I will toss out two examples of socialized medicine: Medicare and military hospital system.
We do not have a health care system that is without flaws, and when I read about other countries, it is obvious that no country has a flawless system.
The military hospital system is large and complex. Civilian hospitals have a mission of meeting needs of the population in its area, and it adjusts and sizes itself to meet those needs. So an area may have a fairly consistent capacity of beds which are always almost full. The military has two broad missions, readiness and care of beneficiaries (family and retirees) The readiness mission is closer to sports medicine with its mostly young and physically fit patient population. The brodaer mission of providing care to benificiaries is closer to civilian health care, with a full range of specialties needed.
The military hospitals have a disproportionate number of military personnel providing care, in times of war we set up hospitals in distant theaters. And certain specialties are in high demand, such as anasthesiologists, emergency and trauma care. But not pediatricians.
The military system uses an established and effective outpatient system of clinics. (I am not familiar enough with the beneficiary system). Its hospitals use different system of quality and efficiency standards, it is not formed around payment for procedure, instead relying on patient outcomes. And by those measures, it performs similar to civilian hospitals. The numbers of excellent military hospitals parallels the numbers of excellent civilian hospitals, (and similar for the less than excellent hospitals). Cost accounting is difficult, the military missions demand certain costs be built into the system, the military aircraft used to transport patients often have some combat role and so have more expensive hardware built into the system (which is why the military uses civilian rates, not real costs. Civilians planes don't have the expensive gizmos war planes need).
Some call for an outright scrapping the separate system and incorporating it into the civilian health care system, others call for strengthening the system to handle all its missions in house by Department of defense. But most call for a slow incorporation, Tricare is a military insurance plan, and it operates, for some, just like any other insurance plan.
On Medicare: Medicare shapes health care, its accounting, its rules, its procedures etc., since it plays such a large role in health care. Medicare sets a rule, and the hospital system accommodates it, and even private insurance follows suit. But is it the politicians who make the myriads of rules? No, it is a complex system of public administrators and medical people.
Is Medicare the cause for the weaknesses in the system? I don't think so, the weaknesses are often tied to demographic and economic forces, which is why rural hospitals have higher reimbursement rates to keep the hospitals from disappearing entirely from rural areas.
We do not have a health care system that is without flaws, and when I read about other countries, it is obvious that no country has a flawless system.
The military hospital system is large and complex. Civilian hospitals have a mission of meeting needs of the population in its area, and it adjusts and sizes itself to meet those needs. So an area may have a fairly consistent capacity of beds which are always almost full. The military has two broad missions, readiness and care of beneficiaries (family and retirees) The readiness mission is closer to sports medicine with its mostly young and physically fit patient population. The brodaer mission of providing care to benificiaries is closer to civilian health care, with a full range of specialties needed.
The military hospitals have a disproportionate number of military personnel providing care, in times of war we set up hospitals in distant theaters. And certain specialties are in high demand, such as anasthesiologists, emergency and trauma care. But not pediatricians.
The military system uses an established and effective outpatient system of clinics. (I am not familiar enough with the beneficiary system). Its hospitals use different system of quality and efficiency standards, it is not formed around payment for procedure, instead relying on patient outcomes. And by those measures, it performs similar to civilian hospitals. The numbers of excellent military hospitals parallels the numbers of excellent civilian hospitals, (and similar for the less than excellent hospitals). Cost accounting is difficult, the military missions demand certain costs be built into the system, the military aircraft used to transport patients often have some combat role and so have more expensive hardware built into the system (which is why the military uses civilian rates, not real costs. Civilians planes don't have the expensive gizmos war planes need).
Some call for an outright scrapping the separate system and incorporating it into the civilian health care system, others call for strengthening the system to handle all its missions in house by Department of defense. But most call for a slow incorporation, Tricare is a military insurance plan, and it operates, for some, just like any other insurance plan.
On Medicare: Medicare shapes health care, its accounting, its rules, its procedures etc., since it plays such a large role in health care. Medicare sets a rule, and the hospital system accommodates it, and even private insurance follows suit. But is it the politicians who make the myriads of rules? No, it is a complex system of public administrators and medical people.
Is Medicare the cause for the weaknesses in the system? I don't think so, the weaknesses are often tied to demographic and economic forces, which is why rural hospitals have higher reimbursement rates to keep the hospitals from disappearing entirely from rural areas.
Comment