health

European healthcare is under the microscope right now. With savage cuts in the wake of the eurozone crisis, will Europeans be forced to abandon cherished public healthcare models? Or are there ways to save universal healthcare in the face of shrinking budgets?

In Greece, new austerity measures now mean that if a person remains unemployed for longer than a year, or if they owe any money to the government (even a parking ticket), they lose their entitlement to state-funded healthcare coverage. With official unemployment figures higher than 22% (and with youth unemployment already above 50%), this means hundreds of thousands of Greeks are being forced to attend free clinics (often run by charities) for basic medical care. Since 2009, the Greek healthcare budget has been slashed by 13 percent, and a new fee of €5 for hospital visits has been introduced.

Spain, meanwhile, has likewise seen falling hospital budgets and rising prescription costs, whilst the country’s Industry Minister, Jose Manuel Soria, recently told Spanish state television that it was “time we end the culture of everything for free.” In Italy, cuts of 8 billion euros are planned for the healthcare system over the next two years. In fact, a recent OECD report found that growth in healthcare spending all across Europe (which had been rising for much of the 2000s) is now grinding to a halt and, in the worst-affected countries, even going into reverse.

Whilst many of the comments you’ve sent us on this topic have called for the “European social model” to be protected, we’ve also had comments arguing that we need to be realistic about what we can afford. Fabian, for example, sent us in the following:

I’m not suggesting that we directly eliminate all these services, but rather that we start a public debate on which services we want the healthcare system to cover and which services should be privately paid for. Fostering and moderating this discussion throughout Europe should be a top priority for European policy makers.

We arranged a Skype video interview with Paola Testori Coggi, Director General for Health and Consumers at the European Commission, and asked her to respond to this comment. Is it time for a debate on what level of public healthcare Europe can really afford?

Ms Testori Coggi was adamant that Europe did not need to abandon its “social model”, but nonetheless argued that greater efficiency was needed:


The social model of Europe, which guarantees access to high-quality healthcare, is a good model and we should not put this in doubt… [but] we need to ensure that public spending is more efficient.

Some of you have sent in comments arguing that advances in health technology might help increase efficiency and drive down costs without reducing the quality of care. However, we’ve also had a couple of comments cautioning against seeing technology as a “magic bullet” to solve all our healthcare problems. Eric, for example, argued that limited resources are better invested in primary health care:

Spend the money and technology on reinforcing access to primary health care (as promised in the Millennium Development Goals anyway) and in the long run, the health care dollars will go a lot further.

But does an emphasis on a technology-driven approach risk privileging that part of the population most able to afford (and most familiar with the use of) new technology? David, another commenter, argued:

Concentrating on that small part of the population with access to medical technology overlooks the real risk in the system that starts in the doctor’s office.

Finally, might a greater emphasis on prevention and healthier living help drive down costs? We had a comment from Enrique arguing that:

We must [increase] the health level of people through better regulation of the agri-food sector to produce food that maintains long-term health, instead of food 80% depleted in vitamins.

What do YOU think? Will austerity force Europeans to abandon existing public healthcare models? Do we need an open debate on the alternatives? Or could steps to improve efficiency in the system help save univeral healthcare? Let us know your thoughts and comments in the form below, and we’ll take them to policy-makers and experts for their reactions.


37 comments Post a commentComment


  1. John Nordstrom

    Would you prefer the American method? Have citizens fend for themselves with sky-high costs for everyone?

    • Tracey Davis

      Gross generalization and largely untrue. System is not perfect and needs to be changed, but this kind of comment is just wrong.

  2. Nicky Foros

    Economics are inextricably tied with the social welfare. Do not forget what happens when the people have a very low economic welfare. We have multiple example during World Wars

  3. Samo Košmrlj

    Yeah we definitely need an open debate, on how to make a major cleaning in the healthcare department. Cut the money that goes straight to pharmaceutic corporations, stop the corruption in the healthcare sector. Give the god damn medicines to people who actually need it, instead of prescribing all sorts of medications to just about everyone who feels a bit dizzy.

