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Dedicated to Mikel and Auntie Eva |
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Belgium’s Single Payer System “Preventive health care is primarily financed by the state, while curative health care is primarily financed by the health insurance system.” Although the government covers those who cannot afford healthcare, an estimated 100,000 people are still not covered (Much better than in the US where millions are not covered). The self-employed are not covered for minor risks although they can buy additional insurance for minor risks (There is a complete list of minor vs. major risks). And, pharmaceuticals are at their own expense (ouch!).
It combines multiple government agencies, health insurers, nonprofit organizations as managers – Phew - complex! And it still has holes, namely: · burgeoning budgets, · some caps on services while unnecessary services occur in other instances, · a temporary 1.5% cap on growth of all expenses, · fee-for-service schedules, · and especially, no incentives to improve quality or reduce cots by increasing efficiencies.
So although Belgium’s healthcare system is probably the best system out there now, it’s likely unsustainable over time. As Porter & Teisberg point out, the ‘single payer system eliminates competition.’ So instead of adopting new innovations, the only way to contain costs is by reducing or capping services as seen in Belgium now. For more info, go to: http://www.expatfocus.com/expatriate-belgium-healthcare-medical
New England Journal of Medicine: http://nejm.org National Healthcare Disparities Report: http://www.ahrq.gov/qual/nhdr05/nhdr05.htm
The Book: Redefining Healthcare Creating Value-Based Competition on Results (Michael E. Porter and Elizabeth Olmsted Teisberg http://www.hbs.edu/rhc/
Chapter 58 of the Acts of 2006 An Act providing Access to Affordable, Quality, Accountable Health Care (Mass government’s new law requiring healthcare coverage by all: http://www.mass.gov/legis/laws/seslaw06/sl060058.htm
Then Cerner Corporation bought APACHE in 2001. They’re a major “supplier of healthcare information technology (HIT) solutions” (See their website: http://www.cerner.com/public/).
A nonprofit, the United Network of Organ Sharing (UNOS), has a federal contract to collect unblinded data for all transplants. Reported on the web, “this system contains data regarding every organ donation and transplant event occurring in the U.S. since 1986,” according to UNOS’s website: www.unos.org.
In 1989, the Society of Thoracic Surgeons (STS, www.sts.org) developed risk-adjusted measures for cardiac surgery, “began collecting voluntary adult cardiac surgery data and compiled a national risk-adjusted database.”
STS has been working with the National Quality Forum (NQF) to develop a set of nationally accepted cardiac measurements. You can find more information on NQF’s website: www.qualityforum.org. |
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Single Payer System Pay Doctors Directly Managed Care Patients Rights
Consumer Driven Pay for Performance Health Savings Accounts Pharmaceuticals
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Putting the ‘care’ back in healthcare |
