It’s not that simple

16 May

It’s not that simple.

The US health coverage system would be the most complex on planet earth according to the article referenced below [1].

Indeed the author of the article published in the rubric “perspective” of the new England Journal of Medicine wrote (quote):

“…the ACA was crafted to leave in place as much as possible of the preexisting system of health insurance. The problem was — and is — that this decision meant that reform had to be built on the most complex, kludgy, and costly system on planet Earth. Multiple layers of health coverage — as a fringe benefit of private employment, as compensation for military service, as public charity for the poor, as public coverage for the elderly and disabled, and as a private commodity purchased by individuals in a remarkably dysfunctional market — overlap and intersect to pay for care through a bewildering variety of agents in a system that even experts seldom fully comprehend.” (end of quote).

Until now I thought it was the French system that occupied the top place with numerous special schemes. If you want to have an idea of the French system you can consult the document issued by the French Agency for the Development and Coordination of International Relations (ADECRI) [2].
click to read the document

Anyway, be it in the US or in France, a nation wide health care coverage system unavoidably has to be complex if it intends to be comprehensive.

1- Aaron HJ. Here to Stay — Beyond the Rough Launch of the ACA. N Engl J Med. 2014 May;Available from: .

2- ADECRI The French Social Protection System, booklet downloadable from the Agency’s website: Copyright © ADECRI, 2008.


One Response to “It’s not that simple”

  1. qualityhealthcareplease May 16, 2014 at 6:09 am #

    Einstein is quoted as saying “formulas should only be as complicated as necessary”. This applies to health care. Health care is complicated and the system to manage it will need to be complicated. Similarly, the stock market is complicated, oil drilling is complicated, and building an airplane is complicated. The real question is who should have to deal with the complexity of health care? In my opinion it should NOT be the patient. The health care system should give people health cards, they go to whatever health care service they need, show the card and get the care — done. No paperwork, no claim forms, no denied claims. But, the complexity exists for the health care system hidden from the patient — let a computer deal with the complexity. Just pay your monthly premium.

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