Our System of health care-view from the inside out

Socialized health care System requires checks on the population and an impeccable records

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In a nationalized health care system, you need to know who is who - otherwise the system could never be able determine who is entitled. The structure depends on how the system is created and designed, but with a nationalized health care system you will be tracked by the state where you reside and how you move in a manner that is unseen in America. The nationalized health care system becomes a vehicle for population control.

If you leave the United States and are no longer a resident of the state, even if you are a citizen and might maintain a driving license, you will have to report immediately if you want to avoid the 13% health care tax. I use the number 13% as it is in Sweden to exemplify the actual tax pressure that is laid upon you for the nationalized health care.

Let's say you moved and you do not want to pay the 13% tax for services you do not receive, can receive, or want to taken out from the tax roll. The mammoth entity has no interest to let you go so easy. You will end up having to reveal your private life - partner, dwellings, travel, money, and job to prove your case that you have the right to leave the public health care system and do not need to pay the tax. If you have to seek an appeal, your information could be a part of administrative court documents that are open and public documents. As soon as you return to the United States, you will be automatically enrolled again and the taxes start to pile up.

Public universal health care has no interest in protecting your privacy. They want their tax money and, to fight for your rights, you will have to prove that you meet the requirements to not be taxable. In that process, your private life is up for display.

The national ID-card and national population registry that includes your medical information is a foundation of the nationalized health care system. You can see where this is going - population control and ability to use the law and health care access to map your whole private life in public searchable databases owned and operated by the government.

By operating an impeccable population registry that tracks where you live, who you live with, when you move and your citizen status including residency the Swedes can separate who can receive universal health care from those not entitled. The Swedish authorities will know if you have a Swedish social security number, with the tap of the keyboard, more information about yourself than you can remember. The Swedish government has taken sharing of information between agencies to a new level. The reason is very simple - to collect health care tax and suppress any tax evasion.

It is heavily centralized and only the central administration can change the registered information in the data. So if you want to change your name, even the slightest change, you have to file an application at a national agency that processes your paperwork. This centralized population registry makes it possible to determine who is who under all circumstances and it is necessary for the national health care system. Otherwise, any person could claim to be entitled.

To implement that in the United States requires a completely new doctrine for population registry and control. In an American context that would require that every existing driving license had to be voided and reapplied under stricter identification rules that would match not only data from Internal Revenue Service, state government, municipal government, Social Security Administration, and Department of Homeland Security but almost any agency that provides services to the general public. The reason why a new population registry would be needed in the United States is the fact that lax rules dating back to the 1940s up until the War on Terrorism, and stricter identification criteria following 9/11, has made a significant percentage of personal information about individuals questionable.

If America instead neglects maintaining secure records, determining eligibility for public health care would not be possible and the floodgates for fraud would open and rampant misuse of the system would prevail. This would eventually bring down the system.

It is financially impossible to create a universal health care system without clearly knowing who is entitled and not. The system needs to have limits of its entitlement. A social security number would not be enough as these numbers have been handed out through decades to temporary residents that might not even live in the United States or might today be out of status as illegal immigrants.

The Congress has investigated the cost of many of the "public options", but still we have no clear picture of the actual realm of the group that would be entitled and under which conditions. The risk is political. It is very easy for political reasons to extend the entitlement. Politicians would have a hard time being firm on illegal immigrants' entitlement, as that would put the politicians on a collision course with mainly the Hispanic community as they represent a significant part of the illegal immigrants. So the easy sell is then that everyone that is a legal resident alien or citizen can join according to one fee plan and then the illegal immigrants can join according to a different fee structure. That assumes that they actually pay the fee which is a wild guess as they are likely to be able to get access to service without having to state that they are illegal immigrants.

It would work politically - but again - without an impeccable population registry and control over who is who on a national level, this is unlikely to succeed. The system would be predestined to fail because of lack of funds. If you design a system to provide the health care needs for a population and then increase that population without any additional funds - then naturally it would lead to a lower level of service, declined quality, and waiting lists for complex procedures. In real terms, American health care goes from being a first world system to a third world system.

Thousands, if not a million, American residents live as any other American citizen but they are still not in good standing with their immigration even if they have been here for ten or fifteen years. A universal health care system will raise issues about who is entitled and who is not.

The alternative is for an American universal health care system to surrender to the fact that there is no order in the population registry and just provide health care for everyone who shows up. If that is done, costs will dramatically increase at some level depending on who will pick up the bill - the state government, the federal government, or the public health care system.

