This was true. That time, China had their 'barefoot' doctors giving basic medical healthcare. Unfortunately, things changed and China moved to almost total private healthcare. Now, China has plans to move towards some sort of mixed insurance and payment system. It will take time to develop.
I had a chat with a Chongqing fellow (Sichuan Province) a few months ago about life in Chongqing. He said that hospitalization for serious flu costs around RMB 40,000. The average joe there makes just over RMB 1,000 per month.
Well, the reality is cost keeps on increasing. No wonder someone is crying the 'end of the world'. Agreed with 'no perfect' system. Just live a healthy life and enjoy badminton. Stop worrying, just do the smackin... it'll keep the docs away.
Long waits in the emergency room. That's about it. Canada's health care system is pretty good in comparison to the US's in my opinion.
I believe a good healthcare system should place more importance and a higher priority on preventive care instead of curative. It is a hopeless and losing battle even for the most advanced healthcare system in the world when the population's improving life style revolves around over indulgence, multiple cars per family, and more processed/fast foods.
Beijing puts public before profit with health reform blueprint Josephine Ma and Zhuang Pinghui Updated on Apr 07, 2009 Beijing has released the long-awaited blueprint on health care reform in an attempt to turn a profit-obsessed medical system into a public service. The 13,000-word reform plan underscores the responsibility of the government in ensuring accessible and affordable public services to all 1.3 billion people on the mainland. Its short-term goal is to provide basic insurance coverage to 90 per cent of residents; provide affordable medicines; and establish a network of rural and urban clinics by 2011. While the blueprint contained few new policies, it set the tone for medical reform in coming years. The plan said: "The government's responsibility in the basic health care system will be strengthened and the government should step up its responsibility in planning, financing, serving and supervising to guarantee the non-profit nature of public health care and promote equality." The aim is to provide a comprehensive system offering basic health care, drugs and medical insurance by 2020. Supporting documents are expected to be released in the coming months, according to analysts. Zhong Nanshan, director of the Guangzhou Institute of Respiratory Disease and a government consultant, said: "There will be a national health care conference in April and I think more concrete details as to how the reforms should be implemented will be released after the meeting." Public hospitals and medical institutes will be the mainstay of health care providers, while the government will "appropriately" increase the proportion of private hospitals. The plan stated the government would encourage private and charity hospitals, but no details were given. One of the key tasks is to turn cash-hungry public hospitals into public hospitals in the real sense. Public hospitals, although owned by the government in name, became obsessed with profit-making after the previous round of medical reform in 1992. This resulted in soaring medical bills and much public anger. A Xinhua commentary said yesterday the medical system became too market-oriented under the open-door policy. "Although more beds are provided to patients, and while the technology of hospitals and quality of doctors were greatly enhanced through competition ... it also resulted in a decline in fairness and efficiency." The blueprint appears cautious about reforming hospitals, but bold steps will be taken in building rural and community clinics. On medical insurance, the central government hopes to narrow the huge differences in benefits that are provided by various medical insurance schemes, and gradually extend coverage to outpatient services. The blueprint also pledges to resolve problems hindering rural migrant workers from enjoying medical insurance, such as allowing them to transfer their insurance accounts when they move cities. In an attempt to boost the role of commercial medical insurance, the government will promote the practice of buying medical insurance from commercial insurers. In terms of cutting costs, the government has made a list of basic drugs, and their manufacturers will be appointed by the government through public bidding. The central government will set the price range for basic drugs, and provincial governments will fix prices within the ranges. The prices of basic medical services provided by hospitals will also be decided by the government. But Huang Jianshi, dean of continuing education at Peking Union Medical College, said it was more important to overhaul the distorted price system of charging excessively for medicine while keeping the values of medical consultations and services unreasonably low. The government also promised to strengthen its supervisory role in insurance and hospital operations. A major criticism of the government is poor supervision of hospital operation and the integrity of medical practitioners, as many hospitals are owned by the authorities.
