I have to admit that I haven’t followed the US debate about health insurance too closely, but I found James Wimberley’s discussion about the Obama health plan interesting:
[Obama] didn’t mention that his universal health insurance plan is basically a clone (via Edwards and Clinton) of the cunning old warhorse’s revolutionary 1884 law. This also left an existing patchwork of enterprise-based plans in place, adding a default public one. So I’ll call Obama’s scheme by its Bismarckian name: a Krankenkasse.
Just some notes about the Scandinavian systems (which are not completely identical):
- One thing they have in common is that they are basically tax-financed, although there are some complications with regard to sickness benefits.
- In Sweden, sickness benefits are administered by a state agency; in Denmark, by local councils (but under national guidelines)
- In Denmark and Sweden, there is no national health care in the strict meaning1 – regional councils are in responsible for running primary and secondary health care. Norway is different these days and there are definitively tendencies towards centralisation of the provision of health care.
- The rule of thumb in Denmark and Sweden seems to be that a health care authority should cover 1-2 million people.
- In principle, these systems will work with private providers of health care. GPs and many specialists are private entrepreneurs in Denmark. Equally, there are a number of private clinics.
- Private insurance has played a minimal role in Denmark and Sweden, but is becoming more popular in Denmark. The question is if work-based private schemes will supplement or crowd-out public health care in the medium to long term.
- You are of cause entitled to emergency care everywhere and there is some choice between different providers, and the systems are of cause regulated by national legislation. [↩]