Illegal immigrants that have arrived within the last years and make up a significant population would create an enormous pressure on a universal health care, if implemented, in states like Texas and California. If they are given universal health care, it would be a pure loss for the system as they mostly work for cash. They will never be payees into the universal health care system as it is based on salary taxes, and they do not file taxes.

The difference is that Sweden has almost no illegal immigrants compared to the United States. The Swedes do not provide health care services for illegal immigrants and the illegal immigrants can be arrested and deported if they require public service without good legal standing.

This firm and uniform standpoint towards illegal immigration is necessary to avoid a universal health care system from crumbling down and to maintain a sustainable ratio between those who pay into the system and those who benefit from it.

The working middle class that would be the backbone to pay into the system would not only face that their existing health care is halved in its service value - but most likely face higher cost of health care as they will be the ones to pick up the bill.

The universal health care system would have maybe 60 million to 70 million "free riders" if based on wage taxes, and maybe half if based on fees, that will not pay anything into the system. We already know that approximately 60 million Americans pay no taxes as adults add to that the estimated 10-15 million illegal immigrants.

There is no way that a universal health care system can be viably implemented unless America creates a population registry that can identify the entitlements for each individual and that would have to be designed from scratch to a high degree as we can not rely on driver's license data as the quality would be too low - too many errors.

Many illegal immigrants have both social security numbers and driver's licenses as these were issued without rigorous control of status before 9/11. The alternative is that you had to show a US passport or a valid foreign passport with a green card to be able to register.

Another problematic task is the number of points of registration. If the registration is done by hospitals - and not a federal agency - then it is highly likely that registration fraud would be rampant. It would be very easy to trespass the control of eligibility if it is registered and determined by a hospital clerk. This supports that the eligibility has to be determined by a central administration that has a vast access to data and information about our lives, income, and medical history. If one single registration at a health care provider or hospital would guarantee you free health care for life and there is no rigorous and audited process - then it is a given that corruption, bribery, and fraud would be synonymous with the system.

This requires a significant level of political strength to confront and set the limits for who is entitled - and here comes the real problem - selling out health care to get the votes of the free riders. It is apparent that the political power of the "free" health care promise is extremely high.

A promise that can not alienate anyone as a tighter population registry would upset the Hispanic population, as many of the illegal immigrants are Hispanics - and many Hispanics might be citizens by birth but their elderly parents are not. Would the voting power of the younger Hispanics act to put pressure to extend health care to elderly that are not citizens? Yes, naturally, as every group tries to maximize its own self-interest.

The risk is, even with an enhanced population registry, that the group of entitled would expand and put additional burden on the system beyond what it was designed for. That could come though political wheeling and dealing, sheer inability from an administrative standpoint to identify groups, or systematic fraud within the system itself.

We can speculate about the outcome but the challenges are clear. This also represents a new threat to the privacy and respect for the private sphere of the citizenry as an increased population registration and control empowers the government with more accurate information about our lives and the way we live our lives. Historically, has any government when given the opportunity to get power taken that opportunity and given that power back to the people after the initial objective was reached? Governments like to stick to power.

To ensure the universal health care system is designed to function as intended it, would require procedures that would limit fraud, amass a significant amount of personal information, have access to all your medical data, and also determine who you are beyond any doubt. Just to be able to determine if you are entitled or not and, track the expenditures you generate.

The aggregation of these data could also open the floodgates for any data mining within these data under the pure excuse that it would help the universal health care system to better "serve you" and lower the costs.

To lower the costs also means to identify which procedures should not be done on which type of patients as it is not viable based on the government's interest to optimize your productivity under your life cycle. The collection of data has a tendency to look inviting and good when we start to collect it but aggregated data and personal information creates a deep intrusion in our privacy.

Jon Kallberg is a Ph.D. Candidate in Public Affairs and has his private political blog http://kallberg.blogs.com/kallberg/ and has written the book "How Socialized Health Care Will Radically Change America" [http://kallberg.blogs.com/kallberg/2010/02/how-socialized-health-care-will-radically-change-america-why-universal-health-care-will-create-a-pol-1.html].

Public health insurance-essential for system lifeguard-American health

There are a lot of discussion on the types of insurance proposals which will be required in the new health care system, which are currently being negotiated in Congress. President Obama has only come out in the framework of public health, which is opposed by private insurers, who say that they cannot compete with the plan, public health, which didn't have to generate a profit. Supporters claim public plan correctly say that it will have more choices and create more competition. Opponents argue that private health plans would go out of business, leaving only the system of health care completely Government.