Seattle doctors try flat-rate no-limit primary care By David Lawsky David Lawsky Tue Jul 7, 5:38 am ET SAN FRANCISCO (Reuters) – A Seattle clinic for people fed up with insurance, started by doctors fed up with insurance, has gotten $4 million in private venture capital money to expand, it announced on Monday. Qliance says it has a profit-making solution to the problems of long waits, rushed doctors and cursory care that bother patients, at the same time that it eliminates the paperwork and pressure that plague primary care doctors. "If you spent five minutes in my office you would notice there is nobody waiting. We don't have to stack them up like jets over Newark," said Garrison Bliss, a doctor and co-founder of the primary care clinic. The new venture funding comes from Second Avenue Partners with participation by New Atlantic Ventures and Clear Fir Partners, bringing total capital raised to about $7.5 million. Co-founder Norm Wu said per-patient revenue is triple that of insurance-based clinics. He said many costs are fixed so the firm, now losing money, will turn to profit as business grows. More than 50 noninsurance clinics operate in 18 U.S. states, based on different business models, Wu noted. The backers believe Qliance can grow very profitable, and the clinic uses stock options to attract new doctors. The next step is to open a suburban office. Qliance says it is a private alternative to the failures of insurance, which have made health care President Obama's top legislative priority in Congress, with a price tag of $1 trillion or more. Qliance customers pay $99 to join, then a flat monthly rate of $39 to $119, depending on age and level of service. Patients can quit without notice and no one is rejected for pre-existing conditions. Patients must go to outside brokers and qualify medically to buy catastrophic care. One broker said a 30-year-old could expect to pay $133 per month for such care, and a 60-year-old nearly $400, plus substantial deductibles. Qliance patients get unrestricted round-the-clock primary care access and 30-minute appointments. "Why would a doctor not want to see sick people? That doesn't make sense, unless you're an insurance company," Bliss said. He rejected the idea that unrestricted access causes overuse, calling that "nonsense promoted by insurance companies .... There's nobody I've ever met who gets their pleasure by seeing doctors." Bliss said dumping rigid, convoluted insurance requirements and paperwork saves large amounts of money. UnitedHealth, which processes 60 billion health care transactions a year, argued in June that better use of technology would save $332 billion annually, with some going to physicians. Other big health insurers include WellPoint, Humana, Cigna and Aetna. (Reporting by David Lawsky; Editing by Richard Chang)
Singapore's System Why don't you guys look at the Singapore's system of healthcare? Not free, but 80% subsidy for citizen and 70% for permanent residence for the lowest class (9 bedded ward). If you go to private GP, it'll cost you $ 30- $ 35 (Singapore Dollar) and if you go to government polyclinic it'll cost you $ 15 for citizen and around $ 20 for permanent residence. If you need to be hospitalized, you better choose government hospitals, becasue if you go to private hospital it might make you bankrupt (if you don't have insurance). And of course there are classes in government hospital, C Class (80 % Subsidy for Citizen and less 10 % for PR), B Class (50 % less 10%), B+, A (no subsidy). C class you cannot choose your doctor but for A you can choose the doctor. If your income more than SGD 3,200 you cannot opt for C Class. There's no such scheme in Singapore like Medicare. Even if you are senior citizen you have to pay the bill. There's also law in Singapore that the children have to be responsible for the parents livelihood (for their living cost and cost of hospitalisation) unless the children are not also well-off.
Many people do look at Singapore's system. In fact, it a model studied by health policy students as it is quite unique. It works successfully in S'pore but can it be copied by other countries? HK once proposed to do something like that but people protested. They prefer to pay private insurance and have the maximum flexibility on choice. If I am not mistaken, Singaporeans have to pay into a provident fund. I think this was originally just for retirement (please correct me), then it gets used to buy property and also subsidise healthcare costs. Drawbacks to implementation of the Singaporean system in other countries include: - the extra amount for healthcare will be added to taxes. - governments don't like personal contributions for healthcare purposes alone because they can't use the money temporarily for other purposes. *ahem* - have you seen the family structure in other countries? There is no way you can implement a law making children pay for parents. - it's good if you have more than one child to support the parents costs. S'pore government trying to help on this
Yes, Singaporean & Permanent Residence need to contribute for provident fund. Averagely if you below 50, the rate should be 34.5 % ( 20 % deducted from your salary, 14.5 % from your employer). From this 34.5 %, it's divided into 3 purposes: for your retirement, for you to buy house, and for medicare. BTW, Singapore healthcare is also expensive. Effective yes. Once you have a prolonged illness than you could be "bankrupt". Unless you have a private insurance. The problem if you are in a middle class position, once you get a "big" illness, it can setback your lifestyle seriously. If you live in privatwe condo, probably you need to downgrade to government flat. Although it's not an official policy, if you are poor, the government won't reject you if you need to hospitalised. Why it's not official? Because, when it becomes official, all the "kiasu" Singaporean will abuse that rules. Free medical fee? Wow... Hongkong as I learn has a policy HKD 100 per night if you are hospitalised in government hospital (for PR only). If I'm not mistaken the private care / private hospital in Hongkong is more expensive than in Singapore.