  4. Zoétán Jenei

    én nem vagyok ellene a magán biztositoknak de azt munkáltatoi járulékokbol tartsák fen és mellete legyen minimális ellátás állampolgári jogon

  5. Radu Micu

    Austerity means giving up on stupid spendings; healthcare is not among them. Search deeper inside!

  6. Albert Saxén

    John, i feel that is somwhat unfair.
    America has the best medicine around. to offer. Where do ppl around the world go? Johns Hopkins, etc.
    This of course shld not be confounded w health care. It is because of Obamacare that the costs r sky high. Patient privileges r gone, Medicare too, it has 4b (!) in taxes.
    ya, premiums r skyrocketing .
    Nicky, I’m sorry, but , ..has got nothing to do w welfare.

  7. Eusebio Manuel Vestias Pecurto

    A saúde publico está a ser um grave problema dos cidadãos do Eurogrupo e da UE os estados estão a empurrar os serviços públicos para o privado os governos sabém que não podem tirar o seviço publico aos seus cidadãos eles devem criar alternativas que protegem os cidadãos do serviços Todos os humanos tem direito á sua saúde

  8. Albert Saxén

    as i say in my bk, symbolism, socialists need progressive taxation to supplement their
    welfare state and conservatives only need a regressive (slim) tax for
    no welfare at all. They’re both wrong.
    Health – yes, universal but coverage not care. It makes use of
    HMOs, pvt insurance

    best systems are a mix.

  9. Albert Saxén

    I mean we’ve been talking abt the fiscal compact. Well..how about a similar model for healthcare?

  10. MandyandPj Leneghan

    Again, the implication and assertion is that there is only one economic model available, that being the current, basket case globalist monopoly capitalist one. An economic model from past centuries that was put in its place in Europe, by citizen revolution and/or near revolutions. A system that the yanks were stuck with on their own for more than a century, now those godfathers that control their (US) government are (have) brought that anti-human organised crime model back ‘home’ so to speak, to Europe. It is way past time for people to begin, not just to protest but to revolt and once again, start the cry for the re- nationalization of all essential services. And send those pirates/privateers back to where they came from. It would appear that the EU has become nothing more than a tool for this criminal capitalist empire, if that be the case, it is way past time for citizens to demand that their nations leave this EU, as soon as possible. We do NOT need this organized crime/capitalist bs, we managed pretty well before they occupied our territories…pj

  11. MandyandPj Leneghan

    John Norstrom, that is precisely where this so called globally intergrated mafia capitalists system is driving us or attempting to drive us but already, citizens are/were fending for ourselves…collectively. What they are suggesting is far worse, having citizens totally and utterly at the mercy of these mafia corporations, including the pirateer healthcare corps. I would rather pay taxes into a collective healthcare budget than be fleeced out of thousands a year to fund the profits of these pirates. I am finding it difficult to understand why, there isn’t a more effective fightback against this mafia takeover, especially when there are supposed to be socialists group within the EP and many member nations. Have they sold out or what, have they been ‘got at’?. It is way past time for lines to be drawn…pj

  12. Marilina Asero

    Yes, we can afford it to the extent it is well managed. We have just to invest properly, avoid waste and go toward prevention and e-health. No private US model in Europe.

  13. Christos Mouzeviris

    like it or not, that is the plan… all right wing parties in Europe support his idea and they are planning it for our future.. So as long as the EPP, Europe’s largest European right-wing party remains in power, that is what is going to happen…Perhaps next time Europeans can get their arses off that sofa, go and vote and vote responsibly in the next European elections.. Otherwise I do not want to read any complaints about what is going to happen… it is being planned as we speak… I do not support it, but it is on the cards… I would most like to see a reform to our social welfare, that does not support people being idle and get money for nothing, but focus all the funds on our youth, give them initials to leave early their homes, get a job, start a family… not give social welfare for life, just because he is lazy and can not do any work, and spend all his/her money in alcohol and drugs… support the European welfare system, but limit the access to the wasters, give bonuses and more benefits to young Europeans to start a new home, get a job and start a family… support education… and create new jobs….

    • Alexandridis George

      That’s where we have to focus. Welfare can be badly used and thats what is hapening in Greece. People should have the incentive to cut expences wherever possible and participate in decisions concerning their health. If we think that our all migthy state will take care of everything without us lifting a little finger or changing some bad habits we are way too wrong!

