While I tend to agree with Paul Krugman that the Obama healthcare proposal is most akin to a Swiss-style healthcare programme {Hat Tip:: KM}, I think it’s useful to look at systems comparatively. This clip is not from Sicko, but from CBS Sunday Morning::
While the French model is having its problems on the financing side and it is indeed embedded with French culture, I think it provides insights into thinking about healthcare as an institution. I’m interested in how policy can shape innovation and if the federal government has monopsony power, it can create incentives for improvements in delivery. The diagnostic approach and the housecalls are interesting approaches, but this would necessitate change. Sociology predicts that there will be institutional resistance to change, but health care reform has the unique opportunity to shape new institutional logics. I saw a presentation at ASA on compliance with a law limiting the hours of medical residents. You would think it was a no-brainer. It’s the law, hence there would be compliance. Wrong. The social construction of the medical establishment overrode this, shaping actual praxis.
Twitterversion:: Clip from #CBS Sunday Morn. on French healthcare. While not directly applicable, food 4 thought re: innov. & improvements.http://url.ie/28qf @Prof_K
Song:: La Mer
Comments 2
pablo — August 20, 2009
Frontline did coverage about the health care system around the world:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
Kenneth M. Kambara — August 20, 2009
@Pablo:: thanks so much for posting the link. I thought I missed that Frontline, but when I clicked on it, I recalled seeing it. It's interesting to compare the systems, but just as interesting to see how they are embedded within cultural values {British, Japanese, German, Taiwanese, & Swiss} and institutions {e.g., the medical profession}. José's post mentions the issue of clashing value orientation and now I'm wondering how much of the healthcare debate is shaped by framing, how much is rooted in dimensions of political ideology {e.g., government intervention}, and the interaction of the two.
The Swiss experience is interesting, as it was a close referendum on reform, but now healthcare is viewed as a success.