Saturday, February 15, 2020

Socialism (6) Effective Medical System

New Zealand has a socialist health care system. Most health care is funded by the government, ie it is a single-payer system. District Health Boards receive grants from the government and are required to provide health care for the people living in their district. The government specifies the quality and quantity of the service that they must provide.

People are free to have medical insurance if they choose. Medical insurance is mostly taken out by people who are quite well off. The benefit is that they can get elective surgery, for knee and hip replacements quicker. However, most acute surgery is provided by the public system. Treatment of chronic sickness cancer is mostly provided by the public system, even for people with medical insurance. The difference is that people with medical insurance can sometimes get new extremely expensive cancer drugs that are not yet available through the public system.

A government entity called Pharmac purchases all prescription drugs and medicines. The big pharmaceutical companies hate it, but being the single buyer for the entire nations enables it to get better purchase prices by pitting them against each other. This limits brand choice a little, but the lower costs mostly outweigh this disadvantage.

My impression is that the NZ healthcare systems functions much better than the United States insurance-based system, yet it costs much less. New Zealand spends about 10 percent of GDP on health care, whereas the United States spends nearly 20 percent (of a much larger GDP). We don’t have people going bankrupt because their medical insurance has introduced unexpected charges. We do not have people who cannot get treatment, because the insurance has failed. Life expectancy is increasing and infant morbidity is declining, unlike the Unites States where the opposite is happening.

The US health care is not free market. It is an uneasy collusion between big insurance, big pharma, big health care providers and the government. This is corporatism, and it does not serve people well.

People who say that socialist health care does now work do not know what they are talking back. Socialist health care does not always work, if the government undermines it by providing insufficient funds, as has happened with the UK system or if the managers of the system are foolish or corrupt, but that happens in insurance-based systems too.

Many American tourists visiting New Zealand who find themselves needing emergency surgery receive it without hesitation. If they are having health insurance, a claim is made on their insurance. Those without health insurance cover still receive surgery. They are given an account when they leave hospital, which they are supposed to pay. Unfortunately, many don’t. Once they leave the country, they just forget about paying for the service they have received. The legal costs for pursuing them are too great, so their debts eventually have to be written off. I find it ironic that people who believe in free markets, who can afford international travel, are quite happy to rip off a system that they think is inferior.

Saying that socialism never works is a bad argument, because there are plenty of situation and examples where it works well. If Christians wish to argue against socialism, they need to do it on moral grounds on pragmatic grounds. Arguments that one system works better than the other will usually fail.

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