  14. MandyandPj Leneghan

    To do that Christos, we have to get out of this integrated global monetary and trading system, that is controlled by the mafia. All that ordinary people need are homes, furnishings, food and a few services. All of which we can build, provide or grow ourselves, This is where the jobs will come from. At the moment, we are forced to trade, which the capitalist like to call free trade, meaning that our people, to aquire a share in this ‘trade’, must compete down to the level of the lowest common denominator, which given our expectations, is impossible. That is why all of our social values and quality of life issues are being downgraded, we are being turned into a continent of peons. And I would not blame the unemployed as you have done, how about those that are syphoning of trillions from the common wealth? This is about ideology, it is that simple. No ordinary citizen, if all the facts were known, could ever support the current system/ideology. That is why, the illusionists, attempt to present, that there are no choices, that there is only one economic model available. Well, by now, even the most apathetic of the dopes should be realizing, that this golbalized mafia system is not working for us but it is working for the elite and ruling classes. We can only all lose under their rules, that is why those rules should be completely and totally discarded and replaced with a peoples system, where the economic system is there to serve the people and not, as it is now, the people being forced to assimilated to suit THEIR, ruling class capitalist system. We have been here before and we beat them then. There needs to be another popular ‘uprising’ if you like and no way rely on this manipulated electoral system to sort it out, what we need is people power that will push those political parties, that claim to be peoples parties back in the right direction. It would be handy, if those already in power, the socialists, the social democrats and other like minded people, would get of their backsides and rally the troops. But I see no evidence of that happening. So in my opinion, the only way to deal with it, is to, first of all, get out of this EU that has become an obstacle, this will allow ordinary people back into the political arena, where it would be far easier to deal with the mafia capitalists at a national and local level. Unless there is a visable change within the EU’s peoples parties, all energy should be on getting out and as soon as possible, in my humble opinion of course…pj

  15. Nikolai Holmov

    Yes of course Europe can save its health care model if it wants to. It can save the Euro, the Eurozone, become a hard power rather than just a soft power, have more or less bureaucracy, have more or less Commissioners, have more or less think tanks etc etc.

    What Europe cannot do and balance the books, is have it all.

    That said, have the EU’s books every been balanced? When were they last audited and signed off by an external auditor?

    There is an enormous amount of graft, corruption, lack of audit trails, overly unnecessary bureaucracy, Brussels and Strasbourg (why both and not just one?), ridiculous amounts of very expensive (in time, or money, or both) entitlements within the Brussels quarter alone (before examining national leaderships), far fetched and never likely to succeed ideas sponsored by EU money, consultation on consultations as to whether there should be consultations, (again time and money or both), needless official visits in a world of high tech communication, money sat in budgets nobody remembers exists and cannot find who holds the keys to that particular budget…..etc, etc, etc!

    What I am saying is there is a tremendous amount of wasted public money both within the EU and its Member States. Add to that the supposed $21 – $32 trillion allowed to go untaxed to havens off-shore because governments will not close loopholes in tax legislation, and all of a sudden the European health model is affordable.

    In the meantime, however, there are pressing issues, such as environmental NGOs winning European Court rulings overturning decisions by the Commission, making Mr Barroso throw his teddy out of the cot because the “authority” of the Commission has been challenged, making him take personal interest and personally launching an appeal.

    Priorities?

  16. Christos Mouzeviris

    And of course, the morons of the EU/IMF and the Greek government chose the worse possible time to implement such harsh measures, not that there are virtually NO jobs in the country and most of the continent…Where must our unemployed go? Migrate all to Canada and Australia? Is that what you want? Get real and some morality please… I wonder how our leaders can sleep in the night, when they know that in Greece, and inevitably Europe is losing 2000 people yearly because of the austerity imposed on the Greeks because of high suicide rates… No morals at all whatsoever left in Europe… I wish for another French revolution and “off with their heads”…. See then if they are going to change their minds…Disgraceful bunch of people…!!!

