We are not the world
Nov. 15th, 2006 11:09 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
lurkittyThere was a time when South Africa was synonymous with hate. Its political system, apartheid, was overt, institutionalized racism. Its leaders were shunned or considered criminals by much of the world. The country was held up as the last bastion of an old, outmoded world that was sick and wrong.
Since the fall of apartheid, South Africa shares an important distinction with the US. It remains the only other developed country that lacks a national health care system. One difference is that they have tried medical savings plans.
When apartheid fell, their system was very much like that of the US: employer-based. Facing the fall of their entire system of government, all sectors were deregulated, including health care. This left a "competitive" system to sort itself out in the wake of th e social revolution.
What happened was the development of the "medical savings account" scheme that freed the consumer form being tied to a job to receive health care. In reality. it skimmed the healthiest young adults from the system, leaving the old-style insurance companies with the burden of dealing with the most infirm with the balance of healthy clients paying into the system. Furthermore, the system ignored the advancing HIV epidemic and had to be forced by the government to cover antiretrovirals under medical savings account plans. The entire effect has been to drive the cost of coverage up, not down. Medical savings accounts do nothing to contain the cost of health care, nor do they increase competition. They are anticompetitive and more costly in the long run! South Africa is now struggling to reregulate its health care market.
The US has to stop and consider the South African experience before leaping head first into the medical savings account debacle. There was a wealthy, advanced nation. They could not make it work. What makes lawmakers think it will work here? The majority of the uninsured in this country don't have enough money to contribute to a conventional savings account, much less a medical savings account. And given that most bankruptcies in this country are undertaken because of medical reasons, few would qualify for such accounts.
The US would do well in following South Africa's lead in turning away from this model.
As to following South Africa's lead? South Africa is the first nation on the African continent to legalize gay marriage. It says something when we are less free than the former home of apartheid.
Since the fall of apartheid, South Africa shares an important distinction with the US. It remains the only other developed country that lacks a national health care system. One difference is that they have tried medical savings plans.
When apartheid fell, their system was very much like that of the US: employer-based. Facing the fall of their entire system of government, all sectors were deregulated, including health care. This left a "competitive" system to sort itself out in the wake of th e social revolution.
What happened was the development of the "medical savings account" scheme that freed the consumer form being tied to a job to receive health care. In reality. it skimmed the healthiest young adults from the system, leaving the old-style insurance companies with the burden of dealing with the most infirm with the balance of healthy clients paying into the system. Furthermore, the system ignored the advancing HIV epidemic and had to be forced by the government to cover antiretrovirals under medical savings account plans. The entire effect has been to drive the cost of coverage up, not down. Medical savings accounts do nothing to contain the cost of health care, nor do they increase competition. They are anticompetitive and more costly in the long run! South Africa is now struggling to reregulate its health care market.
The US has to stop and consider the South African experience before leaping head first into the medical savings account debacle. There was a wealthy, advanced nation. They could not make it work. What makes lawmakers think it will work here? The majority of the uninsured in this country don't have enough money to contribute to a conventional savings account, much less a medical savings account. And given that most bankruptcies in this country are undertaken because of medical reasons, few would qualify for such accounts.
The US would do well in following South Africa's lead in turning away from this model.
As to following South Africa's lead? South Africa is the first nation on the African continent to legalize gay marriage. It says something when we are less free than the former home of apartheid.
