Healthcare Reform
Canadian and European Healthcare Systems
Increasing Health Care Costs

What Should Be Done


Canadian and European Healthcare Sytems


At the moment Germany has the best value in health care in Europe. It is not funded by taxes, and it is compulsory. All German workers pay about 8 percent of their gross income to non-profit insurance companies called sickness funds. Their employers pay about the same amount. Workers can choose among 240 sickness funds. Everybody is in the system except the self employed, civil servants and people earning more than $72,000 per year. These people can buy private health insurance from for profit health insurance companies. This can create unexpected problems. A wife earning $40,000 a year working for a company and having two children would have to use a sickness fund while her self-employed husband could buy the best coverage possible from an insurance company. Since the husband's private coverage is better than his wife and children's coverage, he gets his choice of top doctors - the chief of medicine if he wants. A private room in hospital. When he goes to the doctor, he gets a free cup of coffee and goes to the head of the line. All this embarrasses him - and annoys his wife.

It's important to remember that the German government doesn't provide health care or finance it directly. It does regulate insurance companies closely, the nonprofits in the main system and the for-profits for people who want the best. The insurers can't raise rates if people get sick or raise premiums too much as you get older. The government also requires insurers to keep costs down so things don't get too expensive. Germany like most countries, has the problem of rising costs.

How is the German system different to the American? Premiums are based on how much you earn! 8% of an employees gross wage plus at least another 8% from the employer. You could have two people, same age on the same plan, working in the same company one earns $30,000 per year and one earns $60,000 per year. The one with the higher gross income would pay double what the lower income employee is paying! But the Germans like the system and it works.

Doctors are leaving Germany visit:,1518,399537,00.html



In 2001, the World Health Organization rated France the best in the World because of its universal coverage, responsive healthcare providers, patient and provider freedoms, and the health and longevity of the country's population. Employees pay 20% of their gross salary, the self-employed pay even more. This discourages free enterprise! That means a person grossing $4,000 per month would pay $800 per month for the basic health insurance. The French share Americans' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." Most physicians in France participate in the nation's public health insurance.

Their freedoms of diagnosis and therapy are protected in ways that would make their managed-care-controlled US counterparts envious. Practice liability is greatly diminished by a tort-averse legal system, and medical schools, although extremely competitive to enter, are tuition-free. Thus, French physicians enter their careers with little if any debt and pay much lower malpractice insurance premiums. Nor do France's doctors face the high non-medical personnel payroll expenses that burden American physicians. Sécurité Sociale has created a standardized and speedy system for physician billing and patient reimbursement using electronic funds. It's not uncommon to visit a French medical office and see no nonmedical personnel. Moreover, in contrast to Canada and Britain, there are no waiting lists for procedures and patients need not seek pre-authorizations. In other words, like in the United States, "rationing" is not a word that leaves the lips of hopeful politicians.

Note: The French system is one of the most costly in Europe.

National health insurance in France stands upon two grand historical bargains -- the first with doctors and a second with insurers. Doctors only agreed to participate in compulsory health insurance if the law protected a patient's choice of practitioner and guaranteed physicians' control over medical decision-making. French legislators also overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new healthcare funds. Private health insurers are also central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.

Like all healthcare systems, the French confront ongoing problems. Today French reformers' number one priority is to move health insurance financing away from payroll and wage levies because they hamper employers' willingness to hire. Instead, France is turning toward broad taxes on earned and unearned income alike to pay for healthcare.



As many of you know I was born in London and lived in Britain under the Welfare State system for 31 years. In 2007 I returned to London for the first time in 29 years and what a shock I got, not the least of it being that all my friends had private health insurance. Why? Because the service and waiting periods for treatment is abominable under the National Health Service. You probably remember one of my previous newsletters where I detailed my brother-in-law dying in Britain because he waited for a quadruple bypass for 6 months and died before he got to the top of the waiting list.

Have you heard people say that health care is "free" in Britain?

Apparently those people have never lived in Britain and experienced the crippling taxation! Unlike the French, German and Swiss health systems, the British health service is completely funded by taxes. In 2010 British taxpayers will pay the highest marginal income tax rate in the developed World! A new rate of 60% is being introduced next year and it will be the highest in the 30 countries in the Organization of Economic Co-operation and Development (according to accountants Ernst & Young).

That will put Britain above notoriously high-tax socialized medicine countries such as Denmark, Sweden and Finland.

In addition, Britons pay 15% tax on products and services they buy (value added tax).
The tax on gasoline is $3 per gallon.
The British cannot deduct their mortgages from their income tax.

These are just some of the taxes necessary to sustain socialized medicine.

It's not just the rich people who are taxed. Everybody is taxed.

Want to see what Socialized Medicine in Britain is really like? Look up the following articles on line!

A British Member of Parliament says "Americans! Don't copy the British Healthcare System!

British Health Care in Crisis despite massive investment. Take a look at the costs!

Britain shamed by National Health Service death rates.



Just like Britain, Canada has socialized medicine, the results are even worse!

In 2005 Nadeem Esmail and Michael Walker of the Fraser Institute found that the median waiting time from when a patient was referred by a general practitioner until the time he or she actually received Hospital treatment was 17.7 weeks.

