SOCIAL JUSTICE OF HEALTH REFORM – IT'S NOT ROCKET SCIENCE: Lessons from Four European Health Care Models

The United States is the only remaining so-called advanced nation to rely primarily on privately-regulated health insurance for medical care for the majority its population. In part due to the lack of health care assess, the US developmental ranking in the world has fallen over the decade from 8th to 12th to 13th in 2009. US population comparative health status rankings continue to decline on the most basic fronts including survival to age 60, mortality rates from heart disease, stroke and cancers. Every other advanced, industrialized nation has transformed its health system to include governmentally regulated and financed health care for the majority of their populations. How did they make their transitions from private-sector to public-sector care? What can the US learn from their histories and models? Methodology: Four European countries were examined– two of the largest and oldest universal systems: Germany and France and two of newest system in Europe: Switzerland's and the Netherlands'. Data were collected from the European Observatory on Health Systems and Policies, the World Health Organization, the Organization for Economic Co-operation and Development, and United Nations. Leading experts in these countries were then also interviewed from October to December, 2008. Results: An overview of these social insurance systems is provided including how these systems are relevant for the US, a brief history of their systems' transformations, their basic structures, and how they contain costs. Recommendations: Outlines some unusual aspects of the systems that the US might want to both use and want to avoid.