17 August 2009

Single Provider v Single Payer v Universal Coverage

Krugman notes the distinction between:

(1) a single provider system like Britain or the U.S. Veteran's Administration where "the government itself runs the hospitals and employs the doctors,"

(2) a single payer system like Canada, France or Medicare where "the actual delivery of health care in private hands, but the government pays most of the bills," and

(3) a universal health insurance system like the Swiss, Massachusetts, or the proposed Obama health care reform plan which "relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help."

He doesn't mention the Dutch, but their system is similar to Switzerland.

All three approaches work better than our system in the United States as a whole.

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