You may also want to be screened for celiac disease (a.k.a. coeliac disease). It frequently co-occurs with Hashimoto’s, and is quite common on its own (1 in 100 people have it). It can cause stomach pain, among other things.
/PSA
-
Having Hashimoto means considering screening for other auto-imune diseases, yes, but don’t scare him yet
I don’t remember the prevalence of celiac disease, but that’s because it’s simply not that frequent. A simple look at Wikipedia gave me a prevalence of 0.05–0.27% symptomatic patients, and 0.75% in the US. Anyway, if Nat had celiac disease, we would probably know by now. Celiac disease would make him malnourished by simply eating bread.-
Your numbers are wrong.
Celiac occurs in 1/100 people. It is horrendously underdiagnosed in the US.
Symptomatic patients are the -minority- of people with celiac. It can silently cause cancer, among other problems. Symptoms vary wildly (from “awful” to “none”), and damage occurs whether or not there are any symptoms at all.
Please don’t wave your hand and dismiss what I wrote. I have CD, was undiagnosed for 20 years, and am now dealing with the aftereffects. A test is painless and can prevent many health effects. I wish someone had suggested it to me.
-
-
-
Health Care is a complex subject and concluding some other system is better on the basis of one visit is poor thinking.
The US private system is the main provider of new health procedures and innovation. See Horizon documentary “Fix Me” – the only hope offered to the 4 UK patients was in the US.
Personally I am not prepared to pay high taxes for a “free” European health care system that is abused by the vast majority, because it is perceived as free. Neither is the US monopolistic private system good either, but it is slightly preferable.
The solution is private, non-monopoly health care with a minimal public safety net for all. The safety net should be rationally and fully specified and no left to subjective judgment. Example emergency car accident treatment – yes; treatment for drug / alcohol abuse – no.
-
I lived in the UK for over a decade and have lived in the US for over 5 years. In my experience the US system is most certainly not preferable to the UK one, in spite of its problems.
Also, your “solution” seems unimplementable. What if the car accident was the result of illegal speeding? No treatment then?
-
“concluding some other system is better on the basis of one visit is poor thinking”
And my point is actually quite similar — debating the US health care system on the basis of only having ever experienced the US health care system is missing a large part of the story. There are other systems, and unless you’ve got any real experience with them, you’re arguing in a vacuum.
It seems to me that the US is in a great position right now that we’re absolutely unable to take advantage of. We’re preparing to remake our health care system, and there are decades of data from many alternative systems around the world, from which we could choose whatever works best. Unfortunately this kind of rational behavior is precluded by hateful politics and corruption.
And of course I have had more than one health care experience during my 3 years here in Germany, but I doubt sharing every single story would make any difference in anyone’s opinion.
And finally, I wasn’t “concluding that one system is better.” I was sharing a story, and relating that I think first-hand experience with non-US systems is pretty useful in the health care discussion.
The fact that I can’t do this without getting insulted on my blog is a pretty good sign of how off-the-rails, irrational and hateful the US style of debate has gotten.
-
You US health care system is vastly abused by insurance companies. Having insured people pay way more than the real cost of the medical act proper should send a strong signal to your free-market American brain.
Now, that’s true that some people abuse our European health care system, but the total cost of a few undue medical acts is obviously nothing compared to what your corrupted system pumps out of your people.
Man, just look at the costs ! Money talks much better than ideology. And that’s not even taking into account how you treat poor people in your country. -
spacegoat: “The US private system is the main provider of new health procedures and innovation. See Horizon documentary “Fix Me” – the only hope offered to the 4 UK patients was in the US.”
Well, that’s an interesting question, actually. Why would that be the case? It’s not because the US system is private, I don’t think (despite what you say). The UK system is not entirely public. Everyone must pay the cost of the public healthcare system (it’s funded out of general taxation), but private options are entirely legal. You can live in the UK and use entirely private healthcare: buy insurance from a private company and be treated by private clinics and hospitals. There are multiple companies that offer such services, and some of them do in fact provide treatments the public system (the NHS) does not offer. The fact that the UK also provides a public system would not in any way restrain any of the private health providers from offering the treatment in question.
So, why would you conclude that it’s the fact that the US system is private that means it sometimes provides treatments other systems do not? Your evidence doesn’t seem to support it.
-
-
While I won’t disagree that the US health system has many problems that need fixing, I don’t know that this anecdote alone is sufficient to demonstrate a specific problem — it may well be a factor of the hospital that you’ve chosen to visit.
Case in point, the last time Brian (my husband) went to the MGH ER after being directed there for urgent care by his doctor he had to wait about 4 hours. They finally saw him and diagnosed him with meningitis and rushed him into a quarantine room. Quote: “It’s probably viral, which is the good kind. If it was bacterial you’d be dead by now… we had someone come in last week and they died before we got to see them.” Frightening.
