Letter to the Editor
San Francisco Chronicle, Dec. 2, 2009
In "Lessons on health care from Europe" (Nov. 29), Carolyn Lochhead points to lessons to learn from the "private," multi-payer health care systems in Germany, Switzerland and the Netherlands.
She is right that we can learn from others. Unfortunately, she draws the wrong lessons. Switzerland and Germany have social insurance. For-profit insurance for medically necessary care is banned. Private insurers are tightly regulated by the government, and plans that enroll healthier patients must financially compensate those enrolling sicker patients. And while all European and other systems deliver health care according to need and not ability to pay, the multi-payer varieties have much higher administrative costs than single-payer ones.
In the Netherlands, the recently introduced for-profit insurance applies only to a small portion of services, and the results are mixed at best. As money is diverted from care to advertising, health care needs go unmet, and costs are steadily rising, as is popular discontent.
We should study the impressive achievements of publicly financed, privately delivered single-payer systems in Canada or Taiwan.