October 6, 2009 • 32 mins
In this final installment of their 4-part suite on health care, Josh, Chuck and Molly take a tour of health care systems around the world, from France to Switzerland.
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Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve camera.
It's ready. Are you welcome to stuff you should know
from house Stuff Works dot com? Hey, and welcome to
the podcast. I'm Josh Clark. With me as always this
Charles W. Chuck Bryant sliding into my seat and with
(00:23):
us is Dr Molly Edmonds, m D esquire PhD LLC. Right, Yes,
that get all of those. Molly. Uh. This is uh
the final installment of our four part healthcare reform suite.
We've reached the end of the final countdown. Can I
just say, speaking for Molly and I thank god? Yeah,
you're not speaking for me to Do you think I
(00:44):
like this? Chuck? Are you ready to move on? Yeah? Okay, okay.
So we've talked about healthcare reform. First of all, Molly,
what was that statistic that that you mentioned, um a
long time ago in a in a podcast far far away,
where you said, like only one in a Americans think
that the health care system in the US needs reforming.
(01:05):
Are happy with their healthcare as it is. So. Um,
what we've kind of deconstructed is why healthcare form is
even on the table. We've talked about the uninsured. Right.
We've talked about the fact that UM that America has
UM really really terrible like mortality rates or UM disease rates,
(01:28):
chronic disease rates, that kind of stuff. UM. So that
in and of itself makes the health care system worth fixing. Right.
But one thing that hasn't been brought up, and I
haven't seen it brought up in coverage too much, is
the fact that our health care system is actually keeping
us from competing as well as we could on a
global scale, right, which is why we would compare ourselves
(01:49):
to other health care systems around the world. You know.
The thing is that no one in this country wants
to become like any other system in the world. But
I don't know if you could find anyone who lives
in another country who wants to trade place with an
American that comes to their health care. We'll put We'll
put let's talk about competitiveness and the health care reform
system via Dr Michael Royson, who you guys might remember, right, Yes,
(02:10):
what is he? Dr Roysen is the chief Wellness officer
of the Cleveland Clinic and my hero and the co
author of UM The You the Owner's Manual book series.
Right with Dr Oz here is what he had to say,
because healthcare is a expensive thing in America, and that
(02:32):
we need reform for the economy to function, for jobs
to be created, and for us to be competitive with
Europe and Asia four jobs, and for us to not
worry about a following standard of living, and for people
to not worry, not have the stress of worrying about
will there be health care for me when I need
(02:53):
it that I can afford? Okay, So, if we're going
to keep up with Europe and Asia, like Dr Reason suggested,
we could by reforming our health care system. Um, maybe
we should kind of peek in on what other countries
around the world are doing, whether for better or for worse. Um, Malla,
you wrote this article ten health care systems around the world, right,
(03:13):
which is up on the site. Yeah, it's sort of
I think, a virtual hot air balloon ride through the
world of health care. It was. It was a delightful
one too. It was beautiful, like so many bloody bandages. Um, so,
where was there any particular health care system that struck
you as arguably better than the US or better than
(03:34):
all the other ones? Actually we wait, wait, let's talk
about France. France transition. Oh gotcha get it? Yeah, I do.
Now we mean yes, it's like, okay, France, Uh, they
apparently have the best health care in the world, I
mean World Health Organization. Right. Yeah, it's hard to argue
(03:56):
with who. Moving on then, no, that's actually um, I
think just because it's become a relic in the healthcare
reform debate in the United States that who um two
thousand report of a hundred countries healthcare system rankings is controversial.
I think we should say that. Everybody's like, oh, well
(04:16):
who said that? So okay, it must be true. Um.
But again, you can pick apart anything. But so let's
just stick to the fact that France was rated number
one in the year two thousand by the World Health
Organizations rankings of a countries. Right, right, So all French
citizens will put in money based on their income, you
(04:36):
can't opt out of it, and then in return they'll
get about seventy of their healthcare paid for by the government. Um,
you can get same day appointments, you can choose any
healthcare provider you'd like. Um. But okay, so we said,
s how do they pay for the other thirty percent?
They all have supplemental insurance with either a public or
a private plan, and that is more similar to how
(04:56):
we have in the U S where that supplemental plan
might come mere employer. So there there are a couple
of problems with the French system, and it's not flawless.
There is no flawless plan. We should go ahead and
say that, you lie. Um. I saw one guy that said,
I said it like this. He said, it's sort of
like medicare for everybody with the French system. Yeah, I
(05:17):
got it, and he was he was a pro. So
they make up the other thirty with private plans, right,
private or republic. And that's the problem is if you
have money, then you would probably opt for a private plan.
So some critics would say that the French plan is
too divided by class. People who want really good care
and can pay for it, get it. Those who can
don't write. But they do that in England too. You
(05:38):
can get also get your private insurance, right yeah, and
we should say for a kind of a comprehensive rundown
of England. Molly gave one in the third podcast. Right,
so we're not gonna talk about this, We're okay. I
mean it was a nice step on the balloon ride.
But here's how France got it's awesome writing. Okay, it
spends personal healthcare while that you spins over twice that, UM,
(06:02):
so already they're using money pretty well. And if you
get really sick, like you have just the worst form
of cancer in the world, everything is paid for. Yeah,
that's what I saw that your article. In some other
stuff I read is that if the sicker you are
in France, the better off you've got it, or the
easier and quicker your claims will get paid as well. Exactly.
But it's not just the really sick who benefit. Because UM,
I think what's cool about Frances they have the lowest
(06:24):
rate of deaths that could have been prevented. The US
has the highest number of these preventable deaths that they say,
or you know, if you had had an early diagnosis
or if you'd had an early treatment in condition right,
I did see also in another article I read that UM.
One of the criticisms criticisms is that there's not great
coordination between the GPS and the specialist in France. But
(06:45):
if you're talking about problems, that's not the worst thing
in the world. That's better than being denied for a
pre existing condition. I think, wouldn't you say, I wouldn't say, yeah, Um,
you guys done with France, because I'd like to get
back in the balloon, okay, and just head on over
a few kilometers a few clicks, if you will, to Germany,
(07:11):
which is um out of the out of the healthcare
systems in the in the article, this one's my favorite,
and I'm not embarrassed to say that. One of the
reasons why is because of the ample access to spa
days and even the public health insurance plans, right and
there's two hundred of them, correct, and their employer and
(07:33):
employee funded, right. Yeah. And you know where that comes
from is actually in three old Otto. Von Bismarck was
like the spies. He was like, I want some healthcare
like they had back in the days of guilds. And
so he is basing all of this off the fact
that when you were in your medieval guild for being,
(07:54):
you know, the podcasters guild, the you know clothmaker's guild,
you know with Germany, that was how they named them. Um,
they all pay for each other sick time. They all
got together, and it would be like us saying podcasters,
let's have to pay for Josh's care when he has
a stroke from smoking. I we can't even get podcasters
(08:16):
to unite under this roof. I doubt if we can
get it all around the world. So model, this is
a pretty old system, and um, it's been around for
hundreds of years. But if because they're always willing to
keep reforming it. Yeah, I noticed that in another article
UM from Berlin University. Actually, um, it was kind of
(08:37):
a rundown of the German healthcare system. All these different
years kept coming up, like they try new things like
every year or two. Uh, and it seems like that's
probably what you'd have to do. I think the impression
that a lot of people in America have, whether supporters
or opponents, is that this healthcare reform is going to
happen and that's it. Yeah, And I think you're I
(08:58):
think you make a very bad the point that it
has to keep evolving and changing as problems come up
or as things prove very effective, you know, you put
more money into this or take funding away from that. Right.