On another occasion we were visiting friends in Newburyport overnight and in the morning he woke up with debilitating chest pains. We rushed to the nearby hospital and had an experience at 10am nearly identical to what you describe… there was a waiting area that had 6-8 chairs but they had him in a bed on an EKG before taking any information at all. They eventually decided it was just very severe heartburn, but to be sure they kept him overnight and had him come back for additional tests. The entire cost was significantly lower than your visit (with private insurance, of course).
Without broader data, I cannot draw conclusions except, “do not go to the MGH ER under any circumstances whatsoever!” MGH has the problem of being the largest, most prestigious, and most accessible hospital within hundreds of miles so people just go there by default. I learned from this… when I hurt my ankle a few years ago and wasn’t sure if it was broken, instead of going to MGH (a few blocks from my office) I instead when to the Somerville hospital (a few blocks from my house). I had an X-ray within 10 minutes, and the staff were friendlier and less harried.
If I need something unusual done, I will absolutely go to MGH so I can have the best specialist in the world treat me. But for very routine matters, smaller hospitals win. I’m sure part of MGH’s problem is the first reaction people have when anything goes wrong, “I want the best person on this now!” Not all problems call for the very best doctors.
-
Press Ganey’s 2006 study concluded that the average waiting time in US ERs is 3 hours and 42 minutes. I’m sure there are exceptions in both directions. I have unfortunately had a couple other urgent care experiences here in Germany and the longest I ever had to wait was 10 minutes.
You’re definitely right about MGH though. That ER is a nightmare. I’ve been there twice, and never again!
-
I hope you understand that the reason that crushing chest pain gets more rapid care than (unspecified symptoms for the meningitis case, but probably neck pain, headache, disorientation, etc) is that the differential diagnosis is much briefer, and more ominous, for crushing chest pain. That alone, not the hospital choice, explains the difference in response time.
-
-
nat, that sounds dreamy. i have so many complaints about u.s. health care (most recently a ridiculously expensive bill for baby v’s birth and nicu stay, even though we have health insurance). no system is perfect, but it’s nice to be able to go to the emergency room if you need to.
-
Nat, I like your stories, they always remind me of my two years in Germany. I’d concur that my worst visit over two years in Germany to the dentist and doctor (and we tried fertility treatments several times, so there were LOTS of doctors visits). was better organized than my best visits in the US. I did notice that routine doctor visits were uncomfortable because I was paying cash, and I would bypass a room of people waiting because they presumably knew they were getting cash from me. I always felt guilty about that, especially since I had pretty good luck getting my US insurer to pay for most of the bills. But, everything was always smooth and almost enjoyable.
One thing I would say though is you omit your tax situation. I wasn’t making that much (first year out of grad school, not an executive or senior programmer or anything like that), and I was in the 55% (marginal) income tax bracket. That was in addition to the 16.5% VAT in Saxony. And the other typical government fees like driver’s licenses and such that were more expensive. I’m not saying the tradeoff isn’t worth it, but there is a cost to providing those magical experiences. Just saying someone provides a better experience for an apparently cheap price – ignoring the fact that much of the underlying infrastructure was built on those high tax rates, including the ability to divert non-ER cases to doctor visits – seems disingenuous.
Me, I prefer private insurance in the US for my (now) infrequent visits with the medical establishment. But I’d still move back to Germany in a second if the opportunity arose. Call me conflicted.
-
It is undeniable that you pay higher taxes in Europe, but this is not only because of the (more or less) public health sector, but for a good part because of income redistribution via transfers.
For a fair comparison you have to compare which percentage of GDP the US and Europe is spent on health care: It turns out that Europe spends a LOT less than the US on health care attaining coverage for everybody and a significantly higher level of quality (e.g. a higher life expectancy – even if you take out things like violent crime).
I am a free markets guy on many issues, but the empirical facts are not on the US or free market side with respect to health care. And decisions should be fact and not ideology based.
-
-
Hi Nat, nice piece. i’m from belgium myself and we never really understood all the fuss you Americans are making against the health care reform of Obama. Every now and then we hear another horror story and wonder how it’s even possible. Anyway, good for you to experience the difference (don’t know if you were pro or against before this incident).
-
I live and travel in the EU. The health-care system I have experienced (personally and my kids) in many of the EU members is just excellent. There are some long waiting times (after triage) in my home city’s ER, but the direct cost here is just 60 euro, whatever the treatment. The (public) in-school health programs (hearing, sight, developmental checks and vaccinations) run extremely well.
Private or privately-insured non-emergency treatment is slightly quicker, but the standard of care for public patients is identical. About half of treatments here are public and half privately-insured.
