What Sweden Can Tell Us About Obamacare

[ErikJ]

What Sweden Can Tell Us About Obamacare

By ROBERT H. FRANK 6/15/13 NYTimes

LAST month, for the 37th time, the House of Representatives voted to repeal Obamacare, with many Republicans saying that its call for greater government involvement in the health care system spells doom. Yet most other industrial countries have health care systems with far more government involvement than we are ever likely to see under Obamacare. What does their experience tell us about Republican fears?

While in Sweden this month as a visiting scholar, I’ve asked several Swedish health economists to share their thoughts about that question. They have spent their lives under a system in which most health care providers work directly for the government. Like economists in most other countries, they tend to be skeptical of large bureaucracies. So if extensive government involvement in health care is indeed a recipe for doom, they should have clear evidence of that by now.

Yet none of them voiced the kinds of complaints about recalcitrant bureaucrats and runaway health costs that invariably surface in similar conversations with American colleagues. Little wonder. The Swedish system performs superbly, and my Swedish colleagues cited evidence of that fact with obvious pride.

The United States spends more than $8,000 a person per year on health care, well more than twice what Sweden spends. Yet health outcomes are far better in Sweden along virtually every dimension. Its infant mortality rate, for example, was recently less than half that of the United States. And males aged 15 to 60 are almost twice as likely to die in any given year in the United States than in Sweden.
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http://www.nytimes.com/2013/06/16/business/what-sweden-can-tell-us-about-obamacare.html?_r=0

[Earth_First]

1. Talk about subconcious repetition...

I read 'Sweden' as 'Snowden' several times in that OP.

Off topic, I know. Just an observation.

K&R

[NBachers]

2. Yes, the same thing happened to me.

[bluestate10]

3. You need to get out more. nt

[TrollBuster9090]

4. When you can't quote statistics, FALL BACK ON ANECDOTES. Yes, Sweden spends half as much on

healthcare, covers EVERYBODY, and has better health outcomes.

I've gone through this argument with the anti-socialized medicine crowd more times than I like to remember, and the argument usually goes as follows:

YOU point out that the USA spends more than TWICE AS MUCH PER CAPITA on healthcare than any other developed country. (Not only that, but the USA spends more than twice as much per capita WITHOUT COVERING EVERYBODY.) That's a FACT that's easy to look up. (On Wikipedia, or the CIA World Facts book, where any 'Google Scholar' can find it.) That fact can't be refuted, so your opponent has to claim it's BECAUSE healthcare is so much better.

The 'proof' they'll usually cite is that there are 'so many' people from foreign countries that come to the USA for healthcare that they can't get at home. They'll often thrown in prominent Canadian politicians like Robert Bourassa (Premier of Quebec) and Belinda Stronach (a prominent federal politician) who both came to the USA for cancer treatment, which is obviously a big poke in the eye for the Canadian single-payer system. The right wing noise machine has gone out of their way to repeat these anecdotes over and over again, until almost every right winger can cite them. They'll also usually cite the friend of a cousin of a friend who 'swears' the Canadian healthcare system is shit, and they had to wait SIX MONTHS for a hip replacement. Again, ANECDOTES.

But the fact is, only a handful of very wealthy people from the developed world come to the USA for VERY EXPENSIVE treatments that they can get VERY FAST, from the most sophisticated treatment centers in the world, like the Mayo Clinic or the Sloan Kettering Institute. VERY FEW PEOPLE DO THAT. Only a handful of the very very rich can do this. For the vast, VAST majority of people, they wouldn't trade their single payer systems for the US 'system' for anything. I have some links to polling data (particularly in Canada) proving that, but I don't have them on hand right now.

The NEXT thing that will typically happen is you can cite the fact that MEDICARE has a 2% overhead, while private HMOs like AETNA typically have overheads of 18-20%. (SO much for 'private business being more efficient.') I have links to prove this, as well, but you can easily find them on the internet. Most of them are based on studies done by the Keiser Foundation. The right wing comeback is usually to say that Medicare uses other government facilities to do all their paperwork etc., so that their total overhead expenses don't show up on the books. Bullshit! The reason Medicare has a 2% overhead and United Health has a 20% overhead is because there are no WILLIAM McGUIRE's running Medicare, and taking $1.4 BILLION in compensation. Just think of it. If a hip replacement costs $10 000, you could fund 140 000 hip replacements for the money UNH paid Bill McGuire. This isn't rocket science.

Next, if you CITE the statistics showing single payer systems have better health outcomes, cover EVERYBODY, and have nobody going broke over medical bills, you'll run into the usual argument about how "Taxes are higher in them Soshializt countries." Yes they are, but EXPENSES ARE LOWER. If you take the average US tax bill, and ADD the cost of health insurance to it, you'll see that the average US citizen isn't gaining anything. They pay slightly less in taxes, but end up getting much more expensive, and less efficient healthcare.

Finally, even if your opponent accepts the fact that healthcare is more expensive in the USA, doesn't cover everybody, and has worse outcomes than the northern european countries (ie- Sweden, Denmark, Norway etc.), they'll fall back on the argument that the USA is actually SUBSIDIZING those countries, because all the medical research is done in the USA for profit, and if you took the profit incentive out of healthcare there'd be no innovation.

