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Wednesday, November 05, 2003

Health Care, Here and There

An LJ comment in reply to ehintz's recent post:

I have no direct experience w/the NZ system, but I have asked around a bit about it and I know a few non-residents like yourself who have had to use it in a pinch as well. In short, it sounds way more functional than the US system at this point, and I think I actually consider it a point in favor of moving to NZ for myself rather than a point against as I would have initially thought.

But if I step back and look at the big picture, the real question is not why is NZ's system as good as it is, but what the hell happened to the US system?

I have a feeling that if medical certification were up to some number of competing private organizations rather than one government sanctioned monopoly, then there would be more of a competitive balance between quality of health care and cost -- and in particular as this brought the cost of poor health care down, the medical profession would no longer be a place where anyone willing to go through the paces can make lots of money even if they don't give a shit about their patients, and this in turn would mean more people going into medicine out of interest and care and fewer just looking for a promised dollar.

Further, there is the issue of liability, which is very differently handled in New Zealand than here. I don't know about medical liability specifically, but in general it's much harder to sue someone in NZ and I have a feeling suing a doctor there is damn near impossible -- for better or for worse. In the US, I believe a substantial portion of your medical fees goes to lawyers (via malpractice insurance which even the best doctors pay in large amounts).

And then in New Zealand, the body regulating all the medical devices is also the one who is buying them, so they have incentive to be reasonable with themselves, whereas in the US, there is every incentive to over-regulate every object in order to funnel large sums of money to a small number of politically connected manufacturers who then funnel some back to politics. An analogous example of this is that little piece of yarn on the nose of an R-22 helicopter -- you know, the one that indicates yaw? It costs $5 (a few years ago--probably more now). For a 4 inch piece of (FAA certified!) yarn. You can be sure every piece of medical gauze is similarly sanctioned and priced.

This is not capitalism here in the US. I don't know what to call it, but it's nothing like capitalism.

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