At the New York Times several contributors engage in a tournament-style face-off of the health care systems of the following countries: Canada, Britain, Singapore, Germany, Switzerland, France, Australia and the U.S. Although the U. S. health care system makes it into the semi-finals, it loses there to France.
The country whose system ultimately prevails is Switzerland:
AARON: Switzerland. This is a tough call. Switzerland does a good job of combining conservative and progressive beliefs about health care systems into a workable model providing top-notch access and quality at a reasonable cost. It doesn’t hurt that it does so through private (although heavily regulated) insurance.
CRAIG: France. Its system has more competition among providers than Switzerland’s does.
AUSTIN: Switzerland. The Swiss system is so close to the A.C.A.’s structure (which, to date, has survived all manner of political attacks) that something like it could work in the U.S.
ASHISH: Switzerland Both of these countries spend a lot on health care, outpacing the average among high-income countries, and both perform comparably on measures of access to care. However, in general, the Swiss health care system delivers a higher quality of care across a range of measures and invests more in innovation that fuels new knowledge and, ultimately, better treatments that we all benefit from.
UWE: France. It is cheaper, its financing is more equitable, and its system is simpler.
Not coincidentally, I believe, Switzerland’s per capita spending is second only to that in the United States.
The differences between Switzerland and the United States could hardly be more stark. Switzerland is small, compact, and has a high degree of national consensus and social cohesion. Nearly every matter of significance is subject to a popular vote. Per capita income is higher there than here. It is landlocked. It does not share a 1,500 mile land border with a country where the per capita income is a third of theirs with even worse income inequality. The list is practically endless.
The “tournament” is entertaining and informative but ultimately meaningless. The United States is an outlier and for a health care system to be workable here it will necessarily be an outlier, too.
A good improvement for a national health system here would be a global budget for health providers.
I don’t see any way of doing that without adopting some sort of capitation system like Italy’s.
Switzerland’s is the one that would probably be most acceptable here. While we might not be able to adapt ay of these plans wholesale, I think we could adopt some of what these places do.
Steve