Choosing the Best Healthcare Country

The one number we can be sure of for the Cassidy-Graham Healthcare Plan is 141. Its length is 141 pages.

With no “score” from the Congressional Budget Office, lawmakers have no shared estimate of its fiscal and coverage impact. Meanwhile, predictions vary among respected experts. So, because the healthcare legislation has been in the news, let’s begin will a quickie summary of the plan and then an international overview that could be helpful in the future.

Under the Affordable Care Act, the federal government has a direct massive financial obligation in these three areas:

But, under Cassidy-Graham, those $1.4 trillion in federal obligations get shifted to individual states through block grants. And, each state can decide what it wants to do with those responsibilities. And, the amount states get will not necessarily correspond to what they now receive. So, depending on the state, a lot can change.

In this quickie video from a healthcare expert, you can get a sense of the legislation. Although Dr. Carroll’s bias is quite clear, still, the facts come across:

The Best Healthcare Country

Through a healthcare tournament, the NY Times let five experts and more than 50,000 readers choose a winning healthcare country. The competitors were eight nations. The ladder was like any in a tennis or soccer match.

Britain v. Canada

When Great Britain and Canada battled each other for the single payer title, Britain won. While Britain’s single payer has government paying and providing the care, the Canadians pay and then primarily have the private sector provide. Britain won for its lower cost and faster access. The expert vote was 4 to 1 while participants were 76% to 23% pro Britain.

U.S. v. Singapore

The main theme for the U.S./Singapore competition was the many ideas that each system combined. Here, the U.S. won for its capacity to innovate. Again, the expert vote was 4 to 1. Although Singapore spends much less and controls much more, there was considerable opposition to its 37% wage tax. The popular vote was U.S. with 56% to Singapore’s 43%.

France v. Australia and Switzerland v. Germany

In the rest of the ladder, we had France against Australia with France winning for its accessibility. Last, Switzerland beat Germany. Then, in the semi-finals, the U.S. lost to France because accessibility topped innovation. With Switzerland against Britain, the market drew more votes.

The Finals

That left them with Switzerland and France and a split opinion. Switzerland won, 3-2 for the experts who especially liked its public/private combination and cost control. But in the popular vote, readers favored France, 57% to 42%.

Our Bottom Line: Fiscal Policy

Because we define fiscal policy as spending, taxing and borrowing, healthcare legislation relates to all three. In the U.S., with the financial problems that Medicare and Social Security will soon experience, the expense of healthcare policy looms large.

However, Cassidy-Graham and the NY Times tournament show us that there is so much more.

When the tournament’s experts expressed their votes, they cited taxes and wait times. They were concerned with accessibility and quality for all socio-economic groups. They brought up efficiency and innovation.

Where does this leave us? With many different variations of universal coverage.

My sources and more: You could start or end with the 141 page Cassidy-Graham Plan or skip it entirely. Instead, I recommend the NY Times Tournament and a series of superb YouTube videos. They covered key healthcare topics and were brief. The Graham-Cassidy video is above. But Aaron Carroll also did healthcare system overviews of the eight countries in the “tournament.” It was a perfect shortcut to some grasp of a complex topic. At the least, it will help you decide and defend your own opinion more knowledgeably.

Please note that I had to decide between Cassidy-Graham and Graham-Cassidy. In the media, there was no consistency.