Guaranteed Healthcare

In 1995, Taiwan had 40% of its population without health coverage, a huge rich-poor gap in life expectancy, and a ton of social and economic problems as a result. 

So they did the rational thing:  they introduced a national, non-profit, single-payer health care system.

How’s that working out for them?  Per the Taipei Times:

In the decade since it was launched, the National Health Insurance (NHI) has contributed to a modest reduction in the gap in life expectancy between the rich and poor sections of society, public health researchers found in a recent study….
He found that those in the more marginalized sections of society had benefitted more from the creation of the NHI than those in more privileged groups in terms of increases in life expectancy….In the decade prior to the launch of the NHI, the life expectancy gap between the rich and the poor was steadily widening.

That’s called healthcare justice.  What does it mean for us?

 In an Annals of Internal Medicine editorial that referred to Wen's article, Karen Davis and Andrew Huang said that Taiwan's experience with national health insurance should send a clear message to US policymakers.
"The improvement in life expectancy, although modest, for health class groups with the least healthy outcomes before national health insurance lends credence to the argument that the US should join other industrialized nations in ensuring universal health insurance coverage," the editorial said.

But how could they afford it?

When the Taiwanese set up the system more than 40% of the population was uninsured. They are now covered by the national health insurance scheme - and because of the increased efficiency of the single-payer system - this was done at little or no extra cost….

Taiwanese do not have to worry that changing or losing their jobs will lose them their healthcare. They do not have to make choices between paying the food bills and getting essential prescriptions. Their doctors will not drop their insurance coverage, nor do they get post-operative sticker shock when they discover the anesthetist the hospital booked does not accept their insurance. They do not have to worry about big bills for out-of-network providers - because if a doctor is out of the network the chances are they were thrown out for fraud or malpractice.

The only losers?  The insurance corporations.  Unfortunately those very insurance corporations seems to have a death grip on America medicine.

As a result, here’s what passes for healthcare policy in this country today: states around the country are spending millions to push their citizens to buy expensive, long term care insurance.  Per the Wall St. Journal:

The state endorsements are "the single best thing that has happened to the long-term care industry," says Jesse Slome, executive director of the American Association of Long-Term Care Insurance. Total premiums collected for long-term care, or LTC, policies were $10 billion in 2007, up 21% from $8.2 billion in 2004.

Critics are sounding alarm bells. They argue that the financial benefits of LTC insurance for many target customers are negligible to nonexistent. Their income and assets are so low that they would quickly qualify for free care under Medicaid.

When they’re not acting as, um, promoters for insurers, states like California are setting up complex bureaucracies designed to save money by throwing poor people out of the Medicaid system.

How much pain with the insurance industry inflict upon America before we move to a single-payer system?  And when will our leaders catch up with the people and solve this problem?