When medicine is dispensed by the state, the state gets to decide what medicine is given out. The state is then able to use that power to influence citizens' behavior.
As someone who has lived in an NHS system all her life, I can tell you that it doesn't have to be that way.
If it were, you'd think that the Dutch state would've made sure that the HMOs were forced to cover part of their clients' fees for fitness/sports club memberships, but they haven't. Nor are they saying "medicine X for disease Y gets covered, but medicine Z for the same disease doesn't". They leave the prescription of specific drugs up to the physicians and it's up to the HMOs to convince pharmacies to give out the generic/cheapest version of the drugs the physician prescribes, so the HMO can make a bit of money. I, as a client, sill get everything covered according to the basic package and any additional coverage I might have. Of course, getting drugs approved by the Dutch FDA is a whole different ballgame.
In Holland, things work like this: The government decides what should be in the basic healthcare package. This typically includes all life-saving surgeries, therapies and medications, but also a basic number of physio sessions and other basic therapies people might need to recover from common diseases etc. All HMOs have to cover all their clients for this basic package. Individual clients can choose to get additional coverage (more physio, full coverage for any kind of scrip and therapy, additional dental), which differs from HMO to HMO. So basically, you pick the HMO which offers the best additional coverage for you, if you decide you need it. But everyone gets basic coverage, which means no one can go bankrupt or get in thousand of euros of debt after they've been in a life-threatening accident that takes a year or so and multiple surgeries to recover from and they have to pay the bills for. Which I personally think is a good thing.
Besides, aren't the HMOs in the US deciding who does and who doesn't get treatment and what kind of treatment they might get right now? Somehow I'd rather have a more-or-less independent Surgeon General decide what medications and treatments get on the HMOs "must cover" list than some corporate business! At least the Surgeon General might care about my health a little bit, whereas the corporate business most certainly will only care about how to make as much money off of me as possible.
Just something to think about. And yes, I'd be very worried about the HMOs trying to keep their power over the system, but there's quite a few countries around the world where an NHS mostly works quite well and none where it doesn't work. Of course it's never flawless, but that's that 5% that's =always= part of the statistics.
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Date: 2008-01-28 07:36 am (UTC)As someone who has lived in an NHS system all her life, I can tell you that it doesn't have to be that way.
If it were, you'd think that the Dutch state would've made sure that the HMOs were forced to cover part of their clients' fees for fitness/sports club memberships, but they haven't. Nor are they saying "medicine X for disease Y gets covered, but medicine Z for the same disease doesn't".
They leave the prescription of specific drugs up to the physicians and it's up to the HMOs to convince pharmacies to give out the generic/cheapest version of the drugs the physician prescribes, so the HMO can make a bit of money.
I, as a client, sill get everything covered according to the basic package and any additional coverage I might have.
Of course, getting drugs approved by the Dutch FDA is a whole different ballgame.
In Holland, things work like this:
The government decides what should be in the basic healthcare package. This typically includes all life-saving surgeries, therapies and medications, but also a basic number of physio sessions and other basic therapies people might need to recover from common diseases etc.
All HMOs have to cover all their clients for this basic package.
Individual clients can choose to get additional coverage (more physio, full coverage for any kind of scrip and therapy, additional dental), which differs from HMO to HMO.
So basically, you pick the HMO which offers the best additional coverage for you, if you decide you need it. But everyone gets basic coverage, which means no one can go bankrupt or get in thousand of euros of debt after they've been in a life-threatening accident that takes a year or so and multiple surgeries to recover from and they have to pay the bills for.
Which I personally think is a good thing.
Besides, aren't the HMOs in the US deciding who does and who doesn't get treatment and what kind of treatment they might get right now?
Somehow I'd rather have a more-or-less independent Surgeon General decide what medications and treatments get on the HMOs "must cover" list than some corporate business!
At least the Surgeon General might care about my health a little bit, whereas the corporate business most certainly will only care about how to make as much money off of me as possible.
Just something to think about.
And yes, I'd be very worried about the HMOs trying to keep their power over the system, but there's quite a few countries around the world where an NHS mostly works quite well and none where it doesn't work. Of course it's never flawless, but that's that 5% that's =always= part of the statistics.