Some of their cool new initiatives are these disease management
programs UM, where if the patient gets more counseling from
a doctor, like if a nurse calls them up at
home to make sure they're taking their meds, you know,
(09:20):
sticking with their diet. These people have much um lower
rates of hospital emissions and much lower rates of deaths
from people than people who have the exact same conditions
who aren't getting that counseling. So I think that's a
pretty cool way to approach disease. I don't know, I
could see like half the people in the United States
thinking it's really nice thing to get a call, and
half the people be like, stay out of my business, nurse,
(09:40):
how did you get this number? Right? Well, and you
know it's not like the nurses and the doctors love
the system. I would say that you read a lot
of articles about how the German doctors feel underpaid. To
protests the most often right German doctors says they're paid
about two thirds what American doctors um make, and but
they pay less for malpractice insurance and some of them
go to school for free med school. And you know
(10:02):
one cool factor that I did not manage to squeeze
into this article. But um, those plans, those two in
our plans that we were talking about those plans get
incentives if they get sicker people on their rosters. So
instead of a system like in the US where people
where we tend to deny people, they get benefits for
doing that. In Germany it's pretty cool. Also, saw where
(10:23):
you can in Germany you can go straight to a specialist,
like you don't have to go through your gatekeeper GP,
which's kind of cool. Also, there is a private insurance
market for UM people who make over forty eight thousand
euros a year. It's not compulsory for those people. Actually,
long term health insurance is compulsory for everybody, but basic
(10:43):
health care coverage isn't compulsory for people who make over
forty eight thousand euros a year UM. So there's another
uh I guess accompanying private insurance market, but that's still
regulated by the government. UH. There's like you can't deny
for pre existing condition and UM. And apparently your rates
are assessed when you enter that private system UM based
(11:06):
on your risk. But that's it. There's like a one
time risk assessment and that sticks with you for the
rest of your life. I missed the DEUT. I'm just
gonna go ahead and say that you missed the Deutsche Mark. Yeah,
I missed the deutsch Mark. Miss I missed the frank
I miss this whole euro business. Yeah, but I hate
to change money from country to country, so I thought
it was kind of thrilling. But then you're left with
your leftover coins. Yeah, but then you take them and
(11:28):
you give them to your cousins and nephews and nieces.
I actually haven't been to Europe since the introduce the Euros,
I'd probably love it. Speaking of redistributing money. Oh, I
know we're going next. This is gonna be kind of
a long balloon ride. So it's just fly forward to
when we when we land in Cuba. So Cuba, let's
(11:53):
talk they have healthcare for well, you'd give the skinny
because I have. I just read some articles where they
say it wouldn't so for well, you know the famous example,
I think Cuba. If you're a Michael Moore fans, when
he took people to Cuba so they could get better
care than they could in the United States, and you
know it was meant to embarrass the U s health
care system. There are obviously a lot of critics, as
(12:14):
with anything Michael Moore does, of how it was portrayed
in the movie. And some people say that there is
um sort of one level for the people they're going
to impress and then one level for everyone else, Right,
But I do think that even those people who are
in maybe that lower um echelon get an immense amount
of preventative care. That's pretty pretty cool. Well that's it
(12:34):
sounds like they do, uh do a pretty good job
with preventative care because they kind of have to. Well,
you guys were talking about Germany and doctors or nurses
calling you up to going how you doing. Um, If
you had a problem with that, you probably really have
a problem with Cuba because any any person is subject
to a surprise visit from their physician once a year. Yeah,
they are going to stop at your door, see what
(12:56):
you're doing, What are you eating? They're like, while we're here,
what's under your mattress and what's in your closet? Well, see,
that's sort of the problem is that, you know, because
they have the preventative care, because they may not have
let's say, a fridge or access to really fatty food
or a really great car. Um. So it's almost like
the you know what we would see as the deficiencies
in Cuba have created a culture whereby they walk a lot,
(13:19):
they don't have fast food. I mean it's coming. They
say that that might be sort of the next wave
of obesity, as Cuba is getting some fast food really well.
As a result, Cuba they have I think they spend
two hundred and sixty bucks of person on healthcare a
year A year, Yeah, right, because they're they're really good
with preventative wellness. But I do want to point out,
(13:40):
you know, sometimes I believe you brought it up, Josh,
there's the thought that if we spend a lot less
on healthcare, will really skimp on our innovation. But Cuba
surprisingly is known for its um innovation of medical break facs.
I have heard that they the medical sector is their
sixth largest in exports, obviously not to the US, but
(14:01):
they really got to put themselves on the map with
some vaccines they've come up with first meningitis B and
then hepatitis B and UM. So they're really making a
name for themselves in terms of their pharmaceutical and mechanical
medical equipment exports. Chuck, you reference some articles that you've
read that the Cuban um I think this is one
of the systems where it all depends on who which
(14:21):
side you're reading, because I read a bunch of articles
that said and a lot of these people interviewed Cuban
refugees that were now living in America, and they said
things like there's two health care systems, one for health tourists,
which apparently Michael Moore is a health tourist, and that's
a big deal, kind of camera coup filling yourself around that, right,
you're gonna get treated differently. But there's health tourism is
(14:41):
a big deal there, and you can go and pay cash.
And so there's one system for Communist Party officials and
health tourists and then one for the rest of Cuba,
and they maintain that, you know, if you're the rest
of Cuba, you can't get things like aspirin, you can't
get any biotics unless it's on the black market, and
you don't have access to a lot of like basic
medical care. Uh, you have to bring your own cheets
(15:01):
to the hospital. Stuff like that. Well, I think there's
also a concern that they get these really great statistics
by fudging their numbers a little bit, Like Cuba has
really good rates of mortality. I thought that was interesting.
But in the United States, you know, if if a
baby is born only lives a very short period of time,
we count that, whereas if it was in the same
if it was a lie for the same period of time,
in Cuba, they may count that is dead on arrival. Right,
(15:23):
And didn't you also say that some doctors allegedly will
suggest abortions in the world the government UM suggests they
abort a fetus that could be developmentally disabled or something. Right, Right,
you know, there's just concerned that UM they have great numbers,
but because you know, we don't really know much felt
what goes on inside the country, we don't know exactly
know how to get them right. It was really nice
(15:46):
to visit it. Can it can be hard to separate
your opinions on the Cuban health system from your opinions
just on Cuba the country, right, So I don't want
to oversell Cuba, Okay, but I'm glad I got to
visit the balloon. I don't have any opinions on Cuba
other than what I've heard from a couple of friends
have traveled there and said it was really awesome, the men,
that people were lovely, and the country is beautiful when
politics aside the country itself. The love it's illegal, it's illegal,
(16:08):
actually not true. Um, so you guys, let's head on
over to China. Okay, Well, here we are in China,
and this place is kind of screwed up all. I mean,
I don't know if i'd want to get sick here.
