Taiwan's Single-Payer System? Rocking Out!

In 1995, Taiwan had 40% of its population without health coverage, a huge rich-poor gap in life expectancy, and a ton of social and economic problems as a result.  

So they did the rational thing:  they introduced a national, non-profit, single-payer health care system.

How's that working out for them?  Per the Taipei Times:

In the decade since it was launched, the National Health Insurance (NHI) has contributed to a modest reduction in the gap in life expectancy between the rich and poor sections of society, public health researchers found in a recent study....
He found that those in the more marginalized sections of society had benefitted more from the creation of the NHI than those in more privileged groups in terms of increases in life expectancy....In the decade prior to the launch of the NHI, the life expectancy gap between the rich and the poor was steadily widening.

That's called healthcare justice.  What does it mean for us?
In an Annals of Internal Medicine editorial that referred to Wen's article, Karen Davis and Andrew Huang said that Taiwan's experience with national health insurance should send a clear message to US policymakers.
"The improvement in life expectancy, although modest, for health class groups with the least healthy outcomes before national health insurance lends credence to the argument that the US should join other industrialized nations in ensuring universal health insurance coverage," the editorial said.  

But how could they afford it?
When the Taiwanese set up the system more than 40% of the population was uninsured. They are now covered by the national health insurance scheme - and because of the increased efficiency of the single-payer system - this was done at little or no extra cost....
Taiwanese do not have to worry that changing or losing their jobs will lose them their healthcare. They do not have to make choices between paying the food bills and getting essential prescriptions. Their doctors will not drop their insurance coverage, nor do they get post-operative sticker shock when they discover the anesthetist the hospital booked
does not accept their insurance. They do not have to worry about big bills for out-of-network providers - because if a doctor is out of the network the chances are they were thrown out for fraud or malpractice.

The only losers?  The insurance corporations.  Unfortunately those very insurance corporations seems to have a death grip on America medicine.

As a result, here's what passes for healthcare policy in this country today:  states around the country are spending millions to push their citizens to buy expensive, long term care insurance.  Per the Wall St. Journal:

The state endorsements are "the single best thing that has happened to the long-term care industry," says Jesse Slome, executive director of the American Association of Long-Term Care Insurance. Total premiums collected for long-term care, or LTC, policies were $10 billion in 2007, up 21% from $8.2 billion in 2004.
Critics are sounding alarm bells. They argue that the financial benefits of LTC insurance for many target customers are negligible to nonexistent. Their income and assets are so low that they would quickly qualify for free care under Medicaid.

When they're not acting as, um, promoters for insurers, states like California are setting up complex bureaucracies designed to save money by throwing poor people out of the Medicaid system.

How much pain with the insurance industry inflict upon America before we move to a single-payer system?  And when will our leaders catch up with the people and solve this problem?

...cross-posted at the National Nurses Organizing Committee/California Nurses Association's Breakroom Blog, as we organize for guaranteed healthcare on the single-payer model.  Victimized by the insurance industry?  Tell America your story.



Display:


Another great diary! (2.00 / 1)

Thanks!


Washington Woman

Progressive Blue

by kevin22262 on Fri Feb 29, 2008 at 07:36:01 PM EST

Re: Taiwan's Single-Payer System? Rocking Out! (2.00 / 1)

Great diary! Rec'd!


by freemansfarm on Fri Feb 29, 2008 at 07:47:07 PM EST

And Hopefully... (none / 0)

We'll one day manage to get enough progressive Dems into congress to get single payer pushed through.


by Brillobreaks on Fri Feb 29, 2008 at 07:52:29 PM EST

Re: And Hopefully... (none / 0)

More likely the country will just sort of shift toward that position over time, but my fingers are crossed that it's sooner rather than later.


Torture me once, shame on you; torture me and get away with it, shame on us all.
by freedom78 on Fri Feb 29, 2008 at 07:54:49 PM EST
[ Parent ]

Re: Taiwan's Single-Payer System? Rocking Out! (2.00 / 1)

Excellent diary!


by sricki on Fri Feb 29, 2008 at 09:19:05 PM EST

Republican Health Care Plan (none / 0)

Be Rich or Die!

snark solution: give everybody universal health care except GOP;


by dearreader on Sat Mar 01, 2008 at 12:02:25 AM EST

Re: Taiwan's Single-Payer System? Rocking Out! (2.00 / 1)

Thank you for this information.

I've repeatedly pointed out that the big insurance companies are most in favor of mandates (as seen with the failed CA plan).  

