The Second Version

05/06/07

On Healthcare Systems, Briefly

Because I have already wrote one PhD thesis and that was quite enough for a long while.

Yesterday Jeff Goldstein wrote a piece excoriating Bill Maher for his fact-free euology of France - and as one should expect, bashing of the USA. As often happens, the alleged superiority of the Fench healthcare system was among the pillars of the argument.

I'm not interested in delving in the pros and cons of the American and French systems, but I want to tackle some other root issue.

It is wrong to think that healthcare can be completely free: remember, there is no such thing as a free lunch. In other words, resources are required to provide healthcare: facilities, people, drugs, consumables, salaries and so on. These resources aren't going to be created out of thin air; someone has to pay for it (even if the payment does not take the form of cash).

Different countries then have figured out different methods to obtain the required resources. In most of Europe healthcare is socialized, meaning that is financed with taxes imposed on the general population. In the USA instead healthcare is mainly financed by medical insurances or direct payment for received care.

Other countries may also adopt mixed systems in which healthcare is only in part socialized. Here in Italy, we have to pay a small price (called ticket) for many medical services (it was nearly €40 for the firearms license visit, damn them...).

A few small countries are lucky or wise enough to have large natural resources (and administrate them properly) or generate huge public income - maybe attracting banking business with low taxes and largely anonymous operations - that high quality healthcare can be provided at minimal cost for citizens. However, these cases are rare and the rule seems to be small size; this model does not scale up.

Each system has pros and cons, but socialized systems suffer from the well-known problems of free riders, lack of motivation and discipline among the personnel, graft, corruption and more.

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