When a Trump official praised single-payer health care
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U.S. Health and Human Services Secretary Alex Azar was in Taiwan this week for what was the highest-level meeting between the U.S. and Taiwan in decades. A focus of his trip was to highlight Taiwan’s success in combating COVID-19 and “cooperate with the U.S. to prevent, detect, and respond to health threats.” Azar’s praise for Taiwan’s success in health is significant, especially given that he’s a member of a Republican administration.
Much of Taiwan’s success is due to its government-run, single-payer health system, established 25 years ago on the recommendation of the late Princeton economist Uwe Reinhardt, then a high-level adviser to Taiwan’s government. Reinhardt believed that a single-payer system can best achieve equity and cost savings. It’s also cheap to run, and the public can easily understand it. He was right.
Today, Taiwan’s health system covers everyone with generous benefits for about a third of the cost of American health care. This is a sharp contrast to America, where “nearly 1 in 10 adults say cost would keep them from seeking help if they thought they were infected.” Because everyone is insured and access to care is easy and cheap, there are no barriers, financial or otherwise, to receive care in Taiwan.
Second, Taiwan owes its impressive success in combatting COVID-19 to having a national plan, which is science and evidence-based and IT-driven. They implemented this plan almost immediately upon learning of the first cases of the novel coronavirus in Wuhan in December 2019.
Comment by Don McCanne of PNHP: There is some irony in our HHS Secretary, Alex Azar, praising Taiwan for setting a positive example as part of the global health community when the United States has failed so miserably in its response to the COVID-19 pandemic. Taiwan’s response to the pandemic has been spectacularly successful whereas the United States remains the leader in deaths and other disastrous consequences of the pandemic. What explains the difference?
Tsung-Mei Cheng describes the efforts that Taiwan has made in establishing public health policies and infrastructure so that it is ready for expected and unanticipated demands on its health system, plus they are responsive when the need arises.
One of the differences is that Taiwan has a single payer financing system that ensures that their people have access to the health care system when needed. In contrast, our government leaders, including Alex Azar, have been outspoken against our proposed single payer Medicare for All program, leaving tens of millions of our citizens without affordable access to our health care system and thus prime for spreading this highly contagious disorder. Also the Taiwanese government provided leadership in implementing basic public health policies that would help stem the spread of the coronavirus. In the United States, our government failed in providing this leadership and further often compounded the problems by ridiculing citizen and local government efforts to reduce the spread of this disease.
Taiwan’s efforts should be emulated, and, as Cheng states, we can still reduce the severity of the consequences of our inept national response. Sadly, although we are seeing some modest efforts finally being made, they remain grossly inadequate. It is difficult to see how we can achieve a more dramatic shift towards the necessary interventions we need without a change in leadership. The election is still months away and the time required for a new government to implement the essential changes needed will still require more months – delays during a pandemic that will certainly compound the tragic results that we are experiencing. What is even worse is that the likely replacement government has already promised us that we will not have the single payer Medicare for All system that we desperately need. What kind of leadership is that?
Now that we know the lessons from Taiwan, can’t we do a better job in applying them here? Not only would it help repair our economy, but, much more importantly, it would improve our health and likely prevent the premature loss of hundreds of thousands of lives. Do we really value life that much less than the Taiwanese?
Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction
August 18, 2020 at 7:14 PM #349004ThouArtThatParticipant
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The 1% know the score. The reality is the 1% don’t want to give up the profit and cash flow benefiting their bank accounts. In other words, their greed outweighs our collective health. Until we challenge that mindset in America, nothing will change delivery of for profit healthcare.
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