It used to be pretty good from what I understand
in your article that there was cooperative healthcare system right right,
(16:29):
and they dismantled it and that just didn't go very
well because, uh, you know, no one knew were to
send the bill, and the places they were sending the
bill didn't pay up. And what the huge effect of
this was that there's a giant divide between healthcare and
cities and healthcare in the rural areas. Yeah. One of
the I guess ideas for Chinese healthcare reform was that
(16:49):
all farmers pay a dollar for healthcare, and they bought
in a year, and they balked at that as being
too expensive. Are the rural Chinese that poor really well
just not really taken seriously over there. One Well, I
think they're also saying that yes, a dollar was high,
especially for the care they got. I was reading one
article it was in the New York Times about how
you got us in these world clinics and stray dogs
(17:11):
are walking the halls of the clinics. But it's not
worth a dollar a year. Straight dogs in your hospital.
They bring dogs into American hospitals to perk up cancer
patients and nice, healthy ones, not one that looks like
they're going to die. You don't know whether they're straight
or not. You're talking about the uh like they have
different names at every hospital, I guess. But Love on
(17:32):
four Paws, that kind of programs dogs love to not
enough hospitals. Well, okay, so China is in addition to
it's ridding the hospitals of stray dogs initiatives. Um, they're
planning on building seven hundred thousand I guess probably pet
unfriendly clinics in rural areas. I mean, maybe they'll bring
(17:54):
the nice dogs into those clinics. But yes, they are
in the middle of funneling just a ton of money
into their healthcare system and hopes that they cannot eradicate
this divide between ten years or so, ten or eleven years,
but by the population will have health insurance. They're hoping
the billion on it. Yes, e yen you want. I
(18:21):
don't really know how to pronounce anything in China. Want.
That doesn't sound like very much money to me. It
does to build seven thousand clinics. Yeah, and well. The
other problem is Molly points out that um of that
money UH is supposed to come from the central government,
which means provincial governments are gonna have to make up
the rest. And right now, no one knows if they're
going to pay up right, sort of the problem they
(18:42):
had when they first dismantled them. No one wants to
pay for healthcare. That's true everywhere, but you know one
place where they do pay. There we going back to
a bloom. Now, do we have enough game it's run
on unicorn tiers? Excellent? Okay? Do we have enough unicorn
tiers to make it to tai wall on? You think? Oh?
I hope so, because Taiwan's got a pretty nifty system.
(19:04):
I don't think it would work in this country. But dude,
the smart card. The smart card sounds so convenient, although
kind of mirror bracking for someone like me who has
the tendency to lose things. Wait, wait, you guys can
get to Taiwan. Okay, I wanted to do. I wanted
to brief check before we got there. They're chatting along
the way. Let's just all sit silently in a balloons. Alright.
(19:27):
So we're in Taiwan. Now this is lovely. So back
to the smart card before we were exactly Um, okay,
So you get a smart card. It's got your entire
medical history on it, right, and you can just show
up to a doctor and give them your card and
they can pull up your entire medical history. And that
is how they will also build a government. So it's
like your healthcare credit card that you never have to
(19:48):
see the bill for and it's your entire medical history. Now,
of course, I people who say that's a way too
much information for any government to have about a person.
I like the idea of the smart card. I wouldn't
mind all my medical information being on one car because
I'm a little distressed every time I go to the
doctor and I see them pull out a paper file
in the midst of thousands of paper files, it seems
very archaic to me. Well, I've I've moved quite a
(20:09):
bit and I just hate having to kind of start
over every time with every doctor. And what do you do.
I actually haven't changed doctor as much. You get them
to send everything to your new doctor. I think you're
supposed to. Really, maybe I shouldn't reveal how poorly I
manage my health switchovers. So I am a health writer.
The smart card sounds word well, yeah, medical medical billing,
medical information. It's a huge, huge problem in the US,
(20:31):
just an administrative costs and time. Yeah. And that's the
thing that was cool about what Taiwan did is that
in expanding coverage to cover so much more the population,
that they cut all those costs because now they have
no administrative costs essentially. But the fact matters is that
now Taiwan doesn't spend enough on healthcare to cover their costs,
and the Taiwanese have gotten used to these really low
(20:51):
healthcare costs, and people of our frager RaSE the taxes
the age old story. Yeah, saw, we're a family and
average family premium it's six d and fifty dollars a
year in Taiwan. So I can't even think about car
insurance for that. So are we done with Taiwan? Is
that smart card? This place is really clean, by the way,
have you noticed the food is good? Yeah, let's go
(21:13):
to Russia. Okay, guys, thank you again for nuts speaking
during the balloon ride. So we're in Russia now, and
unfortunately this is not a good place to get six.
So no one drink the water here. Okay, okay, right,
but you can't drink the water in Russia. No, okay? Really, wow,
I didn't know that. You think they would have had
that worked out? So they not in a place that
(21:36):
has one of the four worst healthcare systems in the world. Right,
is there another one we may have heard of that's
in that list? According to Foreign Policy, the United States
also makes that list. It was a foreign policy article,
so it's it's not stellar. The World Health Organization that
we mentioned earlier ranks them out, so, you know, and
(21:56):
they've got a fair bit of money. It seems like
they should be doing doing a little bit better. And
this is another system sort of like China, where they
dismantled their old Soviet system which was pretty well admired
around the world, and tried to create a public private
combo system. And basically this system works well in theory
but sucks in practice. Financially, it doesn't work out, right,
(22:17):
I don't even think of I mean financially personally you
got to show up with a pretty hefty bribe to
see a doctor in Russia. Yeah, I thought that was
really interesting that the on paper or you know, um spoken,
it's um the populations covered, but the government doesn't really
pay up and so to keep operating hospitals and doctors go, um, yeah,
(22:42):
I need you to give me a donation, buddy, or
else I'm not going to you. It's extortion for healthcare,
which is nuts. Can we just be careful because I
don't want Vladimir Putin to listen to this podcast listen
to the word extortion, So let's make stop your brief.
I think. I think what's good to know is that
(23:03):
the World Health Organization, Love It or Leave It, recommends
the countries spend about five percent of their total spending
on healthcare, and Russia spends three. Okay, I don't want
to alarm anybody. Some guys just pointed at us and
are starting to come over, So we should probably get
back to our balloon. Okay, a pretty happy place. Canada. Okay, yeah,
(23:26):
we had a lot of Canadians right in, So what
about us? We have a lot of Canadian fans, and
so we're gonna we're gonna talk about you all now
up there in the Great White North. Okay, I'm gonna
let that one slide. Uh. We're here in Canada now. Um,
thank you Molly for not speaking during the journey. I
couldn't be quilled any longer. I was writing a personals
ad for AMOUNTEE, So let's see if we can find
(23:49):
you one here. But first, let's talk about the healthcare
system in Canada. This is the one that the US
is often compared to. If we're if we go to
socialized men or something this this Canada. I always feel
bad for him because they serve as like some sort
of cautionary tale for what we don't want. But from
what I hear that it's not nearly as bad as
(24:09):
as we've been told by some quar right, people are
trying to treat Canada like the worst case scenario, and
I think that, um, this is due to a lot
of commercials and from what I can understand, I mean,
I haven't talked to these people myself, but it seems
like people are very good about going and finding the
people who did have just staggering long wait times and
put them in the commercial. Right. I have some Canadian
(24:32):
friends who I keep up with on the blog and
they've they've written me before and said, you know, it's
not perfect over here. Wait times aren't nearly as bad
as you're depicted, though, and we'll take it any day.
