Medical Ethics PHIL 148 @ Binghamton University, Sum 11

23Jun/117

News Article 6/23 Sam Ahmed

http://qn.som.yale.edu/content/can-international-perspective-help-create-value-based-health-system
The healthcare solution has become a very hot topic for debate in the United States.  The main issue seems to be largely focused on the amount of insurance coverage and the access to care.  Many people believe that Universal coverage may be the most logical and effective solution to this debate.  Many European nations as well as Canada have instituted these types of systems and it makes sense that the United States would try to learn from them.  For example, the most recent health care reform is similar to the Netherlands where “a recent insurance mandate has resulted in over 98% coverage…”  Swedish healthcare is also universal and for the most part publically funded.  Though these systems seem to work for these countries, they still face the similar problems the United States healthcare system does.  Ultimately, no one country has figured out the perfect solution.
Though finding an easy solution to the health care debate seems impossible, some countries have recently proposed ideas that may lead to an eventual solution.  Germany, for example, is instituting systems that “readjust risks”.  It will incorporate “up to 80 chronic conditions” for full plan reimbursement.  This reimbursement will be based on estimated costs for the care of a given condition.  This would shift the focus from providing health care to all patients to providing health care to patients who need it the most.  For insurance rates, Germany takes a stance that would anger a more Libertarian point of view in that rates are income based.  Those with higher income must pay more for health coverage.
The Netherlands have instituted a system that bundles the prices of potential health care into one lump sum rather than providing partial coverage on some parts of the procedure.  The Diagnosis Treatment Combination or DBC for short includes all treatment activities including any post treatment consultations or x-rays.  The Dutch system also allows for clients to negotiate rates with insurers which allows for potentially flexible rates.  Providing one single payment also eliminates the potential for unnecessary additional services.   This system will provide somewhat of a free market for health care as those with the most economically friendly DBCs will attract the most patients.
In Sweden, there health care system is based on the quality of the treatment.  They have institutions which track the results of each treatment up to 3 months after the procedure has been performed.  The idea here is that by publically posting results of treatments at given hospitals, then patients will be able to select where they want to seek health care based on an unbiased opinion from private registries.  Health care providers are not forced to present information to these registries but never the less almost all providers participate.
These are just three of possibly many reforms being taken around the world for the health care system.  It would be effective for the United States to take these efforts into consideration as they continue to reassess health care.  I believe that a true solution will need to take the positives of the myriad of health care systems around the world.

Which reform do you find to be the most effective?
Do you see any of these reforms working with the United
States?

What ethical perspectives are present in the institution of
these reforms?

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