Would S'poreans abuse the medical system if for free? Let's say you have to wait in queue, no choice of doctor, probably see trainee doctor and nurses (greater potential for mistakes and infection from disease). However, you pay and you see consultant, shorter waiting time, no need to share facilities nor room, better food, more flexible visiting hours, nicer surroundings. Not sure how S'poreans value these things. Yup, private hospital in HK is expensive. I got a surprise when my daughter was hospitalised for fever for two days (investigations very expensive). Almost on par with normal delivery for baby. These are just the hospital costs alone. Surprisingly, HK has almost the longest life expectancy in Asia, 2nd only to Japan. And the public system accounts for more than 95% of expenditure...
House rolls out plan to make health care a right It may surprise some people that in the USA, healthcare is not regarded as a basic human right. It is in other countries. House rolls out plan to make health care a right By RICARDO ALONSO-ZALDIVAR and ERICA WERNER, Associated Press Writers Ricardo Alonso-zaldivar And Erica Werner, Associated Press Writers – 12 mins ago WASHINGTON – House Democrats on Tuesday rolled out a far-reaching $1.5 trillion plan that for the first time would make health care a right and a responsibility for all Americans, with medical providers, employers and the wealthiest picking up most of the tab. The federal government would be responsible for ensuring that every person, regardless of income or the state of their health, has access to an affordable insurance plan. Individuals and employers would have new obligations to get coverage, or face hefty penalties. Health care overhaul is President Barack Obama's top domestic priority, and his goal is to slow rising costs and provide coverage to nearly 50 million uninsured Americans. Democratic leaders said they would push the measure through committee and toward a vote in the full House by month's end, while the pace of activity quickened on the other side of the Capitol. Senate Majority Leader Harry Reid said he wanted floor debate to begin a week from Monday. Other officials said that timetable was likely to slip. Even so, it underscored a renewed sense of urgency. The House legislation unveiled by Speaker Nancy Pelosi and other Democrats would slow the growth of Medicare and Medicaid payments to medical providers. From big hospitals to solo physician practices, providers also would be held to account for quality care, not just ordering up tests and procedures. Insurance companies would be prohibited from denying coverage to the sick. The industry also would face stiff competition from a new government plan designed along the lines of Medicare. The liberal-leaning plan lacked figures on total costs, but a House Democratic aide said the total bill would add up to about $1.5 trillion over 10 years. The aide spoke on condition of anonymity to discuss the private calculations. Most of the bill's costs come in the last five years after the 2012 presidential election. The legislation calls for a 5.4 percent tax increase on individuals making more than $1 million a year, with a gradual tax beginning at $280,000 for individuals. Employers who don't provide coverage would be hit with a penalty equal to 8 percent of workers' wages with an exemption for small businesses. Individuals who decline an offer of affordable coverage would pay 2.5 percent of their incomes as a penalty, up to the average cost of a health insurance plan. With Obama pressing Congress to act on health care this summer, House leaders want to move their bill quickly through three committees and to a floor vote before the August congressional recess. But a group of moderate and conservative Democrats has withheld support, and no Republican votes are expected. The House bill seemed unlikely to win broad backing in the Senate, where the Senate Health, Education, Labor and Pensions Committee was expected to finish its version of the legislation Wednesday in what was looking to be a party-line vote. Another panel, the Senate Finance Committee, was striving to unveil a bill by the end of the week. Standing before a banner that read "Quality Affordable Care for the Middle Class," Pelosi, D-Calif., called the moment "historic and transformative." The bill would provide "stability and peace of mind" by braking costs and guaranteeing coverage, she said. "We are going to accomplish what many people felt wouldn't happen in our lifetime," said House Energy and Commerce Committee Chairman Henry Waxman, D-Calif., one of the main sponsors. Obama, who issued a statement hailing the measure, plans to keep up the pressure on Congress by delivering remarks in the Rose Garden on Wednesday. Speaking in Warren, Mich., where he was promoting new spending for community colleges, Obama anticipated a congressional confrontation over health care. "There's going to be a major debate over the next three weeks," he said, deviating from his prepared text. "And don't be fooled by folks trying to scare you saying we can't change the health care system.We have no choice but to change the health care system because right now it's broken for too many Americans." Separately, Obama spoke by telephone with Sen. Charles Grassley, the Iowa Republican viewed as critical to the fate of bipartisan negotiations in the Senate. House Democrats said the income tax increase in their bill would