And I think wait times were really bad back in
the eighties and early nineties, and then in the nineties
Canada invested billions of dollars to improve the statistics. And
so now if you want to head over to a clinic,
(24:52):
before you go over, you type in which clinic you
want and they will tell you what the weight time is.
So I mean that's sort of transparency. I think it's
pretty hard to find in this country. And then the
wait times aren't it's it's not for like basic care
right and usually for like special elective surgeries and the
right the weights are longest for you know, like knee
replacements sort of elective things. And I think that one
of the ways that Canada does keep their costs low
(25:14):
and comparison to the United States is they don't buy
every single new fangled machine that comes out. In the
United States, we have a tendency to buy every single
cool gadget, and that's and that really can make our
health care systems seem like it's working really well. It
really does provide us a great level of care. But
it doesn't mean that the old machines were necessarily in
bad shape. Right, But there appears to be something of
(25:37):
an equally American sentiment among Canadians that they do like
they're pretty machines like an m R I and new
r m R I. Because there you mentioned in the
article there's a I guess, a subculture of rogue doctors
who offer UM unlicensed illegal medicine for people who don't
(25:57):
want to wait and can pay up. I assume, right, right, mean,
I think that that's sort of the message you can
take from any of these systems is the people who
have money will use it. UM. We should also say
that if you're going to compare country with socialized medicine
to what the US, what the fear of what the
US might become, you shouldn't you shouldn't point to Canada.
(26:18):
You'd be much better off pointing to Britain, because while
Canada does have a single payer government system of healthcare UM,
the hospitals and doctors are private entities, their private enterprises.
Right in Britain, they run the hospitals and pay their doctors.
But in Canada it's just single payer. And let's talk
about that means, because single payer seems like such a
dirty word to people. UM. Here's how Canada pays for
(26:41):
their health insurance. The citizens fund you know, their their
healthcare by paying income taxes and sales taxes and then UM,
all that money is sort of funneled through to the
provinces and the territory. So it's not even like Canada
as an entity is pushing out the money. Gotcha you
clear on that, Josh, I am. Do you want a
(27:02):
fun fact? Yeah? Please? Did you know that open heart
surgery cost less in Toronto than it does in Chicago? Really? Yes,
that's crazy. Also, prescription drugs tend to cost a lot
less in Canada, UM, from what I understand from Roison
during that phone interview, because UM Canada promotes far more
competition among UM pharmaceutical companies. The same pharmaceutical companies that
(27:26):
might be based in the US are doing business here
in the US or bass why their costs are lower
for pharmaceuticals. And also doctors and nurses make a fair
bit less. So I don't know if I don't know
if doctors want to go to Canadian system. Okay, kids,
one last stop on our whistle stop tour, taking a
good one. I feel like doing some skiing. Um, let's
(27:46):
go to Switzerland, a little good chessolate. Okay, here we
are in our last stop. It's beautiful. You see the
red crosses everywhere in the Alps and the nice smiling
rib apple cheep face. I'm going to stay neutral and
not give you an opinion on this. That's their Their
health care system is really expensive, really really expensive. And
(28:09):
yet um, Americans who are looking for alternatives abroad, seemed
to love it. Both Democrats are Republicans because it's a
pretty good system. But it's just expensive. Right. Well, you
know they have free choice, but they pay for that,
they do. What do you mean by that? Well, I
will tell you you know how everyone here is all
freaked out about public health option. Um, it's all private
(28:31):
plans in Switzerland. It's not tied to your employment at all.
You just can go into a marketplace, let's say, for
lack of better word, pick your private plan and um,
you know, making fancily want and it can cost a lot.
You can just seven fifty dollars per family per month.
Not Yeah, so pretty steep. So generally Republicans like the
(28:54):
choice you can have a private plan, and Democrats like
the fact that even though that's expensive, everyone's covered because
those who can't afford it receives sus tous from the government.
But I don't know if you want to go from
being a first expensive most expensive healthcare sites from the
world's second most expensive healthcare in the world. One of
the things I found significant in your article about Switzerland
(29:15):
was that, um, your healthcare providers aren't allowed to make
a profit off of basic healthcare. They make their profit
off of like elective surgeries. Um up tom and trade
things like that. I'll turn the medicine. Just the right
to get a private room in a hospital, that's a
little bit extra. Um. So yeah, every everyone's private plan
is essentially the same, and everyone pays the same. That's
(29:37):
the key thing. It's not tied to how much money
you make. Regressive not progressive. Wow, I got a little
efect for you to one of the largest insurance companies
in Switzerland pays out claims in five business days. That's
awesome and people love it, they said, I'm sure clearly
you guys want to go back to the studio. You
get your kind of like here in Switzerland. I'm going
(30:01):
to go back to the studio and wrap this up,
all right, good knowing you. So I'm here with Josh.
I couldn't let him go alone. Thanks. We left Molly
and her mounty in Switzerland. Let's say those two are
a handsome couple. They are. They're going to live out
the rest of their days in the alps Um, she
promises postcards, Yes, and chocolates. Yes, we have finished the
(30:23):
fourth installment of our podcast Sweet, which means it's the
end of our special healthcare podcast Suite. I have hot
air balloon lag. I know you do, buddy. We'll get
you the bed with some warm milk and a beer
in a second. Okay, yeah, um, chuck, let's wrap this
this puppy up all right. And Molly, she's really here.
We've really Oh yeah she is. She's sitting right there
(30:43):
just daydreaming about the mount here. I like the life
you pulled for us. Yes, um, thank you very much
Molly for joining us. I don't know that we could
have done this without you. It wouldn't have been the same.
Definitely agreed, no problem. Thanks for having me, guys, and
thank you, of course, the Dr Roison who gave us
like an hour of his time quite generously and for free,
like you didn't have lives to say. I was expecting
(31:04):
him to be like a Russian physician, be like I
demand a donation, right, but no he didn't. Um and
thank you for tuning in to listen to our four
part series on healthcare reform. It's an important issue, which
is why we tackled it and hopefully you learn something
from it. Had some of your questions answered. If you
have more questions, you can visit Molly's wonderful articles on
(31:25):
the site. At how stuff works dot com. You can
just type healthcare reform in the handy search bar, and
if you have any questions that you want to direct
towards me and Chuck, you can send those in an
email to stuff Podcast at how stuff works dot com.
For more on this and thousands of other topics, is
(31:46):
that how stuff works dot com. Want more how stuff works,
check out our blogs on the house stuff works dot
com home page. Brought to you by the reinvented two
thousand twelve camera. It's ready, are you
Brought to you by the reinvented two thousand twelve camera.