  17. Christos Mouzeviris

    in most things I agree with you… we have thugs running our economies, and the global economy… but i disagree on the “leave this EU” part… Yes there is a point in that… But from my experience, small countries will not push for any reforms on their own… they are so easy to corrupt by those global “corruptors”…some countries are so small that the whole country’s GDP is less of what those thugs worth or own.. All they have to do is to pour money into their parliament and buy off all of their politicians…As they have done with Greece for example… And Ireland… And many other states… In my opinion it is us the ordinary people and workers of Europe that must unite and support each other…And push for change from within… We have the tools.. We have many citizen’s initiatives we have the European Parliament… Use them and empower them, to throw out the thugs that run our countries for decades now….

  18. Vicente Silva Tavares

    It is a question of comparing the European Health systems with the United States health system. This last one, is the most expensive in the world and do not deliver what the European ones do.

  19. Alexandridis George

    The US system is more expensive because it pays for its costs while our system dreams of a Cuban or Soviet Union heaven where doctors work for their food and research is done by mad loonatic profesors locked by the bureaucrats in a room. So I wonder if the soscial revolution that is on the way will keep all those young scientists that Europe has breed (with cost) within its borders. I do not see that happening, not until we transend in a world where money is irrelevant, and that is not soon I think.

    • catherine benning

      @Alexandridis:

      As you don’t seem to have the gist yet, here is the facts about your money. Money is already worthless. What you are recieving and throughout the Western world, is a fraudulent piece of paper or coin telling you it is worth a certain amount of money. That is untrue.

      The system is bankrupt. What you are already trading with is simply debt. Every Euro you spend is a Euro of more debt. As it is in the UK and in the US. We are living on credit to the people who brought this about deliberately. All of us. Except those who made off with the plunder and lodged it in hidden financial institutions around the world. These people pay no tax. So their money, which is really our money, as they got bailed out by us after creating the crisis from taking our tax fund, lies dormant. There are few jobs because no real investement is being made. And those at the top do not want a solution. It is not in their interests.

      The amount our governments owe, which means we owe, is so huge it could not be paid off in ten of our collective lifetimes, even if we all gave every penny we earn to it.

      And the US sysrtem of health is the biggest fraud in existance. There is no health care in the US. It is akin to pet inusrance, use it once, and the premiums become so high you cannot afford the increase in the following year.

      It does not cover pre-existing conditions or children who are born with illness or deformity or even childbirth. The US has a two tier system where, if you are at deaths door, you will be taken into a State hosital which is of vey low standard. And as an earlier poster wrote, have a bill when you leave even if you are destitute.

      You will not be able to afford medicine or if a diabetic, not able to afford to medicate yourself. It is akin to a third world practice. They dump you in the street from the hospital if you are direlict.

      To help you understand this, I am going to show you.

      First where your money has gone.

      http://www.youtube.com/watch?v=suZb9Z0b05I&feature=related

      Next, how the West is living on debt. Or, credit, right now. This is how they do it.

      http://www.youtube.com/watch?v=iKMmjgi2NIo&feature=related

      How they do it again.

      http://www.youtube.com/watch?v=cNbxK__1Crc

      Have you noticed this coming to your country?

      We have been conned. And the services we worked and paid for are being systematically dismantled, because governments sold out to the World Banks under the guise of, we couldn’t let them go under.

      And here is one on the US health insurance system.

      http://www.youtube.com/watch?v=yEulruTgGiE

  20. John Nordstrom

    It’s important not to confuse the difference between first class medical institutions and actual service people in America receive. While medical colleges in the US are some of the best in the world, the actual amount of healtcare the average American can afford ranks way below the European standard. Legally, hospitals in the US will treat you for emergencies, but you will be stuck with the bill and no amount of bankruptcy litigation will free you from hospital bills. That’s if you don’t have insurance. Insurance companies do not make money by paying for expenses; they make money by denying claims. That’s exactly what they do. As far as Obamacare being the cause for raising costs, the underwriting legislation hasn’t even gone into effect yet.

  21. Peter Schellinck

    If only we would have the courage to align our national systems to an overall European healthcare model based on solidarity and no internal borders. Heath care should be like the Euro, a common right system for all.

