Friday, January 18, 2013

Back in the USSR: a Sour Recipe for Lithuanian Healthcare

Lithuania's newly appointed healthcare minister Vytenis Andriukaitis apparently claimed in a recent interview that the former USSR had offered one of the best health care models in the world.  He mentioned the United Kingdom's NHS as his other icon. Lithuania's minister either suffers from a short memory, from a short sight... or was (hopefully) misquoted.

Universal healthcare systems designed in the past century have demonstrated that they are unsustainable and unable to meet the demands of modern societies. Countries that are still stuck with them have started to react. The British who wanted to avoid some of the NHS's notorious waiting lists could always count on a well established independent private healthcare sector. This has not stopped incremental reforms designed to introduce private provision of care within the NHS. Scandinavian countries have seen the light and have also engaged in segmental privatization of their healthcare systems.  Even Canada has begun to move in that direction.

Germany's obsolescent Bismarckian healthcare mix, highlights the shortcomings of bureaucratic management compared to private efficiency. Repeated surveys pinpointed German physicians' consistent dissatisfaction with the regulatory hurdles spawned by their system (1). Things are beginning to change: German healthcare policies now actively encourage private-public partnerships in order to improve the efficiency of ailing public hospitals (2). The trend in other European Bismarck type systems has also moved towards a significant increase of the private fraction of health care financing and management (3).

In Asia, China opened to market solutions for health care provision through the development of individual health savings accounts similar to those that exist in Singapore. Singapore's seasoned combination of medical savings accounts (Medisave) and insurance probably offers one of the most efficient health care systems in the world today and shows the way for patient empowerment and access to affordable high quality medical care.  

It seemed that former Communist countries had at one sad point in their history reached the abyss in terms of socialized medical care and had thus (painfully) become immune to collectivist quagmires. Thoughtful Lithuanians must clearly continue working towards reforms designed to offer affordable private health care for all. Socialized healthcare not only hurts patients at large. It ultimately hits all citizens who sooner or later end up paying a heavy bill for over regulated and rationed medical care.

(1) Crespo A., Stevens P. "If Government Control is so Great why are German Physicians so Unhapppy", Journal of American Physicians and Surgeons. 2011 vol 16 No2
(2) Roeder F.C. and Labrie Y. "Privatization can bring efficiency gains to public hospitals" ,  iPolitics, 2013 
(3) Maarse H"The privatization of health care in Europe: an eight-country analysis"University of Maastricht.  2006 Oct 31(5) :981-1014.