Hiring hundreds of thousands additional paper pusher and adding complexity will not make things better. A reform is needed, but this ain't it.
A fundamental problem with comparing our system with, for example, Canada's, is that you are dealing with different governments and political processes, different attitudes of the people, etc. Canadians may well be happy with their system, but that does mean Americans would be happy with the same or similar system. Some Americans want single payer, while others [like me] feel that government is already far too involved in health care and that many of the problems we face are a direct result of government intervention.
One other thing that just doesn't translate well from other countries is the population difference. When you have an immensely larger population you necessary interject multiple levels and layers of government between the top and bottom. This means that even in the best of scenarios, problems aren't addressed because of the intense bureaucracy involved, and these programs end up on auto-pilot.
Look at Medicare, for example, which is now an immovable monolith that has assumed a near-dictatorial status. It is not because the people at Medicare don't try hard because I believe most of them do. But big ships are hard to turn around, so you end up with untold billions of dollars wasted and stolen without any real accounting controls at all.
I think we would make a huge mistake to base our health care finance system on some system because it "worked in country x" because there is no country that is just like us -- our "melting pot", our form of government, our political system -- all make for a far more difficult circumstance than those found in other nations and as a result, what works there probably won't work so well here. |
