The real reason that US Congressional republicans haven’t given up on their Trump/ Ryan repeal and replace Obamacare plan (AHCA) is that they need the savings as predicted by the CBO (Congressional Budget Office) as a precursor to their tax reform plans. The republicans in the “freedom caucus” will never consent to tax cuts that are not paid for and which add significantly to the deficit.
Here’s the dilemma. There is no way to accomplish this goal while expanding better healthcare coverage to more peoples while lowering the costs unless the republicans start thinking outside of the box.
Currently, the ACA most resembles the plan that has been implemented by the Netherlands where its government provides universal coverage with the use of insurance companies. It has been asserted by a Washington Post expert that if the republicans went all the way towards duplicating the Netherlands’s system, that the republicans could save billions of dollars while improving the quality, access and affordability for more Americans. This would still keep US healthcare costs at about 17% of our GDP (Gross Domestic Product).
While, I personally wish that the US would emulate the highly ranked Taiwanese healthcare system which costs its country about 6.6% of its GDP with better healthcare outcomes, I realize this is not likely because its delivery system does not rely on healthcare insurance companies. But maybe we can copy some of its best practices as described below.
Here is the rest of the story…
On 5/3/17 Sarah Kliff of the Washington Post penned the following article, “How to save $705 billion in health costs: Be like the Netherlands.”
“Gatekeeping isn’t always popular in health care; the HMOs that came to prominence in the 1990s lost customers in droves, who were sick of limited access to specialists. But that system doesn’t look to have an adverse impact on health care. Survival rates for cancer here and in Netherlands are comparable; the Dutch do even better than us when it comes to treating cervical cancer.”
“The Netherlands certainly isn’t doing the best at health care spending – if we got our per capita costs down to those of lowest-spender Japan, for example, we’d slash $1.25 trillion from our annual health costs. And it does not make a perfect comparison to the United States: When the country passed its universal coverage law its costs were already significantly lower than ours, as the country had passed cost-containment legislation in the 1970s.
There are definitely significant differences between us and the Dutch – and it’s not just our footwear choices. But as we move toward implementing a health insurance system that bears a strong resemblance to that of the Netherlands, the country does provide a more optimistic preview of where we might be headed.
Taiwan has been ranked the #1 country in the world for its healthcare delivery system while only paying 6.6% of its (GDP) gross domestic product on health care, as compared to 17% in the USA( Source: Horban, Rose. “Different Cultures, Different Systems: Comparing Health Care in the U.S. and Taiwan. “North Carolina Health News. 28 August 2013.)
Highlights of Taiwan’s Health Care System (Source: New York Times and North Carolina Health News.org)
• Taiwan citizens have health insurance “Smart Cards” with memory chips, giving instant access to medical history, what medications a person takes and the results of prior hospitalizations.
• Dr. Wui Chiang Lee of the Taiwanese Ministry of Health said many of the poor are “nearly 100 percent subsidized” by the Taiwan government and “the subsidy depends on income and profession.”
• Barcodes are used on patient wristbands and records “to keep from making mistakes.”
• All hospitals “have electronic medical records linked into the main system, a concept health care planners in the U.S. say they want and which is being pushed by the federal Affordable Care Act.”
• Co-payments are “so low that they seldom offer a financial barrier to services.”
• Patients may visit specialists without getting a referral.
• Patients may choose any doctor or hospital they want, unlike in the USA, where patients are limited to providers within a health insurance plan’s network.
• Covered health care includes prevention, Western-style primary care, hospitalization, Chinese massage, acupuncture, traditional herbal medicine, mental health, dental, vision and long-term care.
• For employed citizens, the employer pays 60%, the employee pays 30%, and the government pays 10%.
• The Taiwan government fully subsidizes premiums for the poor, with partial subsidies for veterans, the self-employed and farmers.
• Co-payments are approximately $2 for clinic visits, $4 for hospital outpatient departments, and 10% for the first 30 days of hospitalization and 20% beyond 30 days.
• Prescription co-payments are approximately 20% of the drug and are “capped at $6 for each prescription,” the New York Times reports.
• Taiwan sets a “ceiling on the total co-pays, so patients won’t face bankruptcy.”
• The Taiwan system is paperless, allowing doctors and hospitals to get paid in two weeks or less and keeping administrative costs down.
Netherlands tops health care rankings, with UK in 14th place – Telegraph http://www.telegraph.co.uk › News › Health › Expat Health 2015 –