There is a lot of absolute rubbish talked about reforming the US healthcare system, and the primary characteristic of the people talking rubbish is that they have absolutely zero experience of alternative systems.
-
> Some doctors only accept the private insurance because they make more money from it
That happens, or they at least give you a quicker appointment, or give you more treatment. I think I jumped the (small) queue when I broke my ankle years ago, after saying that I’d just pay the bills personally and claim it from my international health insurance. I then got many bills from various people at the hospital, who I would have had to find again to actually claim from my crappy international health insurance.
And last year I had a same-day appointment with a top specialist when the regular doctor phoned and mentioned that I was privately insured. But I had regular (private) health insurance already then, so claiming was easier.
I’d actually rather be with the non-private health insurance companies, but they don’t allow you to join if you don’t need to and never have joined, which is the case for foreign freelancers or businessmen.
Anyway, yes, it’s pretty good here. There’s still too much paperwork and fighting with insurance companies though. Britiain’s NHS is even better – they just treat you and don’t send you bills.
-
> > Some doctors only accept the private insurance because they make more money from it
> That happens,I forgot my point: It happens but I don’t think they are allowed to do that.
-
-
I am happy you seem to find lots of nice things in germany, and moreover It makes me feel very good to live in a country that has the benefits of good health care and other powerful social insurance. Of course all these are complex systems and there is always room for discussion and improvement but taking it all together the social insurance system in germany is great.
People had to argue for it around one hundret years ago and were actually successfully doing that paying high personal prices. IMO we can be proud of it, it is a feature of a highly developed society to care its not so well situated members, for whatever reason they are in the situation. We should really maintain and develop these systems and accept it as one of our big achievements in history.
Unfortunately currently politics and the broad society in germany are more and more questioning the solidary health care because of costs. People really should be worried about loosing this asset. -
Hmm. I live in a major city, St. Louis, and decided to slice my finger with a chef’s knife a few years ago. Nice flap of skin and deep so it needed stitches. I drove to the nearest hospital emergency room, the second busiest or biggest in town. I don’t recall the preliminaries about paperwork but I do remember getting in to see the doctor right away, getting stitched up and was gone in no time. I have health insurance so it might have cost me $25 out of pocket.
A few years before that, my son dented his head and also needed stitches. My other son broke his arm. In neither case did we wait long at all for care. I guess you can always find someone somewhere who has problems, and it depends on where you are, I can only assume, but I don’t see any of the issues wherever I’ve gone in my life time.
And that’s my point. The squeaky wheel gets the oil and I’m sure the complaints about health care at hospitals is far less of a problem with the hospital than it is with the squeaky wheels. Not that I am not aware of issues with them but I know there are issues with German hospitals, too. And Belgium and France and England and Canada and….
-
I had emergency two months ago here in Finland. I needed to go to “ER” on evening. I had waiting time only about 2 minutes, just the time that I wrote my name to one paper and marked can this treatmen be shared automatically to all doctors if needed or do they need to get my permission to get that information. After I had signed it, I got directed to operation room where nurse made few specific checks for my pain, like ultrasonic, bladder state (because of the operation what could be needed), blood samples and bacteryfarming. It toke about 15 minutes from three different nurses to take those. I was told that I need to wait about 20 minutes because I needed a urologist and they were on that time on operation and first one would be out of soon. They suggested that I just lay on the bed on the room.
After 15 minutes the doctor came, checked my situation and told that I need small operation. He toke me to operation room and nurse prepared the table and bed and doctor went to get local anaesthesia bottle. He said that he use the cold anaesthesia and not needle because on my situation it would not affect so well. The operation toke about 5 minutes. It was just a small cutting, cleaning and parsing. After that I got first treatmen and painkillers and prescription for medicines for one week (7 pills).
Then I drove to the pharmacy to get the medicines. I paid 41 euros for them (7 pills) and I got back from that littlebit under 50%. So the medicines was for me littlebit over 20 euros. Then a week later I got a bill from the ER, it was 24 euros, what is the standard payment.
I do not have insurance because I do not need such until I travel outside of the EU.
Now I need to go to my own personal doctor for who I have called meeting about this and other situation, it will come to cost for me 11 euros. If I still need other operation, it will cost me again extra 24 euros for that 11 euros. So together it would be 35 euros.
I just can not understand how the US people will fall to that propaganda that social healtcare is so bad. You can choose your own doctor, you get treatment right when needed, it is cheap for first three times to see a doctor (11 euros) (after three times doctor visit is free, but the policlinic visit is always 24 euros) and you do not need insurances if you do not travel outside of your own country (in this case, outside EU).
