Gov LPA Research: Sick Around the World


Sick Around the World 3
In Sick Around the World, FRONTLINE teams up with veteran Washington Post foreign correspondent T.R. Reid to find out how five other capitalist democracies deliver health care, and what the United States might learn from their successes and their failures.

The British system is socialized medicine because the government both provides and pays for health care. The British pay taxes for health care, and the government run National Health Service or NHS distributes those funds to health care providers. Hospital doctors are paid salaries while General Practitioners are paid based on the number of patients they see. A small number of specialists work outside the NHS and see private pay patients. Because the system is funded through taxes, administrative costs are low. There are no bills to collect or claims to review. Patients have a medical home with their General Practitioners, who also serves as a gatekeeper to the rest of the system. Patients must see their General Practitioners before going to a specialist. General Practitioners are paid a bonus for keeping their patients healthy and are instrumental in preventive care. Preventive care is an area in which Britain is a world leader.

The Japanese go to the doctor three times as often as Americans, have more than twice as many MRI scans, use more drugs, and spend more days in the hospital. Japan spends about half as much on health care per capita as the United States. Japan uses a social insurance system in which all citizens are required to have health insurance. The Japanese receive insurance either through their work or purchased from a community based plan. Those individuals who cannot afford the premiums receive public assistance. Most health insurance is private and cannot turn down a patient for a pre-existing illness, nor are they allowed to make a profit. Doctors and almost all hospitals are in the private sector. In Japan there are no gatekeepers. Having no gatekeepers means there’s no check on how often the Japanese use health care. The Japanese can go to any specialist when and as often as they like. Every two years the Ministry of Health negotiates with physicians to set the price for every procedure. This helps keeps costs down.  Japan has been so successful at keeping costs down that Japan now spends too little on health care. The result is half of the hospitals in Japan are operating in the red.

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