April 14, 2010
How the Rest of the World Provides Health Care Health Care. (It’s Not All Socialized Medicine)
T. R. Reid
Author of The Healing of America
Minutes of the 28th Meeting of the 68th Year
The 28th meeting of the 68th year was called to order at 10: 15 by President George Hansen who then led the invocation. Minutes of the April 7 meeting were read by Glenn Cullen.
Visitors were introduced:
Cyril Franks introduced Roland Miller,
Clair Jacobus introduced Nancy Beck,
Charles Ufford introduced Anton Lahnston,
Landon Jones introduced Sarah Jones.
Motions to change the by-laws regarding transition to emeritus status to occur at age 85 rather than 86 and to call for the start of the Fall sessions to be mid September in accord with current practice. These changes will be debated and voted on at the meeting of April 21, 2010.
Landon Jones introduced the speaker of the day, T. R. Reid, journalist. Mr. Reid's topic was "How the Rest of the World Provides Health Care (It's not all Socialized Medicine)." Mr. Reid grew up in Michigan and was a member of the Princeton class of 1966. He began his journalistic career writing for the Daily Princetonian. Later he served as Washington Post Bureau Chief in London and Tokyo. He travelled extensively in developed countries around the world and has had first hand experience with health care systems in a number of countries both through the experiences of family members and personally thanks to an injured shoulder. Mr. Reid is a commentator for National Public Radio and is a weekly section editor for the New York Times. He has authored a number of books, the most recent being The Healing of America, a Global Quest for Better, Cheaper and Fairer Health Care.
Mr. Reid began by recounting his first foreign health care experience in London in 1998 when he and his family had just arrived to take up duties as bureau chief. He found the service in the emergency room of an NHS hospital to be speedy, efficient, caring, and most surprisingly free. This led to his interest in the variety of health care systems in various parts of the developing and developed world. Professor Uve Rheinhardt identifies 16 variants in health care around the world. Mr. Reid reduces this for simplicity to four broad classes. The first group he has christened the Beveridge Model after Lord Beveridge of the UK, the author of a social service plan commissioned by Winston Churchill at the end of WW-II.This is essentially the "socialized medicine model followed in Britain, Italy, and Scandinavia. Care is free; the state is the health care provider.
A contrast to the Beveridge model is the Bismark Model followed in Germany, Switzerland, Japan, and France. This was established in Germany in 1883. All people are required to buy insurance with the premium split between the insured and the employer. Insurance companies, physicians, hospitals, and Laboratories are private but heavily regulated.
The third model is the National Health Model, first introduced in Saskatchewan in the 1940s and soon generally adopted by Canada nationwide. This system is now known as "Medicare". Similar plans are followed in South Korea, Taiwan, and Australia. All individuals pay a premium (not a tax); the providers are private and there is a single payer - the government. Resources allocated to specific specialties are restricted and elective treatments are often delayed.
Finally there is the Out-of-pocket Model practiced in a wide variety of modes in the rest of the world. Often this produces government provided health care of some sort in cities and essentially none in rural areas.
Curiously, in the US virtually all models are in use to some extent
Respectfully submitted,
Charles A Gray
Visitors were introduced:
Cyril Franks introduced Roland Miller,
Clair Jacobus introduced Nancy Beck,
Charles Ufford introduced Anton Lahnston,
Landon Jones introduced Sarah Jones.
Motions to change the by-laws regarding transition to emeritus status to occur at age 85 rather than 86 and to call for the start of the Fall sessions to be mid September in accord with current practice. These changes will be debated and voted on at the meeting of April 21, 2010.
Landon Jones introduced the speaker of the day, T. R. Reid, journalist. Mr. Reid's topic was "How the Rest of the World Provides Health Care (It's not all Socialized Medicine)." Mr. Reid grew up in Michigan and was a member of the Princeton class of 1966. He began his journalistic career writing for the Daily Princetonian. Later he served as Washington Post Bureau Chief in London and Tokyo. He travelled extensively in developed countries around the world and has had first hand experience with health care systems in a number of countries both through the experiences of family members and personally thanks to an injured shoulder. Mr. Reid is a commentator for National Public Radio and is a weekly section editor for the New York Times. He has authored a number of books, the most recent being The Healing of America, a Global Quest for Better, Cheaper and Fairer Health Care.
Mr. Reid began by recounting his first foreign health care experience in London in 1998 when he and his family had just arrived to take up duties as bureau chief. He found the service in the emergency room of an NHS hospital to be speedy, efficient, caring, and most surprisingly free. This led to his interest in the variety of health care systems in various parts of the developing and developed world. Professor Uve Rheinhardt identifies 16 variants in health care around the world. Mr. Reid reduces this for simplicity to four broad classes. The first group he has christened the Beveridge Model after Lord Beveridge of the UK, the author of a social service plan commissioned by Winston Churchill at the end of WW-II.This is essentially the "socialized medicine model followed in Britain, Italy, and Scandinavia. Care is free; the state is the health care provider.
A contrast to the Beveridge model is the Bismark Model followed in Germany, Switzerland, Japan, and France. This was established in Germany in 1883. All people are required to buy insurance with the premium split between the insured and the employer. Insurance companies, physicians, hospitals, and Laboratories are private but heavily regulated.
The third model is the National Health Model, first introduced in Saskatchewan in the 1940s and soon generally adopted by Canada nationwide. This system is now known as "Medicare". Similar plans are followed in South Korea, Taiwan, and Australia. All individuals pay a premium (not a tax); the providers are private and there is a single payer - the government. Resources allocated to specific specialties are restricted and elective treatments are often delayed.
Finally there is the Out-of-pocket Model practiced in a wide variety of modes in the rest of the world. Often this produces government provided health care of some sort in cities and essentially none in rural areas.
Curiously, in the US virtually all models are in use to some extent
- The VA and Native American Health System uses the Beveridge Model;
- Medicare and Medicaid are the National Health Model;
- Employed Persons and their Families are generally the Bismark Model;
- The poor, without insurance, follow the Out-of-pocket Model
Respectfully submitted,
Charles A Gray