  22. Peter Schellinck

    “NO”, Europe can no longer afford its current healthcare cost model as business as usual has killed the business. The time is right and the conditions are in place for a revolution in health care delivery. We all by now see the benefit of moving from a focus on disease care to maintaining health and wellness. Now we have to design a new model with a new role for the health care sector, one that moves beyond saving lives in crisis to improving health while restoring ecosystems and regenerating social and natural capital. The basis could be the pool of best practices existing across the EU today.

    In our modern life style the health care industry is uniquely positioned to model health and wellness in a society in need of alternatives to fast food and sedentary lifestyles. On the other hand the delivery of health care has become very complex and chaotic, costs too much, is energy and water intensive and borders on irrelevancy for many of the health issues of our time.

    Not only are health care organizations now among the largest employers in their communities, they are also frequently among the largest consumers of resources.
    It is proven that cost efficiency and effectiveness is a major issue in virtually all EU hospitals. Costs will drop once they accept to introduce productivity improvement schemes and as more of the tasks currently performed only by doctors will shift to nurses and physicians’ assistants. Cross border compatibility together with lower-cost caregivers and lower-cost venues will make our system more affordable and accessible.

    The current infrastructure is designed to rely on high cost facilities. Hence, lowering costs will require small-bore treatment at a new type of facility. At the same time technology is also profoundly changing. It’s moving from being concentrated at the point of care in the hospital to being in the hands of patients and caregivers. Already technology has been geared toward replacing the dialogue between the physician and the patient, designed to reveal the “truth” about medical conditions that most consumers can barely comprehend.

    Our new EU healthcare model is to be creative and based on low-cost ways to deliver health care for EU citizens with underlying chronic conditions. At the same time develop wellness and prevention services to the healthy population. This care must be convenient for both patients and caregivers, and delivered in a way that promotes individual compliance and responsibility. Hence, providing care in retail malls, schools, urgent care clinics, and at home, rather than in higher cost hospitals represent the beginnings of a transformation of a model applied across all national borders. The new healthcare model and industry can truly be a unique EU internal market.

  23. Carl Bechtold

    “Europe” does not have a health care model. The nations that comprise Europe vary significantly in the models they use. Putting the Swiss system in the same bag with the Greeks is nuts — kind of like bagging everything from Chile to Canada and calling it the “American system.”
    The notion of a “European healthcare system” is probably the invention of the Tea Party and similar political extremists. The creation of this sort of straw man construct provides a mythical construct that can be stereotyped and demonized.
    Yes there is that Euro thing going on — but not all of “Europe” is in that consortium. The UK, with its single-payer healthcare system, for example, is sill running on Pounds, not Euros. Swiss employers do not provide health insurance. Individuals buy their own from private companies, and they pay in Francs, not Euros. Insurance is mandatory, and the poor can qualify for subsidies.
    Still, there is probably one thing we can conclude about “European style healthcare.” As far as I can determine, all of the highly developed countries on the continent provide better outcomes at a lower cost than does the United States.

    • catherine benning

      @Carl Bechtold:

      You do not have to have separate health insurance in the UK. Treatment is free at the point of delivery.

      You can, if you want, buy what is called ‘Private Health Insurance’ which allows you to be treated by the same doctors under the same system, as you do when not having it, except you get an earlier appointment and a room that is single in a hospital, rather than a ward. it does not change the care one iota.

      As a person who has used both, I can tell you in all honesty it gives nothing more than speed and a cup of tea whilst waiting, other than a more civil, on their knees approach. If you have an emergency the health insurance makes no difference, you are taken to a hospital and treated in A&E as any other UK citizen is.

      Read about the UK health business, it is called the National health Service, or, the NHS.. It is currently being sold off to the US insurance companies and pharmacuetical corporations, who will drain it of its life blood. Which is against the entire UK populations desire. People at the tiop in politics and elsewhere will make a fortune in blood money. We were lied to as the electorate by this Tory government who said they would not dismantle our NHS, and the government we have now, beginning under the Blair creature who hid his intentions from us all, is concealing, as they take from us what we believed was cradle to grave paid up health insurance in our taxes. But this is going to lead to far more disruption than they envisage.

      http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx

      Continental Europe does not have this kind of service.