apply only to the top 1.2 percent of households, those who earn about one-quarter of all income. The wealthiest 4 percent of small business owners would be among them. The tax would start at 1 percent for couples making $350,000 and individuals earning $280,000, ramp up to 1.5 percent above $500,000 of income, and jump to 5.4 percent for those earning above $1 million. The tax would raise an estimated $544 billion over 10 years. Business groups and the insurance industry immediately assailed the legislation. In a letter to lawmakers, major business organizations branded the 1,000-page bill a job-killer. Its coverage mandate would automatically raise the cost of hiring a new worker, they said. "Exempting some micro-businesses will not prevent this provision from killing many jobs," the letter said. "Congress should allow market forces and employer autonomy to determine what benefits employers provide, rather than deciding by fiat." The business groups also warned that the U.S. health care system could be damaged by adding a government-run insurance plan and a federal council that would make some decisions on benefits, as called for in the legislation. Thirty-one organizations signed the letter, including the U.S. Chamber of Commerce, the Business Roundtable representing top corporate CEOs and the National Retail Federation. The House bill would change the way individuals and many employers get health insurance. It would set up a new national purchasing pool, called an exchange. The exchange would offer a menu of plans, with different levels of coverage. A government plan would be among the options, and the exchange would eventually be open to most employers. Insurers say that combination would drive many of them out of business since the public plan would be able to offer lower premiums to virtually all Americans. But backers of a public plan — including Obama — say it would provide healthy competition for the insurance industry. Under the House bill, the government would provide subsidies to make coverage more affordable for households with incomes up to four times the federal poverty level, or $88,000 for a family of four and $43,000 for an individual. Medicaid — the federal-state health program for the poor — would be expanded to individuals and families up to 133 percent of the poverty line. About 17 million people would remain uninsured — about 6 percent of the population — and half of them would be illegal immigrants. The legislation also would improve the Medicare prescription drug benefit by gradually reducing a coverage gap known as the 'doughnut hole.' The individual and employer coverage requirements would raise about $192 billion over 10 years, the Congressional Budget Office said. Even before the bill was unveiled, the House Ways and Means Committee announced it would vote on the proposal beginning on Thursday. The panel is one of three that must act before the bill can go to the full House, probably later in the month. Some House Democrats privately have expressed concern that they will be required to vote on higher taxes, only to learn later that the Senate does not intend to follow through with legislation of its own. That would leave rank-and-file House Democrats up for re-election next year in the uncomfortable position of having to explain their vote on a costly bill that never reached Obama's desk or became law. ___ Associated Press writers David Espo, Alan Fram and Andrew Taylor contributed to this report.
In the quality of medical care on offer, Singapore is at a wonderful level. However, its waiting times for specialist attention are far from encouraging. See http://www.channelnewsasia.com/stories/singaporelocalnews/view/260554/1/.html Even in outpatient clinics, the wait can be several hours. Of course, private hospitals are faster but they charge heavily. Here's a more recent article: http://www.straitstimes.com/Breaking+News/Singapore/Story/STIStory_276396.html Like almost everything else, healthcare is not free in Singapore. You must pay. The good side is that you get excellent value for your money. The unfortunate side is: what if you can't afford to pay? Here's a year-old article from the Asian Wall Street Journal. The problem has only worsened with the recession and all.
Aahh, yes.. ..the topic which, i'm sure master silentheart and cooler love to dissect...You should read the "sky is falling" thread, at least the last few pages of it; discusses abt the planned "nationalizing" of the healthcare system in the U.S. (by the current White House administration & Congress) It is still a battle and there's no way it will pass very easily. Canadians have it, or something close to it. Are they happy??..
Dear Master C and Master C, I will not dissect the article. I will just make fun of Polosi and the house plan. Please see the insert in green...
America's healthcare woes don't have any easy answers. But here is a small salve -- free, gratis and on-the-house -- from your pinko well-wishers up North: http://www.heretohelp.bc.ca/skills/module5
Yeah.. ..wow, you just basically dissected the article.. We have 3 components, too, in this part. Cheung, on the doctor/medical side; silentheart on the insurance/reg. working people side; and myself, reg. working people side.. Btw, i prefer to be the small "c"..; big "C" is for Cheung..
too much politics in healthcare in North America. Only quasi democracy or one party state like Singapore can pull it off.
