Hari: I have no disagreement with rationing. And from a personal point I minimize my visits to doctors or hospitals. Denmark does a superior job in providing health care, in the first instance, it is not dependent on your job hence it is egalitarian to the core. Second, it is free. These two characteristics are enough to make the system acceptable anywhere. In Australia, where I am, the system is similar but I cannot access it because of my visa status. However, I do have reasonable private health insurance at roughly 250 a month (compared to my family's in Seattle, which is outrageous and benefits don't kick in until one has spent several thousand dollars), much less at current exchange rates.
And because I don't get free healthcare I can claim back some money from the government during tax time. But my private insurance is decent enough to cover a part of my dental (in the US it is rare, one needed separate dental), I can access private hospitals (and those who have free health care must have private insurance to opt for private hospitals), etc. There was an attempt to introduce copayments for the locals which was promptly rejected by the public. So all in all Australia still has a decent health care system. However, ambulance service is expensive and everyone is encouraged to have an insurance (about 100 bucks a year), my insurance covers it. Once I have residency I will give up my private insurance and rely on the free public system. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Anthony P. D'Costa, Chair & Professor of Contemporary Indian Studies Australia India Institute and School of Social & Political Sciences University of Melbourne, 147-149 Barry Street, Carlton VIC 3053, AUSTRALIA Ph: +61 3 9035 6161, http://www.aii.unimelb.edu.au/ <https://owa.unimelb.edu.au/owa/redir.aspx?C=KGdpeyp6YEyjUaiENKoAtx8nOn9uStAIlCVtCNE3uLxqkGIwkWdEYjJXILfPlddrM0Q1713syQQ.&URL=http%3a%2f%2fwww.aii.unimelb.edu.au%2f> Podcast: https://theconversation.com/speaking-with-anthony-dcosta-on-the-challenges-facing-indias-economy-43913 ICAS 9 Adelaide: http://www.icas9.com/workshop-SASAA.php *New Book: *After-Development Dynamics (on South Korea) http://ukcatalogue.oup.com/product/9780198729433.do *Forthcoming Book: **http://www.tandf.net/books/details/9780415564953/ <http://www.tandf.net/books/details/9780415564953/>* *New Book Series (Dynamics of Asian Development)* *http://www.springer.com/series/13342 <http://www.springer.com/series/13342>* xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx On Tue, Oct 27, 2015 at 4:51 PM, hari kumar <[email protected]> wrote: > From: "Anthony D'Costa" <[email protected]> >> Hari: >> I meant that I didn't fall seriously ill and hence never tested the >> health care/delivery system. I have no doubt as to their >> technical/medical abilities but the issues have to do with waiting time and >> sometimes organizational snafus. At least this is what I heard from many of >> my Danish colleagues. One evidence of this "shortcoming" is the presence of >> private hospitals to circumvent the waiting times. But it's clear only the >> very rich in Denmark can afford to have this additional health insurance. >> Anthony >> >> Response; > > Hello Anthony: > Thx you for that clarification. I understand now what you were driving at. > > My own take on that for what it is worth - on 'rationing'. > > So waiting times is a common matter that proponents of a private health > scheme system point to (I sincerely do not mean that you are - please do > not take umbrage!). > In reality - all health care systems are subject to forms of > 'rationing'. This would even apply to systems that I would have no > compunction about calling 'socialist' - whether the system pointed to by > Henry Sigerist in the USSR at one stage; or that of Albania that I visited > myself several times. (This is sincerely not meant as a provocation - I do > not wish to waste my time in fruitless conversations - Please accept this > as a potential illustration). > > This might be understood as the process in critical care scenarios of > 'triage' - perhpas made famous by TV soaps, or better by MASH -reserving > urgent care for those who are sickest. This is - by any other name-smell as > sweet - is a form of 'rationing'. > > Capitalist societies - apply a rationing to health care by one of two > mechanisms by and large - as far as I have seen: > i) Reserving care for those who can and will pay. > ii) Triaging less urgent (& Potentially less Evidence Based Care) for some > vs more more immediate care for life-threatening illness. The classic > example is for eg, of hip replacement: You do not die if your aged hip does > not get done in 6-12 months rather than 1 month. But your Health Related > Quality of LIfe... is another matter. > > Both systems are 'rationing'. But in the case of (ii) - what is important > to me, is that the system is more 'fair' (by my standards anyway) and yet > is flexible to people's wishes. I will try to show what i mean here: > > One 'classic' example for me is that of Coronary Artery Bypass Grafts in > Ontario. At one stage there was rationing of this. The evidence was not > exactly crystal clear - by the gold standard of Randomised Controlled > Trials. There was a waiting list. > What ensued was a rush of patient to the USA. Some costs for this was > borne by the Ontario Government. > > By an increasing democratic pressure from below (patient complaints) - the > Ontario Government did a rush evidence based review - and within 6 months > had allocated adequate resources to get up new Operating rooms and newly > appointed cardiology-cardiac surgical staff, nurses for ORs etc. The > waiting list was dramatically cut as was the rush to the USA. > > Now this was in the pre-'Neanderthal'-Harpar era. > One where both scientists and clinicians and patients - did actually have > a voice - albeit in a capitalist state. > > Denmark - maybe different - I somehow doubt it, and suspect that the > waiting list is for s small fraction of the population and may be largely > for non-'urgent' stuff, albeit affecting Health Related QOL. > Notwithstanding Louis recent tirades against Scandinavian social-democracy > - which largely I agree with - the basic conditions of the working class > are superior to that of their peers in the USA. The smae for Canada. > > Thanks again for clarifying. > Hari Kumar > > _______________________________________________ > pen-l mailing list > [email protected] > https://lists.csuchico.edu/mailman/listinfo/pen-l > >
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