Paul Krugman: The Swiss Menace

Op-Ed Columnist

The Swiss Menace
PAUL KRUGMAN
Published: August 16, 2009



It was the blooper heard round the world. In an editorial denouncing Democratic health reform plans, Investor’s Business Daily tried to frighten its readers by declaring that in Britain, where the government runs health care, the handicapped physicist Stephen Hawking “wouldn’t have a chance,” because the National Health Service would consider his life “essentially worthless.”



Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.

Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.

Let’s talk about health care around the advanced world.

Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.

In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.

The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.

Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.

Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.

In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.

So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.

•

Correction: In Friday’s column I mistakenly asserted that Senator Johnny Isakson was responsible for a provision in a House bill that would allow Medicare to pay for end-of-life counseling. In fact, he is responsible for a provision in a Senate bill that would allow a different, newly created government program to pay for such counseling.





"At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies." 'Paul Krugman

The *Private Insurance Industry* has PROVEN to be a FAILURE!!! We voted for CHANGE...We ELECTED for CHANGE!! It's TIME to CHANGE our current HCS!!! Public Option is the way forward, IF we can't have Single Payer!!

Time to FIGHT THE GREED! Call out the LIARS!!! Enough is Enough!

Have a nice day. :)

"As an Australian"



<snip>

Michael E. Hyers, Master Sergeant, USAF (Ret)
Sat, 08/15/2009 - 23:50 — Mickeyde
As an Australian I may be butting in here where I'm not wanted but I'd like to give some observations on our system of universal health care we have enjoyed since 1973 in my country. First- thank you Mr Myers for your military service-we Aussies have never forgotten the Yanks saved out bacon in the South Pacific in WW2 and we cherish the special friendship that has been forged between our 2 countries.
All political parties in Australia from conservative to liberal and everyone in between now support the public option where everyone has access to good medical care. In fact, the last very conservative PM who got on pretty well with your last president tried to find ways to improve the system-and all public infrastructures need improvement- and he succeeded. In the past 6 years I've had 2 full knee replacements, something I could never have afforded by going private. All I paid for was my TV rental in hospital and taxi-fare home (although the free hospital bus would have got me there).

But nothing is free of course in the end-we pay a medicare supplement in our taxes and we pay it every week but over a few decades that adds up of course and all those years when I haven't needed medical help-suddenly it's there just when I do and haven't got the cash. I see it as no different than paying taxes to build roads, schools , highways and everything else. Plus the government covers the un-employed. pensioners and so on.

Plus of course there is a private option for those who want gold plated treatment away from the hoi polloi like me but I'm happy in the public ward and the doctors are just the same so -whatever !.

I think you should look carefully at the plan eventually your leaders offer you as it your country and your health but I honestly think many Americans are over-reacting to something that we, most of Europe and Scandanavian countries just take for granted now-a right to medical treatment which we don't regard as a luxury and which 90% of doctors and nurses support. I also lived in the UK for 10 years and the British National Health system can be aggravating and unwieldy at times, always underfunded but most problems there are caused by bureaucracy.-and the Brits invented the word and know more ways to complicate any system!.

It's up to you guys in the end-but you should examine what is on offer very minutely. We did back in 1973..gave it a go and we have never looked back.



LINK:: http://blogs.newsobserver.com/multi/first-look-health-c...


An Aussie's input... ;)

In fact, if the will of the great majority of its citizens cannot prevail or even be represented by their government, this government is not of the people, not by the people, not for the people. Such government is so illegitimate. Those selling out the great public interest for mere chump change are underestimating the intelligence and resolve of American people at their own peril.

Obama Boost: New NBC/Wall Street Journal Poll Shows 76% Support For Choice Of Public Plan
http://www.huffingtonpost.com...

In Poll, Wide Support for Government-Run Health: Americans overwhelmingly support substantial changes to the health care system and are strongly behind one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers, according to the latest New York Times/CBS News poll.
http://www.nytimes.com...

Associated Press-Yahoo Poll on Single Payer: 65% - The United States should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.
http://www.pnhp.org...

"So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies."


the fact that we have literally the "best" government that money can buy - the government that serves the interests of the corporations and the elites, at the expense of the majority of the American people.