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make sure that your healthcare system is funded, that it works and is seen to work, and that being a doctor, an administrator or a nurse are seen as socially valuable jobs and not as positions for losers, to be squeezed as much as possible.

In other words, stop repeating that government cannot do the job and focus on actually doing the job. It works in many sectors and many countries.

In the long run, we're all dead. John Maynard Keynes

by Jerome a Paris (etg@eurotrib.com) on Mon May 25th, 2009 at 09:04:54 AM EST
[ Parent ]
In this connection I had the following exchange with Graham Watson MEP. Responding to his press release Parliament backs rights of patients to healthcare without borders (South West Liberal Democrats)
"I do not understand that people who preach a social Europe do not want to give patients the right to get the treatment they need. Is it social to vote against legislation that benefits the European citizen in a concrete way? This is not about liberalisation of health care services, but about free movement of patients. The directive will not interfere in the way national health care systems are organised. They are playing political games on the backs of European patients."
I asked
How do we prevent member states underfunding their public health system and thus freeloading on their neighbours?
and got
Member states will find that health care becomes a form of tourism - visit of relatives etc. & will have an inventive to improve health care.
Head meet desk, etc...

The brainless should not be in banking. — Willem Buitler
by Migeru (migeru at eurotrib dot com) on Mon May 25th, 2009 at 09:11:37 AM EST
[ Parent ]
Graham Watson:
Member states will find that health care becomes a form of tourism

[head explodes]

Medic!

by ThatBritGuy (thatbritguy (at) googlemail.com) on Mon May 25th, 2009 at 09:20:37 AM EST
[ Parent ]
you guys are a crackup, but how about some devil's avocado here?

people have travelled for health, spiritual through pilgrimages, and physical, spa cures.

people even go for a summer beach holiday for their health, on some level.

so travel and health are joined at the hip already, the cheap flights/globalisation thingy has just upped the ante considerably.

it's nothing new, or particularly dramatic, look how may stateside go to mexico for operations, or euros even going as far as thailand for dentistry.

not to denigrate the valid points you're making, just that there is more than one side to the issue, if people want to go somewhere nice and have a holiday, returning with a new nose or choppers (!), it's going to be pretty hard to legislate that into extinction.

~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~

by melo (melometa4(at)gmail.com) on Tue May 26th, 2009 at 02:07:43 AM EST
[ Parent ]
Okay, but that's 'healtchcare' as a lifestyle accessory.

It's missing the point that essential healthcare which isn't available locally might as well not exist.

If I have a heart attack I don't want to be waiting for a doctor to helicopter over from Poland. Likewise if I sprain my foot, I shouldn't have to fly to France for an x-ray.

It doesn't matter how good or 'competitive' these non-UK services are - if they're not immediately available, they'no use to me.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Tue May 26th, 2009 at 04:23:20 AM EST
[ Parent ]
There is a difference between attempting to stamp out health tourism and actively promoting it (and then another yawning gap between promoting it and thinking that it'll solve the underlying problems with our health care systems). Stamping out health tourism is, if not impossible, then at least very probably more trouble than it's worth, but that hardly justifies subsidising it.

And as an aside, if you implement the kind of system where the country you are treated in sends the bill to the country you live in, you run into all kinds of issues. In Poland, for instance, abortion is illegal. In Denmark, it's a fairly routine operation. The Polish authorities might understandably be a tad - ah - miffed, shall we say, that Denmark not only subverts their regulations, it would also be able to bill them for it.

Now, in the particular case of abortion, I happen to think that Poland should sit down, shut up and pretend to be civilised. But suppose that Luxembourg decides that it would be profitable to do chelation therapy for autism, or British lobbyists start pushing the UK as a flag of convenience country for scams like homeopathy?

Should they be able to start a carry trade of people who go there to get free quackery that they'd otherwise have to pay for because their home state doesn't want to sponsor bullshit pseudo-medicine? And then send the bills (along with the bother and cost of dealing with the inevitable complications of using quacks their nostrums instead of real medicine) back to the patients' home countries?

And if you don't allow countries to claim reimbursement for procedures that are not reimbursed in the country they were going to bill, you risk a race to the bottom, where the countries with free, universal health care may end up supporting the cream skimming for-profit health care system of less responsible countries. And if you allow countries to refuse to pay for procedures that they can't be reimbursed for... well, there went the whole mobility of health care thingy...

