Why Not The Best?

Recently one of the architects of the Affordable Care Act (ACA), Ezekiel Emanuel, wrote a Wall Street Journal OP-Ed. In the article, he concedes the ACA has mostly been an expansion of Medicaid.This is a program paying providers so poorly many refuse or severely limit service. In light of this, Emanuel now acknowledges the ACA isn’t working and needs replacement. His recommendation is we look to the health plans of Germany or the Netherlands. He chooses these two, “where citizens choose among competing private health insurers called “sickness funds,” are closest to the U.S. system.”

Why would we want something close to what we have? Our present healthcare system is a costly mess. Just 11 days earlier, George P. Shultz and Vidar Jorgensen had an article on the same Op-Ed page. It pointed to Singapore as providing top-notch healthcare at a low price. By most measures, Singapore is at the top national healthcare heap. Why ignore this success? Why promote the lower performing German and Dutch systems? Maybe Emanuel only writes for the WSJ Op-ed page rather than reading it.

With the possibility of the ACA being declared unconstitutional, real discussion healthcare has to take place. Even if a decision is delayed, it will be a significant topic in the upcoming election. It’s no embarrassment to look to other nations to find what might work better. According to Shultz and Jorgensen, Singapore is the place to start. Some may say Singapore is too small to compare. Yet, many people keep throwing up comparisons to the Scandinavian nations. Only Sweden has a larger population. Singapore also measures up favorably on a per capita wealth basis.

Shultz and Jorgensen mention Scripps College economist Sean Flynn as a statistical source on Singapore. Strangely, this name came up in Steve Forbes’ fact and comment in his magazine’s June/July issue. Forbes lauded Flynn’s book “The Cure That Works.” I found it on Amazon and immediately downloaded the Kindle version.

What I received was a clear and easy to read look at arguably the world’s best healthcare system. The author frames this with an understanding of how we got to our present healthcare system. What’s peculiar is this remarkable book was published over a year ago. Still, Forbes and I are only talking about it now. Regardless of flying under the radar, it is an essential contribution to our healthcare discussion.

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