The Benefits of Socialism....
Posted on 11/22/2008 1:46:23 AM PST by Halfmanhalfamazing
In The Undercover Economist, Tim Harford highly praised the health care policies of Singapore. But it wasn't until I read the section on health care in Ghesquiere's Singapore's Success that I realized how amazing the official numbers are. If the following is true, all the comparisons showing that the U.S. greatly outspends Europe without getting better health are beside the point, because Singapore makes Europe look like the U.S.:
The Singapore government spent only 1.3 percent of GDP on healthcare in 2002, whereas the combined public and private expenditure on healthcare amounted to a low 4.3 percent of GDP. By contrast, the United States spent 14.6 percent of its GDP on healthcare that year, up from 7 percent in 1970... Yet, indicators such as infant mortality rates or years of average healthy life expectancy are slightly more favorable in Singapore than in the United States... It is true that such indicators are also related to the overall living environment and not only to healthcare spending. Nonetheless, international experts rank Singapore's healthcare system among the most successful in the world in terms of cost-effectiveness and community health results.
How does Singapore do it? Singapore is no libertarian health care paradise, but it does self-consciously try to maintain good incentives by narrowly tailoring its departures from laissez-faire:
>The price mechanism and keen attention to incentives facing individuals are relied upon to discourage excessive consumption and to keep waste and costs in check by requiring co-payment by users.
[...]
The state recovers 20-100 percent of its public healthcare outlay through user fees. A patient in a government hospital who chooses the open ward is subsidized by the government at 80 percent. Better-off patients choose more comfortable wards with lower or no government subsidy, in a self-administered means test.
I've heard a lot of smart people warn that co-payments are penny-wise but pound-foolish, because people cut back on high-benefit preventive care. Unless someone is willing to dispute Singapore's budgetary and health data, it looks like we've got strong counter-evidence to this view: Either Singaporeans don't skimp on preventive care when you raise the price, or preventive care isn't all it's cracked up to be.
More details on how Singapore's system works:
* There are mandatory health savings accounts: "Individuals pre-save for medical expenses through mandatory deductions from their paychecks and employer contributions... Only approved categories of medical treatment can be paid for by deducting one's Medisave account, for oneself, grandparents, parents, spouse or children: consultations with private practitioners for minor ailments must be paid from out-of-pocket cash..."
* "The private healthcare system competes with the public healthcare, which helps contain prices in both directions. Private medical insurance is also available."
* Private healthcare providers are required to publish price lists to encourage comparison shopping.
* The government pays for "basic healthcare services... subject to tight expenditure control." Bottom line: The government pays 80% of "basic public healthcare services."
* Government plays a big role with contagious disease, and adds some paternalism on top: "Preventing diseases such as HIV/AIDS, malaria, and tobacco-related illnesses by ensuring good health conditions takes a high priority."
* The government provides optional low-cost catatrophic health insurance, plus a safety net "subject to stringent means-testing."
Its hard to generalize with Singapore. They are, in general, very disciplined and orderly people. Remember they have extreme punishments for even mundane crimes with canings for vandalism and death for drug-possession.
They are also highly educated and can be expected to act rationally: i.e. their rate of obesity is far below the US’s.
HSA are a good idea in that they provide during extreme health crisis that can bankrupt families while aligning incentives to contain costs in the healthcare market. But people are irrational and the liberals have spread a culture of victimization. Pretty soon, we will have a case that prosecutes food companies for causing people to be fat and the floodgates will open once again to expanding the culture of victimhood.
Its hard to generalize with Singapore. They are, in general, very disciplined and orderly people. Remember they have extreme punishments for even mundane crimes with canings for vandalism and death for drug-possession.
They are also highly educated and can be expected to act rationally: i.e. their rate of obesity is far below the US’s.
HSA are a good idea in that they provide during extreme health crisis that can bankrupt families while aligning incentives to contain costs in the healthcare market. But people are irrational and the liberals have spread a culture of victimization. Pretty soon, we will have a case that prosecutes food companies for causing people to be fat and the floodgates will open once again to expanding the culture of victimhood.
This is indeed good news. Having the individual participate
in the cost and savings for their health care is
the basics of free market enterprise.
I have an HSA. The experience of managing your costs
will, if nothing else, make you aware of the benefit of living a healthier life style.
Come on now, americans are more disciplined than you give them credit for.
Keep in mind, they also had the comparison in there for Europe.
Yeah. My main attraction to HSAs would be if everybody had them, that would make capitalism work and costs across the board would come down.
Well you do understand, you have totally flubbed what the Democrats see government run health-care for. They have in mind more like the Cuban model, than a real effective model in mind -— Hoards of people lined up, waiting for their free pie, that never comes.
it won’t work because it’s not “progressive” or “hope filled” and because HSA are counter to what socialists believe like bobble headed Barack.
That’s why I’m trying to fight all of this. Our best weapon is information. THe more that gets disseminated, the better.
We need to undermine this media.
That’s the Cuban health care system in action. Delivering quality care for all.
good luck...trying to get this out which has been around since the early 90’s is like trying to surf the North Shore on glued together Styrofoam plates. We have a media that is hell bent on pushing anything democrat and anti free market/choice unless it’s about abortion.
Singapore has no parasite class, here in the USA we have two: the uneducated illegal immigrants, and the ghetto underclass.
” Singapore has no parasite class, here in the USA we have two: the uneducated illegal immigrants, and the ghetto underclass. “
You forgot the largest, most harmful, parasite class here in the ol’ USA — that one comprised of politicians, ‘journalists’ and the punditry, academics, union leaders, and ‘activitists’ and ‘community organizers’ of all stripes....
Come on now, americans are more disciplined than you give them credit for. ..... Halfmanhalfamazing
Well, we know one thing. There is at least one poster on this thread that has never spent a single hour in medical training in an American inner city hospital.
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We’ve done a good job so far at undermining them.
All it requires is forum postings, emails, flapping your gums, and persistence.
I’d bet most of us haven’t had training in such a hospital.
But I doubt that the inner cities are totally representative of america.
Besides, all of that misses the point of the thread. So many of our current policies encourage irresponsibility. HSAs are just the opposite.
Singapore comparisons: another problem trying to copy countries like Singapore is that they have much more homogeneous populations. The U.S. has a much more diverse population. Diverse populations tend to game the system.
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