O mercado e a saúde

Leitura recomendada: Best Buy: Privatised Healthcare Systems in Europe, por Paul Belien.

Europe has basically two types of healthcare financing systems: the single payer systems, in which healthcare is paid for and organised by the government with money from income taxes (as in Britain and Sweden), and the social insurance or sickness fund systems (as in Germany and France), in which healthcare is financed through mandatory premiums calculated as a percentage of wages. Whatever way European countries have organised their healthcare, they have all seen their costs rise over the past four decades. The European countries provide more equity in healthcare than the United States, but they do so increasingly by shifting the price tag for healthcare to the next generation, by rationing health to the elderly, and by suppressing useful innovations.

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Switzerland, the Netherlands and Germany have each found different answers to the often heard criticism that a private health insurance system does not allow citizens with a high individual health risk to insure themselves. They have created healthcare systems that are less two-tiered than those in their neighbouring countries, because they allow people to buy private health insurance without having to pay twice. Because their systems rely to a larger extent on capitalisation, they have also created an investment pool of domestic capital. Though the systems have their flaws, in general the few privately insured healthcare systems of Europe seem better equipped for the future than Europe’s many government regulated systems. They are interesting laboratories for healthcare reform. They are consumer driven and they are trying out a variety of interesting ideas, such as medical savings accounts, healthcare vouchers, and bonuses. Private systems allow for experimentation, which is a necessary prerequisite for finding solutions.