Neither HRC or BHO are putting forward a single payer.  Both of them offer subsidizes for the poor.  But, at least BHO doesn't force middle class citizens to either buy insurance they can't afford  or pay a fine, and then still not have insurance.

Arguing about mandates is a distraction.  We can see they haven't worked in MA (half still uninsured, and the system is out of money.)  Those who support HRC and BHO should join together to push for a single payer system.


--1jphusseinb-- she's not a monster, as far as I know--diplomat Sinbad, making the world safe--all bluster, no cattle--
by 1jpb on Sat Mar 01, 2008 at 11:39:26 AM EST

Re: Taiwan's Single-Payer System? Rocking Out! (none / 0)

Yes! As John Kitzhaber (former governor of Oregon and ED doc) says, we are focusing on universal insurance when the real problem is universal health care.

Market economics has its place. Capitalism can be an instrument for heightening the productivity and efficiency of the economic engine that is harnessed to produce social justice.

But medical insurance has no function! It is entirely parasitic in nature. Good physicians will decide what care a patient needs (within some limits determined by what the society can afford). Basic morality will decide who gets the care physicians have determined they need (everyone). Rich people will buy additional care that goes beyond medical necessities, if they wish.

So what do you need insurance companies for? Nothing. They just skim money off the top -- a lot of it.


by EMTP democrat on Sat Mar 01, 2008 at 12:22:47 PM EST
[ Parent ]

Re: Taiwan's Single-Payer System? Rocking Out! (none / 0)

Exactly, SCHIP, medicaid, medicare and new subsidizes (from BHO and HRC) are all plans that take the high cost citizens leaving the profitable people for the health insurance companies.

Already, honest health care administrators will tell you that without the existing government health care entities the system would go broke.  And, the government payments are often fee for service (rather than set fees or fees for results), so the incentive is to do things that aren't needed.

A lot of the less expensive health care providers actually have better results than some that cost more than twice as much.

http://www.dartmouthatlas.org/

WAKE UP HRC supporters, unfunded health care mandates hurt working (but not poor enough for subsidizes) families, and they help the insurance companies.


--1jphusseinb-- she's not a monster, as far as I know--diplomat Sinbad, making the world safe--all bluster, no cattle--
by 1jpb on Sat Mar 01, 2008 at 12:51:08 PM EST
[ Parent ]

Re: Taiwan's Single-Payer System? Rocking Out! (2.00 / 1)

This is a big story. I would suggest to the diarist that she also cross-post it at DailyKos and at the Student Doctor Network Forums. This results will not surprise anyone well-informed on the madness and waste of our current system, but we need clear examples like this to hammer the message home.


by EMTP democrat on Sat Mar 01, 2008 at 12:15:17 PM EST

Re: Taiwan's Single-Payer System? Rocking Out! (2.00 / 1)

great diary. I think the health care debate in this country has still got it wrong. For anyone who professes to "love" HDRC's health care plan, it's not the right solution, if anything it can hurt the long-term debate regarding health care in this country. But, it's an important plan when not putting it in context with the preferred Single Payer system.

the BHO plan is a bit more modest. It's got advantages and disadvantages. The advantage is getting more people covered without having them feel like it's being pushed down their throats. This IMO is helpful, only if Democrats fully intend to make the jump to SP at some point down the "near" future. The downside to his plan is obvious, people get left off the rolls of being insured.

make no mistake of it, the HDRC plan can be damaging moving forward, only because of the mandates. Yes, I agree with anyone who says that everyone should have insurance but not at the risk of pissing off those people whom cannot afford it. If the very people who this type of legislation helps most aren't happy with being forced to purchase health care, the better the argument the right has in rolling back programs to where they are now.

The only logical solution for a fully functional universal health care system is single payer. Both our candidates praise SP yet neither think our country is ready for it (insurance companies are too damn powerful). BHO is right in getting people active to build enough consensus to fight the insurance companies when the time is right. He's also extremely right when it comes to diminishing the power of lobbyists, something HDRC has not been able to denounce publicly. As she says, "some lobbyists are good". That's B.S. "good lobbyists" should not have to exist for government to pass "good" legistlation.

While Hillary might be a "fighter", whatever the heck that means, what this country will need is a huge swell of support from ordinary Americans who will help push the right type of agenda forward. It's really up to all of us to get apathetic friends and family involved in the political process so government can't run counter tot he will of the American voters.


!
by alex100 on Sat Mar 01, 2008 at 12:20:44 PM EST


You are not logged in.

In order to post a comment, you must be logged in. If you have a member account, please log in to comment.

If not, you can make an account right here. It's quick and free.