Beyond “Sicko”— Thoughts on Health System Reform
نویسندگان
چکیده
CAPLAN: I know of no evidence that the citizens of nations with universal coverage “overutilize” health care services. Some of these systems tightly regulate access to specialty care by requiring referrals from primary care physicians, so they use gate-keeping to discourage overuse. Others strictly control expenditures on high technology and on expensive drugs; you can’t overutilize resources that are not there. To give a bit of credit to the nations with universal coverage, they also tend to be more oriented toward prevention so they have well-baby programs, visiting nurses, some house calls, good physical exams for kids. This cuts back on overuse since demand is somewhat controlled by providers, not consumers. Lastly, the financial incentives to indulge overuse in terms of doctors‚ time and energy do not exist in salaried systems of compensation. The U.S. seems to be far more prone to inefficiency in the use of services then do the nations of Western Europe, Australia, New Zealand, Japan or Singapore.
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