As I write this I am in Warsaw, Poland. As is my habit when I travel, I asked locals about their health care system. While the average person may not be an expert on the technicalities of the system, they know first hand how it works. No matter who I ask from Russia, to Germany, Costa Rica, England, France, etc. and now Poland the answer is similar. If you see your regular (primary care) doctor it’s fine, but if you are referred to a specialist or for further testing or scans you wait and wait, months is often the reply. I don’t know all the reasons for this consistency and perhaps they vary from country to country, but there is one common theme. The systems are all run by or heavily controlled by government. Budget worries and a shortage of providers and facilities is usually what people think is the cause of long delays.
I asked one fellow what percentage of pay is taken in taxes for health care. He didn’t know the percentage, but he knew it was $150 which is 12.5% of the average monthly income in Poland. He then added, “but you wait.” In Poland the people I spoke with made it a point to note that if you don’t want to wait and have the money, you can pay privately. In Germany they pay 15.5% (half paid by employer) of pay for health care, extra for each dependent and if you can get a better deal you can buy private coverage from any one of hundreds of insurance companies. If you use a doctor, you pay a $10 co-pay each quarter to keep over utilization down.
All this doesn’t mean these systems are bad or that people are not generally happy with them because I hear very few serious complaints. They like the fact payroll taxes pay for their care although not the amount deducted.
The fact is there is a price to pay for centrally managed health care and providing universal coverage. That price is that you can’t have everything you want when you want it (or necessarily for what you perceive as “affordable”).
There are many people in America who see such as system in our future and perhaps they are right, but we should realize that there is more to this than just coverage for all.
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