      The greatest problem in the UK is health care tourism and those who come to the UK to get treatement on the NHS and leave once well. Immigration also has brought it into dire straits. Millions having entered under the lunatic open door policy set up again by Blair. Our present goverment likewise is obsessed with giving our tax paid for benefits to foreigners in the millions even though we cannot sustain such influx. And we are seeing where this foolish, childish, irresponsible act has led us.

      Our politicians should all be in jail for treason.

  24. Ozcan

    I can understand that there is a crisis in Europe but why must the ordinary citizen pay for this crap. You can keep punishing the people with austerity measurements but in the end it are the elite, those fine gentlemen that are ruining our society bit by bit. i would say go confiscate their porsches rolexes and their pompeous vila’s before you start to unplug hardworking people from their insuline.

  25. Ozcan

    and we should prevent fortuneseekers from abroad to abuse our welfare system.

  26. Janet Darbey

    The ”European’ model of health care does not exist as all the countries have their own systems and some are working better than others. In Greece where I live the National health system has been breaking down for years now. The greedy doctors still ask patient for brown envelopes of money so they can get treatment faster or better than the others.

    Now the government have raised the price of phone calls to get an appointment with the doctor to over a euro a minute. But the staff do not answer the phones as there are only about 20 appointments available for each 200 applicants. The phone is put on hold so you pay for an hour or more of no reply.

    If you want to call at the clinic in Corfu to get an appointment you have to queue outside the doors at 7am in order to run upstairs and get in another queue with hundreds of people to get one of the 20 appointments. It’s a disgrace as the old people and disabled cannot queue or rush to the front to beat the others.

    The lucky ones can afford to see a doctor privately. There are people here who do not have the medicines they need because of shortages and because the chemists refuse to supply them on credit to the health system book.

    If anyone of the pencil pushers in the EU would like to see our ‘system’ at work I would be happy to take them to see for themselves. It is a shambles!!!!!

  27. Jamshed Poonawalla

    …to whom it may concern:

    Do not worry.

    A European communication platform for the professional associations is missing!

    Many people already starving, have no money to afford the monthly payments, the future is cloudy and there is no communication as to identify possible solutions.

    In order to stabilize Europe and to enable a fair coexisting, it might not be of detriment to set up new information superhighway between politics, the professions and the public, as well as between and within professional organizations in the European partner organizations?

    Thus, we know just who exploits the system self-serving.

    Entry and exit points of ‘power’ – not just money – can be seen more easily when they are standardized.
    There are infinitely more good things to do than to feel sorry for a coalition of non-delegates. What about the people in their professions, and how it looks at their prospects in the growing democratic structures?

    So far, we cannot perceive you in your professions.
    Only the people in their professions can form Europe.

    In close cooperation and handshake with the other chamber professionals! ^^

    How can such a thing – so wonderful and new – be initialfired, understandable for us all, without breaking it?

    I alone as a single decent german Apotheker doing my will not make it …
    lets empower Europe together ;-)

  28. Javier Delgado Rivera

    There is an aspect of this debate that is being consistently overlooked – the importance of maintaining sound public health systems to promote economic growth. It isn’t rocket science. If an increasing number of people have to put aside an extra bit of their income (assuming they have some) for medical treatment, it will further hit the already-fragile consumption indicators that keep our economies stagnated (virtually or as a matter of fact).

    It is also easy to forget that the health sector is an important driver of our economies, generating large numbers of jobs across the EU in what in many Members States account for up to 10 percent of their GDP.

    We also know that early medical care is far cheaper that advanced treatment. Discouraging people to visit their GD (by introducing fees, however small they are) when the first symptoms of what might be a serious condition kick in is not only wrong from a public health care viewpoint – it also guarantees fatter health bills down the road.

    As the European Public Health Alliance (EPHA) puts it, “healthy individuals create, find and keep jobs, as well as being better able to cope with insecurity and stress.“

    http://www.epha.org

    I have the impression that health care is mostly seen as a hurdle in the pursuing of balanced budgets instead of, as a driver of growth, an ally. (not to mentioned well-being and as a fundamental pillar of our social rights).

