DG's recent post made me think, "Where is the best health care in the world?"

What do you think? What do you like or dislike about health care, or your plan in particular? Perhaps there are elements from different systems that, if combined under good management, could produce something even better.

I would enjoy batting this around with everyone. No politics are intended.

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What do you like or dislike about health care, or your plan in particular?

I hate how the insurance companies are running the show now instead of the doctors. Patients have to take the meds that the drug companies want them to take, and the medical insurance companies try to limit the days that a patient stays in the hospital.

When I had to be hospitalized for 42 days, after 10 days had gone by, Blue Cross/Blue Shield wanted me released. There was no way the doctor would release me in a life or death situation, so he (or the hospital) had to call them every 4 days to get an okay from them in order for me to stay. Actually, there's more, but you get the general idea.

"Of all the forms of injustice, inequality in health care is the most shocking and inhumane." Martin Luther King Jr.

With over 40 million of our citizens not covered by healthcare insurance of any kind, and a World Health Orgaization ranking placing the United States of America in 37th place, how can we accept the status quo?

I don't think that it is a matter of geography that determines where one finds the best health care in the world. It must be obvious that where money is no object, the best health care is available to anyone able to afford it. I can have plastic surgery in Switzerland, my gall bladder taken out in Spain, my heart by-pass in Italy, orthopedic procedure in San Francisco, and so on if only I can pick up the tab. But is there some reason why a child in Detroit whose parents are below the poverty level should go without timely intervention for a life-threatening condition ?

Could we patch up our quarrel with the French and get them to tell us how they got to be ranked #1?

Personally, I cannot complain about the health care that I receive, but I have to agree with Honi, I do see this happening to people that I know. The Doctors should be the ones who determine what health care a person receives, not the insurance companies.

So far, is it fair to say people would like to see:

- elimination of decision-making by insurance companies
- reduced influence of pharmaceutical companies in medication choice
- timely, quality health care for all citizens regardless of capacity to pay
- a European vacation for frankvan (and will he still look like Van Gogh after his Swiss plastic surgery?)

It is NOT fair to say anything - based on what three or four people on AP say, obviously. The question concerns The Best Health Care in the World!!! And the world's only remaining super power should not be borrowing money from China to finance tax cuts for the wealthy, and invasions of third world countries while tolerating a shameful ranking only marginally ahead of CUBA!IMHO!

That was just "so far" - I imagine a list will be quite lengthy. There seems to be a lot to sort out.

No wonder we're just ahead of Cuba. Our per capita spending (in 2000) was $4500, just nicking out Cuba at $186. Source

The French system is not as simple as the single payer U.K or the Canadian model. Perhaps Fred Puli will care to weigh in here based on personal experience.Here is some info on the French model.

If I do go to Switzerland for plastic surgery, Fuse, I'll get that missing ear replaced. What are you hiding from?? Is your picture in the attic like Dorian's?

Colin in Paris may be a better person to ask (and may correct me, as I have limited experience and knowledge of this system which is, incidentally, almost frighteningly prompt and good). As I see it the French system sounds complicated. It is not so in practice.The fees chargeable are fixed. Everyone carries a card which is swiped by the doctor: it bears the info about them and their status. Even those who are not eligible for full payment of the costs pay only about 20 per cent of the bill, the rest being paid by the government. In practice over 99 per cent of people in France are fully reimbursed (according to the French Embassy). The top up insurance is very cheap, as you'd expect in the circumstances. Furthermore it is impossible for someone whose insurance is paid by their employer to lose that cover if they change job.Insurers quote the same rate for everyone: it is dependent on your age and sex, not what your medical history is.The questionnaires ask puzzling questions, which surely only a bureaucrat would ask, such as 'Are you divorced,unmarried, married/in a civil union?' but not whether you have diabetes or had a heart attack recently

The government has recently (2005) removed one of the strange features of the system. Until then a patient could shop around until they found a doctor whose opinion they approved of. So if the first doctor did not prescribe a spell in some health spa, and they fancied such a holiday treatment, they'd simply go to another and another until they found one to oblige them. This vagrant clientele was costing the state money, since the state was paying for each visit. By the way, the French regard health spas as legitimate and your doctor may prescribe one.Naturally it wasn't just spas but any treatment and any opinion that could be hunted. Another feature was instant access to specialists. You didn't have to go to a GP (family doctor). You could march into any hospital or any specialist's office and see the specialist directly. That was obviously open to abuse and inefficient and was a strange way of dealing with cases.Now you have to see a general doctor first and you are expected to nominate your doctor and not go on a vagrancy tour of the French medical world .

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Is your picture in the attic like Dorian's?

It probably should be!