And how much I pay about this in taxes? Nothing at all in the end when even considering that everyone can get the treatment when needed. And even if you do not have money to pay these small feeds, example if you are unemployed, you can always go to social office with the bills and the government pays it for you…. Because faster you are cured, faster you are back in normal life and faster you product more to whole country and everyone are more happy.Only thing what is missing is that big corporations are not gaining money. The bad thing is that Finland is slipping to same situation as in US. and some officials are trying to force people to privat hospitals and doctors, what is very expensive and slows down whole healtcare system. But big corporations are driving that idea because they get much more money from that.
-
I lived in Stuttgart, Germany for 3 years and was amazed at the quality and price of medical care.
I spent two weeks in a German hospital, including two surgeries (originally for an operation that would have been outpatient in the US), and had the best care of my life. I felt fine for most of the stay, but the German doctors were very insistent that I just relax – so I ended up just taking walks around the hospital and reading a lot. It ended up being quite nice.
The most ridiculous part was that my hospital nights were billed at 75 Euro/night, and the total cost of my two weeks stay, including the operation, was right under 10k Euro. I just paid out of pocket and billed my US insurance company, who seemed more than happy to pay the relatively cheap bill.
Even visits to a general practitioner in Germany was cheap – around 20/euro a visit (before any insurance).
Whatever Germany is doing, the US should emulate.
-
This is exactly the same system they have in Australia and I honestly don’t know why people in the USA are arguing that health care has to be this black and white model of a ’socialized’ single payer system and a complete private health industry.
In Australia, the government takes care of the majority of health expenses and you end up paying a ‘gap’ which is usually about 10%. Doctors can elect whether to ‘bulk bill’ and be paid by the government although they are usually not as qualified. Private doctors charge you directly and will take private health insurance.
There is a different mentality towards healthcare here. It isn’t some luxury that only the rich can have and that people must cheat you out of – rather it’s about providing the best possible coverage to ensure people stay on the higher tiers.
Private health insurance organizations don’t have a key objective to try and deny you coverage or overcharge you because they know they are competing with the baseline the government has set. Rather they try to offer you an even better service than what the government can provide to keep you on their plan.
-
The total cost of treatment is lowest when you treat early.
Our daughter got a second degree burn on her arm from some hot tea. So far we’ve seen three doctors, two of who are specialists. We’re continually seeing a doctor and a nurse twice a week until it is healed. The point is that if there is an infection or it does not heal properly you have to operate which is much more expensive.
Total (11 visits) time spent in waiting rooms: 45 minutes
Total cost (in Sweden): $16 -
Hey, i wanted to mention that there is a Michael Moore movie on that topic. One that discusses the US vs. others system.
-
As a German, reading this article made me a little bit proud to my country. The health and social systems here are subject of never-ending political discussions. It’s good to read Your point of view “from outside”. But I’m a fan of this system of a basic health and social ensurance for everybody. Who want to get more – okay he/she also should pay more. I cannot understand why the plans of president Obama to introduce a basic health insurance system for all Americans have such a strong opposition inside the U.S. – in my opinion it’s a foundation for more social peace. The Clinton administration already tried it – and failed. Okay, it will not be inexpensive but this money will be a better investment than weapons, wars, etc.
Cheers, Guenter -
The difference between the United States and the most of western Europe countries can be found in the question “How many ‘State’ or ‘Government’ do we need?”
You will find different answers.
But there are some native duties for the executive of a country. To provide healthcare for every citizen is one of it.
There are some trends in Germany to dismiss the caring society from being responsible for the healthcare of everyone but to exceed the individual liabilty.This will lead to a strong, money-making high end healthcare for people which can afford such luxury.
And it will lead to inefficient medical care for the poor, with a lack of (profit-cutting) precautional healthcare for all.
As you can see in the USA.It is worth to think about it.
Greetings from Lower Saxony,
Bernd
-
On the one hand, it’s not possible to defend the American system of health care. It combines the worst of free-market health care with the worst of socialist health care.
On the other hand, socialist health care systems are groaning under the cost of giving everyone free health care.
The solution is to recognize that there are no free lunches. Get government out of the health care system. Stop giving doctors a franchise so they are the richest people around. Stop forcing pill makers to test their products, and put the burden on the pill sellers. You want an effective pill? Buy it from somebody who stands behind it. Stop allowing pill makers to patent their pills (patents are for machines, not substances).
In other words, move to a REAL free market system, not one where every politically powerful entity gets a franchise to extract money from the citizenry. But oh, what am I thinking?? Free markets don’t work, because whenever you have a free market, government steps in to protect privileged powerful parties from ACTUALLY HAVING TO COMPETE for our business.
What we really need is separation of state and market. Hey, it works for religion!
38 comments