  29. Mac

    Hi,

    Having thought a lot about all this topic, I am very surprised to read everywhere that we should find a solution to keep the existing system working as is.

    It is a fact that general medical cares are necessary and must be an objective in any developed society – after all, the goal is to increase everybody well being. Aside this, it supports the whole system by giving an stable working market (healthy speaking).

    Europe and US are not very different considering medical expenditures. The difference lies in the nature: Europe uses almost exclusively public funds (i.e. taxes) & debt, while US uses the private sector with insurances. For years we kept spending more and more money in this system, saying that in the end medical cares are expensive, and that’s why we should spend to much. But has anybody ever wondered why it is so expensive? What should be the real price for this? What is the real value of a medical care? After all, it is a profession that you should do not only for money but because you want to help people.

    In Europe, what I can say is that prices are set by the governments, which means they do know how much they pay the doctors for a consultation (despite the fact that most of doctors make black money asking more that what they write on your check). To this, they add what they call “school quotas” leading to shortage of medics (in economy a shortage always leads to an increase of the price). You shall add to the whole a fact which is the power of the medic on you when you are sick – whatever he would ask you.. you would pay if it really pains a lot and there is a way for you to pay that much! From my point of view, these points can only lead to a very high cost of medical cares, which actually are medical people salaries. To get a salary scale, let’s say around 30k€ a month for a starter, so between 26 and 30 years old. I would like to emphasize that the cost of studies in Europe are not very high for most of countries (even almost free for many people – and that doesn’t depend on your marks; just on the parents revenues).

    Therefore, in Europe, the price is set in advance for most of the case. The government will refund you or pay directly the doctor with that amount… so not very different than the american system using insurances. In the end, a normal European citizen pays taxes that will be used to pay medical cares, which is not bad at all. It is very obvious that as everybody will need it but not at the same time, a shared solution can be effective (i.e. social security or private insurance).

    What gets alarming is when you notice the gap between a normal worker (even with a PHD, master’s degree or more than one of each) having an average salary of 45k a YEAR while a doctor (dentist, physiologist, etc.) can have around 30k a MONTH, and even more if working hard (meaning more patient a day, so less quality). In Europe, what is happening now is that around 20% of the GDP is distributed by the government to 1% of the population (medical people even a self employed nurse earns 20k a MONTH). It is not surprising to see that they buy all the houses, most expensive cars, boats and then rent it to young workers. Is it normal? What is normal? How should it be?

    On my side, I would say that the question is not “can we afford the medical cares?” but maybe more “Shouldn’t we limit the price paid for medical cares across Europe and US? What would happen? Can the system really collapse if we decide to reduce the price? ….”. I am not sure about the right answers. Anyway, what is sure is that not all medics will run away… either because of degree’s equivalence problem, language gap, living culture difference or even just getting the working permit necessary. So, why are our governments spending around 30/40% of their budget on this? Why don’t they just reduce the price of 20% and therefore the expenditures? What is controlling this? What is sure is that what is currently done is not liberal as not the market decides, but the law or some private agreements (plus some black money).

    Everybody thinks that finance is responsible for this, but I am not sure. The finance world speaks about risk and value. I think that what is happening now is a crisis of value, nothing else. We pay (paid) too much for certain things which are not bringing the gains we would expect. This lead to an increase in the debt and an increase to the cost of labor indirectly… why lead industries to be less competitive in the world. Indeed, the more you increase the debt, the more you ask taxes. In the end, what suffers is the cost of a worker and the margin that you can have in your company. It is therefore not strange to see that many companies can’t afford profits and that investors are asking higher returns: indeed, the money they put won’t serve the general wellness but to mainly to support the medical scheme & fiscal evasion.

    That was just another way to see things. I hope to get your point of view about that.

    Kr,
    Mac

  30. mac

    Hi,

    Having thought a lot about all this topic, I am very surprised to read everywhere that we should find a solution to keep the existing system working as is.

    It is a fact that general medical cares are necessary and must be an objective in any developed society – after all, the goal is to increase everybody well being. Aside this, it supports the whole system by giving an stable working market (healthy speaking).

