The List: The World’s Worst Healthcare Reforms

This month, U.S. policymakers are working to overhaul their country’s healthcare system. In the past, they’ve looked to other countries’ models for guidance on how to make healthcare less expensive, more efficient, and more equitable. Here are four reforms they should avoid at all costs.

BY ANNIE LOWREY | JULY 22, 2009

RUSSIA

NATALIA KOLESNIKOVA/AFP/Getty Images

System: Free basic medical care provided by the government, with a byzantine and under-regulated employer-based private insurance market

Reform: Before it collapsed, the Soviet Union had an enormous socialized medical system, with millions of hospital beds and hundreds of thousands of healthcare workers. The transition from that system to a public-private model, between 1989 and 1993, went, in a word, horribly.

Ninety percent of Russians are technically covered. But, doctors and hospitals extract "donations" for free care. Anyone who can afford it pays out-of-pocket for private hospitals and doctors. In theory, consumers can pick their own insurance plan. In reality, their employers generally do it for them, bought-off by the insurers.

In 2006, Vladimir Putin's government approved a $3.2 billion health care reform plan that failed to improve the system. The reform contained a hodgepodge of policy priorities, such as paying doctors to perform primary care, but did not address any of the healthcare system's structural defects.

Even with the $3.2 billion infusion, Russia still allocates only 3.4 percent of government spending to healthcare, whereas the World Health Organization (WHO) recommends 5 percent.

 SUBJECTS:
 

Annie Lowrey is assistant editor at FP.

SUPAGOLD

12:26 PM ET

August 15, 2009

Good point about that Massachusetts "victory"

How's that going for them? From the washington post blog describing and interview with the Mass state treasurer:

-- The program has so far cost 30 percent more than anticipated.
-- It already has a $9 billion shortfall projected over the next two years.
-- Costs have risen 41 percent since the program's inception, well outpacing the rise in healthcare costs nationwide, which stands at 18 percent.
-- We thought this program would mean fewer people would go to hospitals, which is the highest cost any insurance plan has to pay. In fact, fewer people are not going to hospitals.
-- A Harvard study shows 60 percent of state residents are unhappy with the plan. The most unhappy? Those whom it should be helping the most -- those making $25,000 to $50,000 per year.
-- To cut costs, the program is now having to kick out legal immigrants.

Cahill summed up: "This is not a miracle by any stretch of the imagination."

http://voices.washingtonpost.com/economy-watch/2009/07/mass_treasurer_rips_mandated_h.html

Hopefully we can implement a victory like that nationwide!