TALK about a flip-flop. Having initially promised to
reverse it, Republican nominee Mitt Romney now says that if he wins the
presidency, he will retain some elements of "ObamaCare".
Romney may find some clues on what to keep in The Lancet,
which last week published research showing that having all Americans
take out health insurance is the only way to get a healthcare system
that truly benefits everyone (doi.org/jbv).
In countries such as China,
Vietnam, the Philippines, India and Ghana, up to half of all costs are
paid "out of pocket", that is, directly at the time of treatment. Data
from 120 countries, cited in another paper (doi.org/jbw),
showed that for each 10 per cent increase in government health
expenditure per head, 5 per cent fewer women die in childbirth. But for
each extra 10 per cent paid out of pocket, there were 11 more deaths per
1000 women.
The key to effective universal healthcare is to have pooled finances
,
through either direct taxation related to income or mandatory
insurance, says Bill Savedoff of the Center for Global Development in
Washington DC, lead author of one of the papers. "If everyone pays out
of pocket, the rich get the care they want but the poor don't," he says.
"When you combine people's payments into a pool, you start to be able
to manage care for whole populations."
,
through either direct taxation related to income or mandatory
insurance, says Bill Savedoff of the Center for Global Development in
Washington DC, lead author of one of the papers. "If everyone pays out
of pocket, the rich get the care they want but the poor don't," he says.
"When you combine people's payments into a pool, you start to be able
to manage care for whole populations."
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