Daily Archives: August 27, 2004

Viktiga amarikanska data om den ineffektiva amerikanska privata sjukvården

Published by:

Paul Krugman, ekonomiprofessor vid Princeton i delstaten New Jersey har en utomordentligt viktig artikel i New York Times som borde ge de flesta svenskar en riktig tankeställare. Det visar sig nämligen att privatsjukvård, tvärt emot vad SvD just i dessa dagar förespråkar är ***mindre effektivt *** än den socialistiska sjukvården i bl.a. Frankrike.
Jag har inte de svenska siffrorna, men någon vänlig läsare kanske kan hitta dom.
Innan Sverige jublande inför privat sjukvård enligt amerikanskt mönster, vore det inte en bra ide att först kolla med ekonomer som Krugman? Privat sjukvård enligt amerikansk modell skulle bli förödande för Sverige. Alltså, den amerikanska privatsjukvården är mindre effektiv och alltså betydligt mer kostsam per kapita än mycket av den “socialistiska” europeiska och kanadensiska sjukvården.

Det är mycket farligt att den svenska synen på USA idags ägs av moderater och folkpartister som använder USA för att propagera för en ofta helt felaktig bild av USA.

Working Americans have two great concerns: the growing difficulty of getting health insurance, and the continuing difficulty they have in finding jobs. These concerns may have a common cause: soaring insurance premiums.

In most advanced countries, the government provides everyone with health insurance. In America, however, the government offers insurance only if you’re elderly (Medicare) or poor (Medicaid). Otherwise, you’re expected to get private health insurance, usually through your job. But insurance premiums are exploding, and the system of employment-linked insurance is falling apart.

Some employers have dropped their health plans. Others have maintained benefits for current workers, but are finding ways to avoid paying benefits to new hires – for example, by using temporary workers. And some businesses, while continuing to provide health benefits, are refusing to hire more workers.

In other words, rising health care costs aren’t just causing a rapid rise in the ranks of the uninsured (confirmed by yesterday’s Census Bureau report); they’re also, because of their link to employment, a major reason why this economic recovery has generated fewer jobs than any previous economic expansion.

Clearly, health care reform is an urgent social and economic issue. …

The fact is that the mainly private U.S. health care system spends far more than the mainly public health care systems of other advanced countries, but gets worse results. In 2001, we spent $4,887 on health care per capita, compared with $2,792 in Canada and $2,561 in France. Yet the U.S. does worse than either country by any measure of health care success you care to name – life expectancy, infant mortality, whatever. (At its best, U.S. health care is the best in the world. But the ranks of Americans who can’t afford the best, and may have no insurance at all, are large and growing.)

And the U.S. system does have very high overhead: private insurers and H.M.O.’s spend much more on administrative expenses, as opposed to actual medical treatment, than public agencies at home or abroad.

Does this mean that the American way is wrong, and that we should switch to a Canadian-style single-payer system? Well, yes. Put it this way: in Canada, respectable business executives are ardent defenders of “socialized medicine.” Two years ago the Conference Board of Canada – a who’s who of the nation’s corporate elite – issued a report urging fellow Canadians to bear in mind not just the “symbolic value” of universal health care, but its “economic contribution to the competitiveness of Canadian businesses.”