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

CHINA

China Photos/Getty Images

System: A state-subsidized, public-private health insurance model

Reform:  Starting in the late 1980s, China started to erode its centralized "cooperative medical system" and put a decentralized, partly privatized, market-oriented model in place. In theory, most Chinese were to pay income-scaled and government-subsidized sums into insurance pools.

But the reforms pushed costs onto local governments that were unwilling to pay for them. Government spending on healthcare fell. More than 100 million people lost their coverage.

Now, two-thirds of Chinese people have to pay directly for doctors and hospitals. If they cannot afford care, there are some free and low-cost clinics, though they are woefully substandard. Less than 1 percent of Chinese medical professionals have graduate degrees. China's system, which is burdensomely expensive for the poor, is one of the most income-sensitive in the world.

This year, the country announced a new overhaul. As with everything in China, it's big: Between 2009 and 2011, it plans to spend $124 billion to make sure that all have access to primary care.  The government plans to build 700,000 new clinics, for instance. Plus, President Hu Jintao has promised to revamp the health insurance system, ensuring that each Chinese person pays something he or she can afford for the guarantee of coverage.

 

Annie Lowrey is assistant editor at FP.

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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!

 
January/February 2010