commentaries

A big thank you to the Doctor for an interesting insight. Too many Americans talk about our system along ideological lines. Guess what? There are lots of competing models out there that provide evidence of what works and what doesn't. My belief is the most successful countries in the future will be looking for best practices based on evidence, not trying to conform their practices to any particular ideology. To have German medical professionals reading the Star Tribune, a local/regional paper covering a medical system that is among the worst in the world shows me one thing: The Germans are looking for ideas and evidence for improvement everywhere. God, I wish our doctors were like that, reading up on the pros and cons of other OECD country's health systems. Reading even regional papers. It sounds like both systems need some reform. All things being equal, I'd bet on the Germans to get their situation straightened out before us, at least based on the idea that Germans are apparently looking for evidence on what they should do rather than waxing on about ideological extremes like we do.

So, basically, government control results in marginal care. I don't think that Americans believe that will be the case here as they are all on the Liberal Kool-Aid and walk, talk and vote like little zombies. The instant they hear the truth it's la-la-la time. Too late for us, I guess.

"Would you want a decision about an operation to driven by economic reasons or medical reasons? Should a patient really be an opportunity for economic improvement for a hospital? What does a doctor do when his administration tells him to get more profit out of his department?" You mean the situation we are dealing with in the US?

Everybody should be able to have a car. Not everyone can have a Porsche. Thanks, Doc. I am sure your patients love you!

What the supporters of an American national health care system stubbornly or ignorantly fail to realize is that nearly every country in the world that has nationalized health care also has some kind of private medical care delivery system and/or company provided supplementary medical insurance plan or a private health care delivery system where people who can afford private care that is not provided by the national health care system can get private medical services. Where, you might ask? England, Ireland, Canada, France, Australia, Italy, Singapore, and many others! Why? Because this is the only way that patients don't need to wait a year for some treatments, prescriptions and treatments that the national systems cannot afford to provide, etc. In short, nationalized health care systems must ration and limit care, because the amount of money to pay for care is limited by the revenues governments have to spend on health care.

Step up "elle". Pay someone else's medical care yourself! Making some "third party" pay is NOT charity or social responsibility.

Our healthcare system is rationed; it is based on your ability to pay.Dr Gunnemann points out that Germans pay 15% of their income for health insurance.Many Americans pay more than that.What percent of a person's income should be spent on health insurance. Maybe when we answer that question we came have an honest debate about healthcare. I don't hear either President Obama or the Republicans defining just what affordable healthcare is.I have a pretty good idea of what affordable healthcare is not!

It's true that the writer of the original article was mistaken about the German system being single payer. I've done a lot of reading on the topic, and I already knew that. But a couple of ways in which the German system differs from ours: 1) Insurance companies are limited in how much they can pay their executives, 2) Doctors are respected, but there's no expectation that being a doctor is a license to print money (for one thing, German universities charge little or no tuition, so doctors don't have huge student loans to pay off), 3) Insurance companies are required to reimburse providers within two weeks unless they can prove fraud, 4) While there may be copayments required of German patients, there are no deductibles. If the Obamacare plan had adopted those sensible measures, I'd be more in favor of it.

Medical and Legal professionals should be public just like military, firemen, police and teachers. The most fair and economic system.

Basic logic - you can't use an efficient-as-measured-by-dollars system that delivers health care-as-measured by return-to-health and mortality... That's like measuring your height using a thermometer... You have to measure them by the same measure. And that continual flipping of measure is why the medical system becomes inefficient- layers are added to try to make health metrics = dollar metrics.. In human endeavor, you set a goal of being or state - and leave that measure and determine a budget, find financing, and allocate using a measure of resources. And then return to accomplishing the goal. Or you jabber and waste.. The US health care system discussions keep going at it backwards - no goal, no budget - we just check results and add paper when the results are not what we want -- how about a quantitative goal and a budget value first? "All healthy" and "pay what it takes/lowest cost to do it" just keeps us spinning our wheels and shoveling money into the boiler of our old money-guzzling engine for no other reason than to keep the steam up.