It's ready. Are you welcome to stuff you should know
from house Stuff Works dot com? Hey, and welcome to
the podcast. I'm Josh Clark. With me as always this
Charles W. Chuck Bryant sliding into my seat and with
(00:23):
us is Dr Molly Edmonds, m D esquire PhD LLC. Right, Yes,
that get all of those. Molly. Uh. This is uh
the final installment of our four part healthcare reform suite.
We've reached the end of the final countdown. Can I
just say, speaking for Molly and I thank god? Yeah,
you're not speaking for me to Do you think I
(00:44):
like this? Chuck? Are you ready to move on? Yeah? Okay, okay.
So we've talked about healthcare reform. First of all, Molly,
what was that statistic that that you mentioned, um a
long time ago in a in a podcast far far away,
where you said, like only one in a Americans think
that the health care system in the US needs reforming.
(01:05):
Are happy with their healthcare as it is. So. Um,
what we've kind of deconstructed is why healthcare form is
even on the table. We've talked about the uninsured. Right.
We've talked about the fact that UM that America has
UM really really terrible like mortality rates or UM disease rates,
(01:28):
chronic disease rates, that kind of stuff. UM. So that
in and of itself makes the health care system worth fixing. Right.
But one thing that hasn't been brought up, and I
haven't seen it brought up in coverage too much, is
the fact that our health care system is actually keeping
us from competing as well as we could on a
global scale, right, which is why we would compare ourselves
(01:49):
to other health care systems around the world. You know.
The thing is that no one in this country wants
to become like any other system in the world. But
I don't know if you could find anyone who lives
in another country who wants to trade place with an
American that comes to their health care. We'll put We'll
put let's talk about competitiveness and the health care reform
system via Dr Michael Royson, who you guys might remember, right, Yes,
(02:10):
what is he? Dr Roysen is the chief Wellness officer
of the Cleveland Clinic and my hero and the co
author of UM The You the Owner's Manual book series.
Right with Dr Oz here is what he had to say,
because healthcare is a expensive thing in America, and that
(02:32):
we need reform for the economy to function, for jobs
to be created, and for us to be competitive with
Europe and Asia four jobs, and for us to not
worry about a following standard of living, and for people
to not worry, not have the stress of worrying about
will there be health care for me when I need
(02:53):
it that I can afford? Okay, So, if we're going
to keep up with Europe and Asia, like Dr Reason suggested,
we could by reforming our health care system. Um, maybe
we should kind of peek in on what other countries
around the world are doing, whether for better or for worse. Um, Malla,
you wrote this article ten health care systems around the world, right,
(03:13):
which is up on the site. Yeah, it's sort of
I think, a virtual hot air balloon ride through the
world of health care. It was. It was a delightful
one too. It was beautiful, like so many bloody bandages. Um, so,
where was there any particular health care system that struck
you as arguably better than the US or better than
(03:34):
all the other ones? Actually we wait, wait, let's talk
about France. France transition. Oh gotcha get it? Yeah, I do.
Now we mean yes, it's like, okay, France, Uh, they
apparently have the best health care in the world, I
mean World Health Organization. Right. Yeah, it's hard to argue
(03:56):
with who. Moving on then, no, that's actually um, I
think just because it's become a relic in the healthcare
reform debate in the United States that who um two
thousand report of a hundred countries healthcare system rankings is controversial.
I think we should say that. Everybody's like, oh, well
(04:16):
who said that? So okay, it must be true. Um.
But again, you can pick apart anything. But so let's
just stick to the fact that France was rated number
one in the year two thousand by the World Health
Organizations rankings of a countries. Right, right, So all French
citizens will put in money based on their income, you
(04:36):
can't opt out of it, and then in return they'll
get about seventy of their healthcare paid for by the government. Um,
you can get same day appointments, you can choose any
healthcare provider you'd like. Um. But okay, so we said,
s how do they pay for the other thirty percent?
They all have supplemental insurance with either a public or
a private plan, and that is more similar to how
(04:56):
we have in the U S where that supplemental plan
might come mere employer. So there there are a couple
of problems with the French system, and it's not flawless.
There is no flawless plan. We should go ahead and
say that, you lie. Um. I saw one guy that said,
I said it like this. He said, it's sort of
like medicare for everybody with the French system. Yeah, I
(05:17):
got it, and he was he was a pro. So
they make up the other thirty with private plans, right,
private or republic. And that's the problem is if you
have money, then you would probably opt for a private plan.
So some critics would say that the French plan is
too divided by class. People who want really good care
and can pay for it, get it. Those who can
don't write. But they do that in England too. You
(05:38):
can get also get your private insurance, right yeah, and
we should say for a kind of a comprehensive rundown
of England. Molly gave one in the third podcast. Right,
so we're not gonna talk about this, We're okay. I
mean it was a nice step on the balloon ride.
But here's how France got it's awesome writing. Okay, it
spends personal healthcare while that you spins over twice that, UM,
(06:02):
so already they're using money pretty well. And if you
get really sick, like you have just the worst form
of cancer in the world, everything is paid for. Yeah,
that's what I saw that your article. In some other
stuff I read is that if the sicker you are
in France, the better off you've got it, or the
easier and quicker your claims will get paid as well. Exactly.
But it's not just the really sick who benefit. Because UM,
I think what's cool about Frances they have the lowest
(06:24):
rate of deaths that could have been prevented. The US
has the highest number of these preventable deaths that they say,
or you know, if you had had an early diagnosis
or if you'd had an early treatment in condition right,
I did see also in another article I read that UM.
One of the criticisms criticisms is that there's not great
coordination between the GPS and the specialist in France. But
(06:45):
if you're talking about problems, that's not the worst thing
in the world. That's better than being denied for a
pre existing condition. I think, wouldn't you say, I wouldn't say, yeah, Um,
you guys done with France, because I'd like to get
back in the balloon, okay, and just head on over
a few kilometers a few clicks, if you will, to Germany,
(07:11):
which is um out of the out of the healthcare
systems in the in the article, this one's my favorite,
and I'm not embarrassed to say that. One of the
reasons why is because of the ample access to spa
days and even the public health insurance plans, right and
there's two hundred of them, correct, and their employer and
(07:33):
employee funded, right. Yeah. And you know where that comes
from is actually in three old Otto. Von Bismarck was
like the spies. He was like, I want some healthcare
like they had back in the days of guilds. And
so he is basing all of this off the fact
that when you were in your medieval guild for being,
(07:54):
you know, the podcasters guild, the you know clothmaker's guild,
you know with Germany, that was how they named them. Um,
they all pay for each other sick time. They all
got together, and it would be like us saying podcasters,
let's have to pay for Josh's care when he has
a stroke from smoking. I we can't even get podcasters
(08:16):
to unite under this roof. I doubt if we can
get it all around the world. So model, this is
a pretty old system, and um, it's been around for
hundreds of years. But if because they're always willing to
keep reforming it. Yeah, I noticed that in another article
UM from Berlin University. Actually, um, it was kind of
(08:37):
a rundown of the German healthcare system. All these different
years kept coming up, like they try new things like
every year or two. Uh, and it seems like that's
probably what you'd have to do. I think the impression
that a lot of people in America have, whether supporters
or opponents, is that this healthcare reform is going to
happen and that's it. Yeah, And I think you're I
(08:58):
think you make a very bad the point that it
has to keep evolving and changing as problems come up
or as things prove very effective, you know, you put
more money into this or take funding away from that. Right.
