Lives at risk : single-payer national health insurance around the world

Virtually everyone agrees that our health care system needs reform. But what kind of reform? Some want a return to the system that prevailed in the 1950s. Others would like to see the adaptation of the government-run systems prevalent in other countries. The latter, national health insurance or single-payer health insurance, appears to be gaining ground in the United States. Before Americans find themselves participating in a health care system that has failed in every country it was adopted, we should be asking ourselves whether such a system is effective and efficient. In Lives at Risk, the authors examine the critical failures of national health insurance systems without focusing on minor blemishes or easily correctable problems. In doing so, the purpose is to identify the problems common to all countries with national health insurance and to explain why these problems emerge. Most national health care systems are in a state of sustained internal crisis as costs rise and the stated goals of universal access and quality care are not met. In almost all cases, the reason is the same: the politics of medicine. The problems of government-run health care systems flow inexorably from the fact that they are government-run rather than market driven. "Virtually everyone agrees that our health care system needs reform. But what kind of reform? Some want a return to the system that prevailed in the 1950s. Others would like to see the adaptation of the government-run systems prevalent in other countries. The latter, national health insurance or single-payer health insurance, appears to be gaining ground in the United States. Before Americans find themselves participating in a health care system that has failed in every country it was adopted, we should be asking ourselves whether such a system is effective and efficient. In Lives at Risk, the authors examine the critical failures of national health insurance systems without focusing on minor blemishes or easily correctable problems. In doing so, the purpose is to identify the problems common to all countries with national health insurance and to explain why these problems emerge. Most national health care systems are in a state of sustained internal crisis as costs rise and the stated goals of universal access and quality care are not met. In almost all cases, the reason is the same: the politics of medicine. The problems of government-run health care systems flow inexorably from the fact that they are government-run rather than market driven."--Back cover Cover ......Page 1 Contents......Page 4 Introduction......Page 6 Part I: Twenty Myths......Page 20 1. Rights......Page 22 2. Equality......Page 32 3. Needs......Page 47 4. Outcomes......Page 52 5. Technology......Page 62 6. Quality......Page 70 7. Costs......Page 80 8. Efficiency......Page 87 9. Unnecessary Care......Page 95 10. Administrative Costs......Page 106 11. Priorities......Page 115 12. Prevention......Page 119 13. Managed Care......Page 128 14. International Competitiveness......Page 141 15. The Elderly......Page 145 16. Minorities......Page 150 17. Rural Areas......Page 155 18. Prescription Drugs......Page 162 19 . Public Opinion......Page 172 20. Reform......Page 178 Part II: The Politics and Economics of Health Care Systems......Page 180 21. The Politics of Medicine......Page 182 22. Is Managed Competition the Answer?......Page 196 Part III: Reforming the U.S. Health Care System......Page 209 23. Designing an Ideal Health Care System......Page 211 24. Designing Ideal Health Insurance......Page 229 Afterword ......Page 248