"Too many minds, one mind."

The one thing that I've learned and have been influenced by our class in thinking is that health care is a right. Initially, I had a difficult time understanding this idea, but looking at various health care systems around the world showed me that most countries think the same way, therefore providing universal coverage.

In Israel's case, I find it interesting that prior to the National Health Insurance law in 1995, 96% of the population was already covered by one of the four "sick funds." The article states that this was possible because of graduated membership fees, which were "founded on need, not on the ability to pay," and also the employers health tax. What was so wrong with this program that they instituted a new law? Was this for the 4% uninsured?

Before the US jumps onto the universal coverage bandwagon, maybe we can apply the "founded on need, not ability to pay" concept. Health insurance fees based on income and family status, would make insurance in the states more varied, yet more affordable. But, then again, since our insurance market is so profit-driven, I really don't know what the insurance companies would feel about this.

The biggest difficulty with the US reform is the US mindset. In the movie, "The Last Samurai," there is a scene in the movie where Tom Cruise is learning to sword fight, but keeps losing to his opponent. A man in the audience approaches him and says, "too many minds, one mind." Then Tom Cruise thinks about the statement, then wins his first match. Similarly, the US is filled with too many minds and opinions. Before we make any reform, we must reunite.

Israel has partial similar health insurance system as U.S., but the availability of services to their people was founded on need, not ability to pay. The ratio of physicians to 1000 persons is 4.6, one of the highest levels in the world and the health system has over 2000 community-oriented primary care clinics operated by the sick funds, the Ministry of Health or the municipalities. The Ministry of Health also operates and funds a successful community health service: a nation-wide public network of 850 mother-and-child-care centers, which offers low-cost easily-accessible services, health education programs, regular checkups to monitor child development and a comprehensive immunization program (newborn to 5 years). As the article mentioned all these health-prevented approach above, the U.S. health care reform could definitely learn to put more emphasize on prevented health programs and facilities, the community-oriented primary care clinics and the public network mother-and-child-care centers are the basic primary care access to people, the U.S. health care system could just simply follow these primary facilities ideas and then enhance the financing management of these facilities; with better primary care emphasize, the future health care cost of total population would have the chance to go down to help rationing the huge U.S. expenditure of health care and relatively poor quality.

Reform by modeling others...

Since United States' main issues are the amount of uninsured and inflated health care costs, United States could learn from Israel that:

- "Two factors have played a major role in the maintenance of a high level of coverage among the population: Membership dues were graduated by income and based on family status, and availability of services was founded on need, not ability to pay."

Because of historical and cultural reasons, I believe the second statement doesn't hold true in the United States, but should be. Health care in the United States has been left to the free market and therefore competes on ability to pay, not need. If the reform passes, health care in the United States will be limited in the free market by government.


Also, to design the insurance exchange component of the U.S. reform it could follow Israel's "basket of basic health services" guidelines:

- "Every resident must register as a member with one of the four sick funds."
(Individual mandate)

- "The sick funds may not bar applicants on any grounds, including age and state of health."
(no exclusion based on pre-existing conditions)

- "Equal status is accorded to all four sick funds."
(Not included in U.S. reform? I don't know exactly what this means...)

- "Health care services covered by the law" are predetermined.
(Public option)

Although, Israel has budget issues also.

For blog question: healthcare system in Israel

Click on the link to learn about Israel's healthcare system.