In short, there's a number of highly non-trivial issues here that need to be fleshed out, and appeals to "competition" strike me as being more an example of the belief in the power of incantation than in the power of evidence.

- Jake

If you only spend 20 minutes of the rest of your life on economics, go spend them here.

by JakeS (JangoSierra 'at' gmail 'dot' com) on Tue May 26th, 2009 at 05:08:07 AM EST
[ Parent ]
That comment would be worth posting as a diary, to continue this discussion.

In the long run, we're all dead. John Maynard Keynes
by Jerome a Paris (etg@eurotrib.com) on Tue May 26th, 2009 at 05:43:13 AM EST
[ Parent ]
Link.

- Jake

If you only spend 20 minutes of the rest of your life on economics, go spend them here.

by JakeS (JangoSierra 'at' gmail 'dot' com) on Tue May 26th, 2009 at 08:07:25 AM EST
[ Parent ]
What he could have said is that if nation A underfunds its health care and sends all its patients to nation B, nation B will still send the bills back to nation A.

Peak oil is not an energy crisis. It is a liquid fuel crisis.
by Starvid (arvid.hallen at gmail.com) on Mon May 25th, 2009 at 09:22:44 AM EST
[ Parent ]
Member states will find that health care becomes a form of tourism - visit of relatives etc. & will have an inventive to improve health care.

There are several ways to say "fuck you." That is one of them.

- Jake

If you only spend 20 minutes of the rest of your life on economics, go spend them here.

by JakeS (JangoSierra 'at' gmail 'dot' com) on Mon May 25th, 2009 at 01:41:20 PM EST
[ Parent ]
make sure that your healthcare system [...] works

Haha, yes. That's the problem, isn't it? Political blockages seem to crop up whenever we try to reform our health care system and cut away the bureaucracy. It's not really that the care is bad, it's world class, the problem is the waiting times. The low efficiency.

And because of the impossibility of reform, instead of having a sound tax-financed system with a mix of private and public care institutions we have gotten one which desperately tries to block all private alternatives, but which allows privately financed health insurance with which you can skip the lines in both public hospitals and the handful or private ones they haven't manage to stop.

Marvelous, innit?

Peak oil is not an energy crisis. It is a liquid fuel crisis.

by Starvid (arvid.hallen at gmail.com) on Mon May 25th, 2009 at 09:14:13 AM EST
[ Parent ]
I think you are confusing the issue of health care in general with your opinion about the Swedish health care system.

There is actually a wide variety of approaches to health care in Europe (and the industrialised world in general.)

Many mix public and private institutions, many have private health insurance systems in parallel to state funding.

While none are as inefficient as the "privatised" american system, all of them, from the market-liberal Germans to completely state controlled Norwegians, are being squeezed by rising costs.

The fact is, people get older as we get more and more treatments and a more efficient health care system.

Hospitals hold the ultimate captive market. The better they work the more customers they have.

Moving the deck chairs around isn't going to unsink the Titanic. If you want a better functioning health care system you have to increase the funding or stop treating people.

by Trond Ove on Mon May 25th, 2009 at 09:34:21 AM EST
[ Parent ]
Trond Ove:

Hospitals hold the ultimate captive market. The better they work the more customers they have.

Moving the deck chairs around isn't going to unsink the Titanic. If you want a better functioning health care system you have to increase the funding or stop treating people.

heh, i would have thought the better the hospital, the faster they'd move the customers out.

till the common wisdom about diet changes, and it's easier -and cheaper- to get a soyburger than a dead cowburger, no amount of deck chair repositioning is ever going to work efficiently, let alone keep pace with boomer aging.

last week they arrested nurses in america for protesting the absence of any single payer plan, health providers are heartily p-o'd that they have insurance companies ruling how they treat patients.

her in yurp it's better, but hospitals remain germ traps, and doctors aren't thrilled with the arrangements, all the while working ridiculous hours guaranteed to cause burnout.

~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~

by melo (melometa4(at)gmail.com) on Tue May 26th, 2009 at 04:00:56 AM EST
[ Parent ]

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