Some of their cool new initiatives are these disease management
programs UM, where if the patient gets more counseling from
a doctor, like if a nurse calls them up at
home to make sure they're taking their meds, you know,
(09:20):
sticking with their diet. These people have much um lower
rates of hospital emissions and much lower rates of deaths
from people than people who have the exact same conditions
who aren't getting that counseling. So I think that's a
pretty cool way to approach disease. I don't know, I
could see like half the people in the United States
thinking it's really nice thing to get a call, and
half the people be like, stay out of my business, nurse,
(09:40):
how did you get this number? Right? Well, and you
know it's not like the nurses and the doctors love
the system. I would say that you read a lot
of articles about how the German doctors feel underpaid. To
protests the most often right German doctors says they're paid
about two thirds what American doctors um make, and but
they pay less for malpractice insurance and some of them
go to school for free med school. And you know
(10:02):
one cool factor that I did not manage to squeeze
into this article. But um, those plans, those two in
our plans that we were talking about those plans get
incentives if they get sicker people on their rosters. So
instead of a system like in the US where people
where we tend to deny people, they get benefits for
doing that. In Germany it's pretty cool. Also, saw where
(10:23):
you can in Germany you can go straight to a specialist,
like you don't have to go through your gatekeeper GP,
which's kind of cool. Also, there is a private insurance
market for UM people who make over forty eight thousand
euros a year. It's not compulsory for those people. Actually,
long term health insurance is compulsory for everybody, but basic
(10:43):
health care coverage isn't compulsory for people who make over
forty eight thousand euros a year UM. So there's another
uh I guess accompanying private insurance market, but that's still
regulated by the government. UH. There's like you can't deny
for pre existing condition and UM. And apparently your rates
are assessed when you enter that private system UM based
(11:06):
on your risk. But that's it. There's like a one
time risk assessment and that sticks with you for the
rest of your life. I missed the DEUT. I'm just
gonna go ahead and say that you missed the Deutsche Mark. Yeah,
I missed the deutsch Mark. Miss I missed the frank
I miss this whole euro business. Yeah, but I hate
to change money from country to country, so I thought
it was kind of thrilling. But then you're left with
your leftover coins. Yeah, but then you take them and
(11:28):
you give them to your cousins and nephews and nieces.
I actually haven't been to Europe since the introduce the Euros,
I'd probably love it. Speaking of redistributing money. Oh, I
know we're going next. This is gonna be kind of
a long balloon ride. So it's just fly forward to
when we when we land in Cuba. So Cuba, let's
(11:53):
talk they have healthcare for well, you'd give the skinny
because I have. I just read some articles where they
say it wouldn't so for well, you know the famous example,
I think Cuba. If you're a Michael Moore fans, when
he took people to Cuba so they could get better
care than they could in the United States, and you
know it was meant to embarrass the U s health
care system. There are obviously a lot of critics, as
(12:14):
with anything Michael Moore does, of how it was portrayed
in the movie. And some people say that there is
um sort of one level for the people they're going
to impress and then one level for everyone else, Right,
But I do think that even those people who are
in maybe that lower um echelon get an immense amount
of preventative care. That's pretty pretty cool. Well that's it
(12:34):
sounds like they do, uh do a pretty good job
with preventative care because they kind of have to. Well,
you guys were talking about Germany and doctors or nurses
calling you up to going how you doing. Um, If
you had a problem with that, you probably really have
a problem with Cuba because any any person is subject
to a surprise visit from their physician once a year. Yeah,
they are going to stop at your door, see what
(12:56):
you're doing, What are you eating? They're like, while we're here,
what's under your mattress and what's in your closet? Well, see,
that's sort of the problem is that, you know, because
they have the preventative care, because they may not have
let's say, a fridge or access to really fatty food
or a really great car. Um. So it's almost like
the you know what we would see as the deficiencies
in Cuba have created a culture whereby they walk a lot,
(13:19):
they don't have fast food. I mean it's coming. They
say that that might be sort of the next wave
of obesity, as Cuba is getting some fast food really well.
As a result, Cuba they have I think they spend
two hundred and sixty bucks of person on healthcare a
year A year, Yeah, right, because they're they're really good
with preventative wellness. But I do want to point out,
(13:40):
you know, sometimes I believe you brought it up, Josh,
there's the thought that if we spend a lot less
on healthcare, will really skimp on our innovation. But Cuba
surprisingly is known for its um innovation of medical break facs.
I have heard that they the medical sector is their
sixth largest in exports, obviously not to the US, but
(14:01):
they really got to put themselves on the map with
some vaccines they've come up with first meningitis B and
then hepatitis B and UM. So they're really making a
name for themselves in terms of their pharmaceutical and mechanical
medical equipment exports. Chuck, you reference some articles that you've
read that the Cuban um I think this is one
of the systems where it all depends on who which
(14:21):
side you're reading, because I read a bunch of articles
that said and a lot of these people interviewed Cuban
refugees that were now living in America, and they said
things like there's two health care systems, one for health tourists,
which apparently Michael Moore is a health tourist, and that's
a big deal, kind of camera coup filling yourself around that, right,
you're gonna get treated differently. But there's health tourism is
(14:41):
a big deal there, and you can go and pay cash.
And so there's one system for Communist Party officials and
health tourists and then one for the rest of Cuba,
and they maintain that, you know, if you're the rest
of Cuba, you can't get things like aspirin, you can't
get any biotics unless it's on the black market, and
you don't have access to a lot of like basic
medical care. Uh, you have to bring your own cheets
(15:01):
to the hospital. Stuff like that. Well, I think there's
also a concern that they get these really great statistics
by fudging their numbers a little bit, Like Cuba has
really good rates of mortality. I thought that was interesting.
But in the United States, you know, if if a
baby is born only lives a very short period of time,
we count that, whereas if it was in the same
if it was a lie for the same period of time,
in Cuba, they may count that is dead on arrival. Right,
(15:23):
And didn't you also say that some doctors allegedly will
suggest abortions in the world the government UM suggests they
abort a fetus that could be developmentally disabled or something. Right, Right,
you know, there's just concerned that UM they have great numbers,
but because you know, we don't really know much felt
what goes on inside the country, we don't know exactly
know how to get them right. It was really nice
(15:46):
to visit it. Can it can be hard to separate
your opinions on the Cuban health system from your opinions
just on Cuba the country, right, So I don't want
to oversell Cuba, Okay, but I'm glad I got to
visit the balloon. I don't have any opinions on Cuba
other than what I've heard from a couple of friends
have traveled there and said it was really awesome, the men,
that people were lovely, and the country is beautiful when
politics aside the country itself. The love it's illegal, it's illegal,
(16:08):
actually not true. Um, so you guys, let's head on
over to China. Okay, Well, here we are in China,
and this place is kind of screwed up all. I mean,
I don't know if i'd want to get sick here.