Of course, all parties are exaggerating and taking up extreme positions. They are all at the time of the compromise and hopefully reach some form of agreement. Sad part is that at the moment they do not seem to be thinking of the person in the Centre of all this-the patient. Widely considered that the costs of health care, too many in this country, at the same time Americans at least 47 million are uninsured. So, from the perspective of patients, if you have health insurance, you pay way too much and getting a low value, and if you do not have it, and then simply continue to have problems. What dreadful choice. The noting of America.

The objectives of the capital health system are to lower costs and extend care to the uninsured. Obama wants a bill on his desk in October at the latest. Where can I start the Congress to compromise and why is it that Republicans in particular believe that the plans for public health are likely to be so dreadful. What is proof of this belief beyond their own philosophical ideas. Regularly make up alleged ogre "socialized medicine" whenever discusses plans for the public, but there is no evidence that countries with Federal systems with greater control over their health care, particularly in Europe, have worse health outcomes, the UNITED STATES. In fact, the contrary is TRUE, the results are much better overall health and costs much less money per capita of the population.

As a physician who has lived and worked in the USA, Australia and the United Kingdom, and who has an interest in the Organization of health services, I think that America can move forward in a way that is relatively simple, as long as we always keep the patient at the center of each system of health care plan. It is important that we do not design a system of health care primarily to protect the level of profit for some or all of the various components, whether they are vendors, insurers, health or pharmaceutical companies. We have the ability to pick the best parts of other health systems around the world, including those in the possible reform of American health care, and we should learn from other countries.

What can we do?

Firstly we should philosophy private partnerships. Australia is a good example where this works great. This means that public and private, not just private. The activities of the core American and social philosophy are based on the entities so that each new capitalist approach to health care must combine the need for profits in certain sectors of the health system, with the need to develop a number of basic public health services, which may be less likely to ever make a profit. The financing of care to include selection and should be implemented in many cases, through payments for annual or episodic whole person care, and not on a piece of individual rates as at present. These payment systems capitated works well for Kaiser Permanente, and in the UK. The primary benefit of this approach is rather to force more resources to the prevention of diseases and wellness promotion, and not for the treatment of diseases, which have begun already.

The public health care system, seemingly strongly supported by President Obama includes universal basic health insurance, as well as insurance of catastrophic care. We know that this type of system is also in America and is generally accepted and popular, because we have a very successful example of Medicare for seniors. Effectively widening the basis for Medicare for other populations could prevent many of the bankruptcy caused by the cost of health care and could include many of the current uninsured. Public insurance then you will probably pay for many services, emergency health and isolation, as well as the public health service, outstanding and postnatal care, and early, as well as some special care population, who cannot afford private health insurance, such as unemployment benefits, and some depletion or geographically isolated groups. Of course they would still be Medicare for seniors. These are areas where it will be less competition with private insurers, who are usually kept from them, but, of course, any private health insurers will be able to enter these markets and to compete if they wish to.

The private component might be funded with assistance from the wider tax incentives financial or similar tools to encourage most of the people (or businesses) to purchase private insurance. The aim should be that at least 80-90% of the population should have private insurance or comprehensive insurance or insurance payment to support the core Government provided insurance. It is important to achieve this level of insurance to ensure that everyone is financially responsible for at least a reasonable proportion of our health care costs. Here the Republicans are right as it is important that we do not care as something, which is supplied free of charge. The private sector should offer the full range of services from birth to death, but the industry should be more precisely regulated, so that they, for example, should be prevented from excluding patients due to the existing conditions. They should also have the possibility of additional charges for some services, "low", such as plastic.

These ideas are taken from and recognize the best parts of America, Australia and British healthcare systems. No country has a system of excellent health, and no country will ever. America can afford to choose the best from other countries as debates how to improve its health care system. Lets hope that Congress may be creative, look outwardly, and do not get the time down in political dogma.

Peter Yellowlees MD has recently published "health in the age of information-how can you and your doctor may use the Internet to work with". available in the http://www.InformationAgeHealth.com and most shops. E-Book download from RTM API, Blackberry, PDA and other mobile devices called "4 simple steps to better health-the appearance of the Interior" is available at Smashwords http://www.smashwords.com/books/view/1271in

National health care system in Japan and Taiwan-this could be possible for us?

Each society is affected by national amendments or new motion implemented; in connection with this problem one may think it is unrelated to its environment, you can very well affect it through the chain of cause and effect.

Health care is immediate problem applies to all of us. We have all the experience and need. Suppose you want to ask yourself if the present serious system care is satisfactory and accessible to all. It is health, medicare and medical treatment available only on selected groups? Many people to vote for a candidate who can restore the current health care system or which pioneer better distribution of health care for our country. Personally I hope that the health amendment is available and affordable for all.