    Europe and US are not very different considering medical expenditures. The difference lies in the nature: Europe uses almost exclusively public funds (i.e. taxes) & debt, while US uses the private sector with insurances. For years we kept spending more and more money in this system, saying that in the end medical cares are expensive, and that’s why we should spend to much. But has anybody ever wondered why it is so expensive? What should be the real price for this? What is the real value of a medical care? After all, it is a profession that you should do not only for money but because you want to help people.

    In Europe, what I can say is that prices are set by the governments, which means they do know how much they pay the doctors for a consultation (despite the fact that most of doctors make black money asking more that what they write on your check). To this, they add what they call “school quotas” leading to shortage of medics (in economy a shortage always leads to an increase of the price). You shall add to the whole a fact which is the power of the medic on you when you are sick – whatever he would ask you.. you would pay if it really pains a lot and there is a way for you to pay that much! From my point of view, these points can only lead to a very high cost of medical cares, which actually are medical people salaries. To get a salary scale, let’s say around 30k€ a month for a starter, so between 26 and 30 years old. I would like to emphasize that the cost of studies in Europe are not very high for most of countries (even almost free for many people – and that doesn’t depend on your marks; just on the parents revenues).

    Therefore, in Europe, the price is set in advance for most of the case. The government will refund you or pay directly the doctor with that amount… so not very different than the american system using insurances. In the end, a normal European citizen pays taxes that will be used to pay medical cares, which is not bad at all. It is very obvious that as everybody will need it but not at the same time, a shared solution can be effective (i.e. social security or private insurance).

    What gets alarming is when you notice the gap between a normal worker (even with a PHD, master’s degree or more than one of each) having an average salary of 45k a YEAR while a doctor (dentist, physiologist, etc.) can have around 30k a MONTH, and even more if working hard (meaning more patient a day, so less quality). In Europe, what is happening now is that around 20% of the GDP is distributed by the government to 1% of the population (medical people even a self employed nurse earns 20k a MONTH). It is not surprising to see that they buy all the houses, most expensive cars, boats and then rent it to young workers. Is it normal? What is normal? How should it be?

    On my side, I would say that the question is not “can we afford the medical cares?” but maybe more “Shouldn’t we limit the price paid for medical cares across Europe and US? What would happen? Can the system really collapse if we decide to reduce the price? ….”. I am not sure about the right answers. Anyway, what is sure is that not all medics will run away… either because of degree’s equivalence problem, language gap, living culture difference or even just getting the working permit necessary. So, why are our governments spending around 30/40% of their budget on this? Why don’t they just reduce the price of 20% and therefore the expenditures? What is controlling this? What is sure is that what is currently done is not liberal as not the market decides, but the law or some private agreements (plus some black money).

    Everybody thinks that finance is responsible for this, but I am not sure. The finance world speaks about risk and value. I think that what is happening now is a crisis of value, nothing else. We pay (paid) too much for certain things which are not bringing the gains we would expect. This lead to an increase in the debt and an increase to the cost of labor indirectly… which leads industries to be less competitive in the world. Indeed, the more you increase the debt, the more you ask taxes. In the end, what suffers is the cost of a worker and the margin that you can have in your company. It is therefore not strange to see that many companies can’t afford profits and that investors are asking higher returns: indeed, the money they put won’t serve the general wellness but to mainly to support the medical scheme & fiscal evasion.

    That was just another way to see things. I hope to get your point of view about that.

    Kr,
    Mac

  31. matthew

    The healthcare system benefits are actually only enjoyed by a few. Not everyone goes to the doctor.

    And they are abused, and over used. there needs to be charges for routine things like going to the doctor or the dentist. Buyer should chose his provider and pay.

    But for accidents and emergencies; people should not be turned away because they cant pay. I remember in Singapore being wheeled around to the cashier before going to the hospital bed and operation. That is also not ideal, althouth the expensive service was excellent, and much better and quicker than the state run hospital.

  32. matthew

    The insurance system is not a good idea. Insurance often does not pay, or restricts treatment. Private savings accounts for medical procedures, taken out of payroll would be better. See CPF Fund in Singapore for an example of how this works.

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