Again, untrue. First, SIX out of the top ten pharmaceutical companies are based in europe, not the USA (you can look that one up, too). Second, socialized healthcare doesn't socialize the pharmaceutical companies, or the medical device companies. Those industries are still for profit. The only thing that gets eliminated is the insurance guy in the cubicle who gets between you and your doctor. Socialized medicine does not socialize healthcare research. It just moves THE RATIONING of healthcare away from who can PAY for it best, to who NEEDS it most.

Yes, healthcare IS ALWAYS RATIONED, whether you have private or public healthcare. It's just that with public healthcare it's rationed according to need, not ability to pay.

And THAT, my friends, is what's at the root of resistance to socialized medicine. It's not based on ideology or economic theory, it's based on resentment of the poor, with overtones of racism. You've got working class people who think if we move to a socialized medicare system, care for THEM will be WORSE---specifically BECAUSE government will allocate it to poor people, who are currently just dying for lack of proper healthcare.

This isn't true, but it's damned hard to convince the average redneck that it's not true. Their resistance to it is visceral, not logical.

We have to just keep on quoting the STATISTICS that show that healthcare is BETTER FOR EVERYBODY in countries with socialized medicine. Keep citing the STATISTICS over and over again, until they finally speak LOUDER than the astroturfed anecdotes.

The second argument

[Demeter]

5. Sweden provides HEATH CARE; Obama feeds the Health INSURANCE INDUSTRY

You can't compare apples and horse apples.

[Hydra]

14. That was my first though

This is a good argument for single payer...but we're not getting that.

[dsc]

6. In complete fairness our insane gun laws also have a part in this

I am quite sure that some of that twice as likely to die in a given year for those males who are b/w 15 and 60 is from the fact they are literally tens of times more likely to die from gun shots here than in Sweden.

[Yo_Mama]

7. But what does Sweden's socialized healthcare system have to do with Obamacare?

They don't charge people $40 to go to their physician, $25 for a generic medication, $50 for a lab test or X-ray. I would think many people would be much happier with a Swedish type system than what we are getting, and I find it weirder than all hell that someone is conflating the Swedish system with what we are setting up - a system that protects hospitals but doesn't provide affordable health care for the poorer in our population.

I would much prefer the Swedish system than what we are getting. I find it rather offensive that anyone assumes that we are so dumb as to believe that's what we are getting. Obamacare puts the private insurance companies in charge, and ask any doctor, and the doctor will tell you that these insurance companies keep imposing more and more hoops to jump through to get their patients care. I would think that most doctors would prefer the Swedish system to what we are getting too.

[ErikJ]

9. I think it was to refute the Con's "Govt run health care system" propaganda

THe Swedish system is ALL govt run and ours is just regulated by the govt. And theirs is much better than ours.

[Yo_Mama]

10. I think people would be okay with a government-run health care system

After all, that's basically Medicare.

But I don't think a government-mandated private insurance system works at all the same way, and those complaining about a government takeover of the private insurance system have a legitimate argument, which is entirely separate from the issue of an actual socialized health care system.

Letting private insurance companies control standards of care combined with the government mandate to deal with the private insurance companies (a government-granted monopoly) is almost the antithesis of the Swedish/Canadian type of model. In the Swedish/Canadian type of systems, government looks at the needs and provides the resources, but individual doctors figure out what the needs of the patient are. The way Obamacare is designed, insurance companies are controlling access to care instead of doctors, but the market is allocating resources. This means that wealthier areas are going to have more resources than they really need, but poorer areas are going to have shortages.

So I don't think the article makes any sense at all.

[ErikJ]

11. Its simply the degree of govt involvement.

The govt involvement is obviously much more than ours. And their system (our Medicare as well) is more successful which directly refutes their propaganda.

[Yo_Mama]

12. No, it doesn't

Because government involvement in the Obamacare system is not the same at all as government involvement in a national socialized health care system.

I'm sorry, but I am going to insist on this point. The primary difference between a system such as the Canadian or Swedish ones and the one being set up under ACA is that in the C/A type of system, government (a subsegment thereof, usually well staffed with medical types) determines how the money allocated is spent on basic healthcare assets and resources (hospitals, clinics, equipment, medicines, etc). Doctors then determine who needs the resources. Access to doctors is not limited by the financial resources of the patient.

In the Obamacare system, government isn't making those choices at all. The way Obamacare has been set up, access for the poor is sharply less than for the wealthy. This means that a much larger share of spending will go toward private companies (ins cos) and toward fluffier-but-profitable stuff (boutique demand for health care services going toward the younger/more wealthy), but there will be much less access to basic medical services for the poorer. This is going to sharply raise costs.

There is a dramatic difference between the types of government involvement and you cannot truthfully draw an equivalence between the two. Only someone who knows nothing about how the health care system in the US actually works can honestly do that, but ignorance and conviction does not equal accuracy.

[ErikJ]

13. Most basically: OCare is govt REGULATION of private insurance and

Swedens is govt owned and operated.

[Quantess]

8. No, no, and NO!

Sweden is single payer.