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Krugman om sjukvård

"The most privatized health care system in the advanced world is also the most bloated and bureaucratic."
Paul Krugman om nackdelar med privatiserad sjukvård:
"...[B]ecause we rely much more heavily than anyone else on private insurance, our total administrative costs are much higher. According to the [WHO], the higher costs of private insurers are 'mainly due to the extensive bureaucracy required to assess risk, rate premiums, design benefit packages and review, pay or refuse claims.' Public insurance plans have far less bureaucracy because they don't try to screen out high-risk clients or charge them higher fees.

And the costs directly incurred by insurers are only half the story. Doctors 'must hire office personnel just to deal with the insurance companies,' Dr. Atul Gawande, a practicing physician, wrote in The New Yorker. 'A well-run office can get the insurer's rejection rate down from 30 percent to, say, 15 percent. That's how a doctor makes money. ... It's a war with insurance, every step of the way' (Min anm: se Piecework, 4 april 2005).

Isn't competition supposed to make the private sector more efficient than the public sector? Well, as the World Health Organization put it in a discussion of Western Europe, private insurers generally don't compete by delivering care at lower cost. Instead, they 'compete on the basis of risk selection' - that is, by turning away people who are likely to have high medical bills and by refusing or delaying any payment they can."
Paul Krugman: Passing the Buck, New York Times 22 april 2005
Paul Krugman: The Medical Money Pit, New York Times 15 april 2005

Göran Rosenberg: Är sjukvård en affärsverksamhet?, DN 31 mars 2005

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28 apr 2005


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