It used to be pretty good from what I understand
in your article that there was cooperative healthcare system right right,
(16:29):
and they dismantled it and that just didn't go very
well because, uh, you know, no one knew were to
send the bill, and the places they were sending the
bill didn't pay up. And what the huge effect of
this was that there's a giant divide between healthcare and
cities and healthcare in the rural areas. Yeah. One of
the I guess ideas for Chinese healthcare reform was that
(16:49):
all farmers pay a dollar for healthcare, and they bought
in a year, and they balked at that as being
too expensive. Are the rural Chinese that poor really well
just not really taken seriously over there. One Well, I
think they're also saying that yes, a dollar was high,
especially for the care they got. I was reading one
article it was in the New York Times about how
you got us in these world clinics and stray dogs
(17:11):
are walking the halls of the clinics. But it's not
worth a dollar a year. Straight dogs in your hospital.
They bring dogs into American hospitals to perk up cancer
patients and nice, healthy ones, not one that looks like
they're going to die. You don't know whether they're straight
or not. You're talking about the uh like they have
different names at every hospital, I guess. But Love on
(17:32):
four Paws, that kind of programs dogs love to not
enough hospitals. Well, okay, so China is in addition to
it's ridding the hospitals of stray dogs initiatives. Um, they're
planning on building seven hundred thousand I guess probably pet
unfriendly clinics in rural areas. I mean, maybe they'll bring
(17:54):
the nice dogs into those clinics. But yes, they are
in the middle of funneling just a ton of money
into their healthcare system and hopes that they cannot eradicate
this divide between ten years or so, ten or eleven years,
but by the population will have health insurance. They're hoping
the billion on it. Yes, e yen you want. I
(18:21):
don't really know how to pronounce anything in China. Want.
That doesn't sound like very much money to me. It
does to build seven thousand clinics. Yeah, and well. The
other problem is Molly points out that um of that
money UH is supposed to come from the central government,
which means provincial governments are gonna have to make up
the rest. And right now, no one knows if they're
going to pay up right, sort of the problem they
(18:42):
had when they first dismantled them. No one wants to
pay for healthcare. That's true everywhere, but you know one
place where they do pay. There we going back to
a bloom. Now, do we have enough game it's run
on unicorn tiers? Excellent? Okay? Do we have enough unicorn
tiers to make it to tai wall on? You think? Oh?
I hope so, because Taiwan's got a pretty nifty system.
(19:04):
I don't think it would work in this country. But dude,
the smart card. The smart card sounds so convenient, although
kind of mirror bracking for someone like me who has
the tendency to lose things. Wait, wait, you guys can
get to Taiwan. Okay, I wanted to do. I wanted
to brief check before we got there. They're chatting along
the way. Let's just all sit silently in a balloons. Alright.
(19:27):
So we're in Taiwan. Now this is lovely. So back
to the smart card before we were exactly Um, okay,
So you get a smart card. It's got your entire
medical history on it, right, and you can just show
up to a doctor and give them your card and
they can pull up your entire medical history. And that
is how they will also build a government. So it's
like your healthcare credit card that you never have to
(19:48):
see the bill for and it's your entire medical history. Now,
of course, I people who say that's a way too
much information for any government to have about a person.
I like the idea of the smart card. I wouldn't
mind all my medical information being on one car because
I'm a little distressed every time I go to the
doctor and I see them pull out a paper file
in the midst of thousands of paper files, it seems
very archaic to me. Well, I've I've moved quite a
(20:09):
bit and I just hate having to kind of start
over every time with every doctor. And what do you do.
I actually haven't changed doctor as much. You get them
to send everything to your new doctor. I think you're
supposed to. Really, maybe I shouldn't reveal how poorly I
manage my health switchovers. So I am a health writer.
The smart card sounds word well, yeah, medical medical billing,
medical information. It's a huge, huge problem in the US,
(20:31):
just an administrative costs and time. Yeah. And that's the
thing that was cool about what Taiwan did is that
in expanding coverage to cover so much more the population,
that they cut all those costs because now they have
no administrative costs essentially. But the fact matters is that
now Taiwan doesn't spend enough on healthcare to cover their costs,
and the Taiwanese have gotten used to these really low
(20:51):
healthcare costs, and people of our frager RaSE the taxes
the age old story. Yeah, saw, we're a family and
average family premium it's six d and fifty dollars a
year in Taiwan. So I can't even think about car
insurance for that. So are we done with Taiwan? Is
that smart card? This place is really clean, by the way,
have you noticed the food is good? Yeah, let's go
(21:13):
to Russia. Okay, guys, thank you again for nuts speaking
during the balloon ride. So we're in Russia now, and
unfortunately this is not a good place to get six.
So no one drink the water here. Okay, okay, right,
but you can't drink the water in Russia. No, okay? Really, wow,
I didn't know that. You think they would have had
that worked out? So they not in a place that
(21:36):
has one of the four worst healthcare systems in the world. Right,
is there another one we may have heard of that's
in that list? According to Foreign Policy, the United States
also makes that list. It was a foreign policy article,
so it's it's not stellar. The World Health Organization that
we mentioned earlier ranks them out, so, you know, and
(21:56):
they've got a fair bit of money. It seems like
they should be doing doing a little bit better. And
this is another system sort of like China, where they
dismantled their old Soviet system which was pretty well admired
around the world, and tried to create a public private
combo system. And basically this system works well in theory
but sucks in practice. Financially, it doesn't work out, right,
(22:17):
I don't even think of I mean financially personally you
got to show up with a pretty hefty bribe to
see a doctor in Russia. Yeah, I thought that was
really interesting that the on paper or you know, um spoken,
it's um the populations covered, but the government doesn't really
pay up and so to keep operating hospitals and doctors go, um, yeah,
(22:42):
I need you to give me a donation, buddy, or
else I'm not going to you. It's extortion for healthcare,
which is nuts. Can we just be careful because I
don't want Vladimir Putin to listen to this podcast listen
to the word extortion, So let's make stop your brief.
I think. I think what's good to know is that
(23:03):
the World Health Organization, Love It or Leave It, recommends
the countries spend about five percent of their total spending
on healthcare, and Russia spends three. Okay, I don't want
to alarm anybody. Some guys just pointed at us and
are starting to come over, So we should probably get
back to our balloon. Okay, a pretty happy place. Canada. Okay, yeah,
(23:26):
we had a lot of Canadians right in, So what
about us? We have a lot of Canadian fans, and
so we're gonna we're gonna talk about you all now
up there in the Great White North. Okay, I'm gonna
let that one slide. Uh. We're here in Canada now. Um,
thank you Molly for not speaking during the journey. I
couldn't be quilled any longer. I was writing a personals
ad for AMOUNTEE, So let's see if we can find
(23:49):
you one here. But first, let's talk about the healthcare
system in Canada. This is the one that the US
is often compared to. If we're if we go to
socialized men or something this this Canada. I always feel
bad for him because they serve as like some sort
of cautionary tale for what we don't want. But from
what I hear that it's not nearly as bad as
(24:09):
as we've been told by some quar right, people are
trying to treat Canada like the worst case scenario, and
I think that, um, this is due to a lot
of commercials and from what I can understand, I mean,
I haven't talked to these people myself, but it seems
like people are very good about going and finding the
people who did have just staggering long wait times and
put them in the commercial. Right. I have some Canadian
(24:32):
friends who I keep up with on the blog and
they've they've written me before and said, you know, it's
not perfect over here. Wait times aren't nearly as bad
as you're depicted, though, and we'll take it any day.