The ability to receive primary health care is a fundamental need for all people. Meeting the basic needs of persons, and shelter makes it easier for you to sense that people with better health can contribute to society. Realistic and attainable standard of health should be established for all people. To this end, the need for nonprofit travel operator to establish and maintain it. Life and health of persons should not be compromised for a profit of several organizations.

Before moving to Japan, and the contract of insurance to my parents in the United States. Their policy covered by children of the family until the age of twenty-four. After graduating from University, moved to Japan and started my first job there. I was a member of the Japanese national health insurance through the company I worked for. Generally there are two types of health insurance in Japan: national health insurance and employer-sponsored health insurance. Typically, under employer sponsored insurance, insurance premium is calculated in accordance with income, the number of subsidiaries and corporate subsidies. For someone who is self-employed or unemployed, national health insurance costs a minimum of 13300 Yen, or about 110 $ per month, plus a small percentage of income for those who are self-employed. In other words, everyone can obtain insurance from around 100 dollars per month. In contrast to the Medicaid program in the United States, which is available only to certain low-income groups with specific requirements for the eligibility of Japanese health insurance is available for every citizen and legal residents. There is a ceiling for the Japanese national insurance covers, but covers all the basics and beyond.

In most cases in Japan patients choose their doctor and hospital. There is no limit to the doctors or the hospital may visit. This is a true competition among clinics, hospitals and doctors, not for profit, but for the quality. The same insurance that people have in Japan gives them the freedom to get a second opinion and naturally eliminates those physicians whose practices are data. Doctor visits, treatments and medicine are not free; one is responsible for 30 percent of their medical bills. Japanese health costs are significantly lower than costs in the United States. Thirty per cent of the medical bill is still a reasonable amount one can afford. There are also special cases or categories of diseases for which insurance would more demand. If one end of the payment, the insurance does not automatically invalid. Insurance will continue to include people as long as it gets missed payments. After all, some people run into difficulties in life at one point or another. Sounds good for real? It is true.

In Taiwan, with no recognition of the world politically, has one top public health care system in the world. After moving to Taiwan due to my husband to transfer a year go, recognized and appreciated system where universal or national healthcare is available to all, more than ever. When you speak with a universal, national or Pubic health insurance, people often turn their attention to the system of health care, well-debated and discussed in Canada. There are those whose views are negative, claiming that the medical service insurance single payer system cannot perform its ultimate, and those whose views are positive, saying that they do not live in fear of ever having to face bankruptcy for outrageous medical BILLS. From my informal investigations, québécois more I came across the favour of their national health system. Most of those who can help in improving their national healthcare systems stated that the people of Canada are secured in the need for more in their basic physical and psychological needs met.

In Taiwan there is also sponsored by the Government of universal health care not only of their citizens, but also for foreign residents, who live in Taiwan. Foreign residents can apply for insurance, sponsored by the Government after proving their legal status, who has his habitual residence in Taiwan. Insurance fee starts from basic 600NT or around 18 US DOLLARS per month. For those in higher income brackets, is calculated on the basis of their insurance on the percentage of their income on 600Nt. fees are waive former soldiers, those who are physically challenged and people who have adverse economic consequences.

Interestingly, the national health insurance in Taiwan only has been established for a little more than two decades, since 1985. Policy makers Government studied the health care system with various foreign countries and composes the first Taiwan national health care system from the concepts and methods from other countries. It is said that the national insurance system in Taiwan is like a puzzle is completed with cuts from which its country and people. Now, this insurance covers the entire population, including legal foreign residents. According to research funded by the national health research in Taiwan and the Bureau of national health insurance in Taiwan costs of health care do not grow after universal scope has been fixed (Jui-Fen & Hsiao, 2003.) What does that tell us?

Primary health care programme can greatly reduce the consequences of the disease is left untreated. Primary health care does not mean free of charge or mindless expenditure without control. To build a healthy nation, we should take a closer look at the current U.S. health insurance. After all the nation sound starts with the health of its inhabitants.

Writer's information:
The writer is a Chinese-American. After graduating from Queens College in New York City, moved to Japan and began teaching English as a second language. In the 15years old in Japan became his wife, mother and a lecturer at the university. He continued his studies after giving birth to her daughter and now leads his thesis in education. It is a positive person who is always looking forward to the challenge of new things. In Japan, many friends and students have been affected by its words and encouragement, especially women. Using herself as examples, she encourages women to student life, open minded and have confidence in Auto. Now she is temporarily residing in Taiwan with his family.

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