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I'm not sure I understand your points.  My reason for separating out 1,, 2, and 3 is precisely because entitlements (to public healthcare, at least) should be "rights" and not privileges dependent on your citizenship, country of residence, or private insurance coverage.

The issue of how those entitlements are met through service delivery, and how those services are managed and funded should be entirely separate and can allow for some regional/national variation.  For instance the UK might deliver all public services through the NHS whereas in Ireland some might be delivered through public hospitals, and others by private hospitals under contract to the state to deliver certain services at standard prices.

I'm sure we all have our favourite models (mine is all public), but there are huge ideological issues here which would preclude progress any time soon if we tried to impose one model.

So why not focus on the EU defining entitlements and standard treatment protocols and prices, and let member states decide how best to manage the delivery of those services at standard prices?

notes from no w here

by Frank Schnittger (mail Frankschnittger at hot dotty communists) on Wed May 27th, 2009 at 06:50:46 PM EST
[ Parent ]
Well, your scheme actually does consider pts. 1) and 3) at the same time: It specifies which treatment protocols citizens have an absolute right to, and it then specifies how treatment is to be funded: Bill it to the Treasury of the country of residence, and then they can have the fight with the insurance companies, governmental sub-units or whomever is in charge of funding these things.

What I'm afraid of is that the list of patient rights will be implemented, but no transfer scheme will be set up that enables the provider to bill somebody and be sure to get his money. And then you're essentially billing the good guys, because they take patients in without first checking whether they get paid for them, whereas the bad guys tell them to sod off if there's no money on the barrelhead.

And, of course, there's the perennial risk that a partial list of health care rights will be used as an excuse to underfund other health care provision ("well, Bruxelles says that we have to pay this sum of money to a French hospital, so that comes out of your budget..."). But I count that as a problem with a state-level democratic deficit, rather than a problem at the federal level.

- 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 Wed May 27th, 2009 at 07:46:48 PM EST
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