And I think wait times were really bad back in
the eighties and early nineties, and then in the nineties
Canada invested billions of dollars to improve the statistics. And
so now if you want to head over to a clinic,
(24:52):
before you go over, you type in which clinic you
want and they will tell you what the weight time is.
So I mean that's sort of transparency. I think it's
pretty hard to find in this country. And then the
wait times aren't it's it's not for like basic care
right and usually for like special elective surgeries and the
right the weights are longest for you know, like knee
replacements sort of elective things. And I think that one
of the ways that Canada does keep their costs low
(25:14):
and comparison to the United States is they don't buy
every single new fangled machine that comes out. In the
United States, we have a tendency to buy every single
cool gadget, and that's and that really can make our
health care systems seem like it's working really well. It
really does provide us a great level of care. But
it doesn't mean that the old machines were necessarily in
bad shape. Right, But there appears to be something of
(25:37):
an equally American sentiment among Canadians that they do like
they're pretty machines like an m R I and new
r m R I. Because there you mentioned in the
article there's a I guess, a subculture of rogue doctors
who offer UM unlicensed illegal medicine for people who don't
(25:57):
want to wait and can pay up. I assume, right, right, mean,
I think that that's sort of the message you can
take from any of these systems is the people who
have money will use it. UM. We should also say
that if you're going to compare country with socialized medicine
to what the US, what the fear of what the
US might become, you shouldn't you shouldn't point to Canada.
(26:18):
You'd be much better off pointing to Britain, because while
Canada does have a single payer government system of healthcare UM,
the hospitals and doctors are private entities, their private enterprises.
Right in Britain, they run the hospitals and pay their doctors.
But in Canada it's just single payer. And let's talk
about that means, because single payer seems like such a
dirty word to people. UM. Here's how Canada pays for
(26:41):
their health insurance. The citizens fund you know, their their
healthcare by paying income taxes and sales taxes and then UM,
all that money is sort of funneled through to the
provinces and the territory. So it's not even like Canada
as an entity is pushing out the money. Gotcha you
clear on that, Josh, I am. Do you want a
(27:02):
fun fact? Yeah? Please? Did you know that open heart
surgery cost less in Toronto than it does in Chicago? Really? Yes,
that's crazy. Also, prescription drugs tend to cost a lot
less in Canada, UM, from what I understand from Roison
during that phone interview, because UM Canada promotes far more
competition among UM pharmaceutical companies. The same pharmaceutical companies that
(27:26):
might be based in the US are doing business here
in the US or bass why their costs are lower
for pharmaceuticals. And also doctors and nurses make a fair
bit less. So I don't know if I don't know
if doctors want to go to Canadian system. Okay, kids,
one last stop on our whistle stop tour, taking a
good one. I feel like doing some skiing. Um, let's
(27:46):
go to Switzerland, a little good chessolate. Okay, here we
are in our last stop. It's beautiful. You see the
red crosses everywhere in the Alps and the nice smiling
rib apple cheep face. I'm going to stay neutral and
not give you an opinion on this. That's their Their
health care system is really expensive, really really expensive. And
(28:09):
yet um, Americans who are looking for alternatives abroad, seemed
to love it. Both Democrats are Republicans because it's a
pretty good system. But it's just expensive. Right. Well, you
know they have free choice, but they pay for that,
they do. What do you mean by that? Well, I
will tell you you know how everyone here is all
freaked out about public health option. Um, it's all private
(28:31):
plans in Switzerland. It's not tied to your employment at all.
You just can go into a marketplace, let's say, for
lack of better word, pick your private plan and um,
you know, making fancily want and it can cost a lot.
You can just seven fifty dollars per family per month.
Not Yeah, so pretty steep. So generally Republicans like the
(28:54):
choice you can have a private plan, and Democrats like
the fact that even though that's expensive, everyone's covered because
those who can't afford it receives sus tous from the government.
But I don't know if you want to go from
being a first expensive most expensive healthcare sites from the
world's second most expensive healthcare in the world. One of
the things I found significant in your article about Switzerland
(29:15):
was that, um, your healthcare providers aren't allowed to make
a profit off of basic healthcare. They make their profit
off of like elective surgeries. Um up tom and trade
things like that. I'll turn the medicine. Just the right
to get a private room in a hospital, that's a
little bit extra. Um. So yeah, every everyone's private plan
is essentially the same, and everyone pays the same. That's
(29:37):
the key thing. It's not tied to how much money
you make. Regressive not progressive. Wow, I got a little
efect for you to one of the largest insurance companies
in Switzerland pays out claims in five business days. That's
awesome and people love it, they said, I'm sure clearly
you guys want to go back to the studio. You
get your kind of like here in Switzerland. I'm going
(30:01):
to go back to the studio and wrap this up,
all right, good knowing you. So I'm here with Josh.
I couldn't let him go alone. Thanks. We left Molly
and her mounty in Switzerland. Let's say those two are
a handsome couple. They are. They're going to live out
the rest of their days in the alps Um, she
promises postcards, Yes, and chocolates. Yes, we have finished the
(30:23):
fourth installment of our podcast Sweet, which means it's the
end of our special healthcare podcast Suite. I have hot
air balloon lag. I know you do, buddy. We'll get
you the bed with some warm milk and a beer
in a second. Okay, yeah, um, chuck, let's wrap this
this puppy up all right. And Molly, she's really here.
We've really Oh yeah she is. She's sitting right there
(30:43):
just daydreaming about the mount here. I like the life
you pulled for us. Yes, um, thank you very much
Molly for joining us. I don't know that we could
have done this without you. It wouldn't have been the same.
Definitely agreed, no problem. Thanks for having me, guys, and
thank you, of course, the Dr Roison who gave us
like an hour of his time quite generously and for free,
like you didn't have lives to say. I was expecting
(31:04):
him to be like a Russian physician, be like I
demand a donation, right, but no he didn't. Um and
thank you for tuning in to listen to our four
part series on healthcare reform. It's an important issue, which
is why we tackled it and hopefully you learn something
from it. Had some of your questions answered. If you
have more questions, you can visit Molly's wonderful articles on
(31:25):
the site. At how stuff works dot com. You can
just type healthcare reform in the handy search bar, and
if you have any questions that you want to direct
towards me and Chuck, you can send those in an
email to stuff Podcast at how stuff works dot com.
For more on this and thousands of other topics, is
(31:46):
that how stuff works dot com. Want more how stuff works,
check out our blogs on the house stuff works dot
com home page. Brought to you by the reinvented two
thousand twelve camera. It's ready, are you
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