Such long waits for needed care jeopardize patient health, according to many doctors and health policy experts. A 2004 survey of Canadian health care professionals, conducted by Ipsos-Reid on behalf of the Canadian Medical Association and Canadian Nurses Association, revealed significant concerns. "The primary consequence of delayed access to health care is the worsening conditions of their patients," the survey found. It also reported 12 percent of physicians and 4 percent of nurses believe they have had patients die specifically because of long waits for needed care. "Long waits can have several consequences," explains Dr. Robert Hamilton, a retired surgeon in Illinois. "Chronic conditions can become acute, with increased morbidity and mortality, and curable malignancies may become incurable." Hamilton also notes many orthopedic procedures, such as hip replacement and knee replacement, are done to relieve pain, which can be severe while a patient is forced to wait. Canadians fed up with waiting months or even years for treatment are finding ways around the government-run system.
CBS News reported in a March 20, 2005 story the tale of Jane Pelton of Ottawa, mother of a teenager who was told it would take up to three years for surgery to repair a torn knee ligament. Rather than watch her daughter wear a knee brace and suffer for three years, Pelton opted to go to a private clinic in Vancouver and pay out of her own pocket for surgery. "Every day we're paying for health care, yet when we go to access it, it's just not there," said Pelton, in comments aimed at the government system her taxes pay for and is supposed to guarantee free care.


Some Canadians have resorted to lawsuits to get the care they need in what they and their doctors believe is a reasonable time. In June 2005, the Supreme Court of Canada ruled Quebec could not ban private health insurance for services covered under the government-run system. The lawsuit was brought by a Canadian doctor, Jacques Chaoulli, and Montreal businessman George Zeliotis, who waited a year for hip replacement surgery. "Access to a waiting list is not access to health care," the Supreme Court said in its ruling striking down Quebec's ban.

A similar lawsuit was filed in Quebec on behalf of 10,000 women with breast cancer who were forced into long waits for
radiation therapy. Anahit Cilinger was one such patient. After having a lymph node removed in October 1999, she was put on a waiting list for radiation therapy. Three months later and with no end to the waiting in sight, she traveled to her native Turkey and paid for the treatment. I don't want other sick people to have to go through the kind of suffering I did," Cilinger told Ingrid Peretz of The Globe and Mail in a March 10, 2004 interview.

The Canadian federal government pledged in 2004 to increase spending on health care by $41 billion (Canadian) over the next 10 years to address wait lists, but Esmail and Walker point to the fact that additional spending in the past has not led to reductions in wait times. "Provinces that spend more on health care are not rewarded with shorter waiting lists," Esmail and Walker write. They conclude that as long as Canada keeps a single-payer health care system, Canadian patients will continue to be forced into long waits for needed care.

"Many Americans look to Canada's Medicare program as a panacea for what they perceive to be the American health care system's failures," Esmail told Health Care News. "These wonderful visions of Canada's socialized health program tend to ignore the very real costs that system imposes on Canadians in need of medically necessary care: Long wait times that can stretch into months or even years of painful and detrimental delay. The reality is that Canada's program is a model for no
one, not even Canada."

I suggest you go online and read these articles, scroll down the first page and listen to "A Short Course in Brain Surgery"

The Ugly Truth About Canadian Health Care, visit:


Görann Persson had to wait eight months during 2003 and 2004 for a hip replacement operation. Persson was not a very pleasant person to begin with, and he became even grumpier due to the pain he endured while waiting for his operation.
As a result, Persson walked with a limp, reportedly used strong pain medication and had to reduce his workload.
What made Persson unique was not his wait for hip surgery.

Persson stood out because he was Prime Minister of Sweden at the time!

Persson could surely have used his position in the government to gain access to private care, essentially jumping the waiting list. Yet Perrson stated that he planned on waiting for his surgery like everyone else Since that time Sweden's health system has gone further downhill. I bet the President of The United States wouldn't wait 8 months!

Sweden's Single-Payer Health System Provides a Warning to Other Nations


All Swiss insurance is private insurance. Insurance companies are mandated to offer the same "basic benefits package." Some physicians operate outside the negotiated schedules and individuals can purchase supplemental insurance to cover the cost of these higher cost physicians. 60% of Swiss citizens only have a basic plan.
There is no waiting for treatment and everyone must buy health insurance. It is the best system in Europe, but expensive.
The World Health Organization ranks Switzerland as second only to America in terms of timely care.



Health care is supposed to be free in Russia, but Russians know that every hospital has its under-the-table price list.
That's why the family of Khazerya Ziyayetdinova, a 70-year-old woman suffering from severe bedsores, brought cash every time they visited her at Hospital 67 in Moscow. To have Ziyayetdinova recover in a room instead of the hallway, relatives slipped an orderly $300. They paid nurses $20 to give injections, change bedpans and unclog catheters. Every chat with Ziyayetdinova's doctor cost $40. "Our health-care system is still in the Middle Ages," said Vera Pavlova, Ziyayetdinova's daughter-in-law, sitting in her home in this small town 54 miles southwest of Moscow. "There's low professionalism,
corruption - it makes me very worried about finding myself in a situation where I might need medical treatment." Russia is an unhealthy nation, and its health-care system is just as sick. Its hospitals are understaffed, poorly equipped and rife with
corruption. I am not going to spend time on health care in Russia, but if you want to know how bad socialized
medicine can get I suggest you visit the Web Site of the Chicago Tribune and read the whole story.


Why Are Health Care Costs Increasing?


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