Only in America–I’m tired of using this title

Uwe Reinhardt points out that community rating in health insurance is the norm in virtually all industrialized nations. Community ratings in these countries include age which means the elderly are not charged more than younger people–a policy omitted from our current health reform legislation.

The health systems of Switzerland, the Netherlands and Germany are frequently cited as potential models for a reformed American health system. All three countries offer their citizens a wide choice of health insurers — none of which is a government-run health plan. Yet in all three countries full community rating is de rigueur.

Meanwhile in the “best” health system in the world, insurers have been free to overcharge those with risk including the elderly to discourage their purchase of insurance resulting in part, in the 50 million citizens without insurance.

In the article Reinhardt contrasts the sense of “community” in various countries and the ethic that allows, indeed facilitates, the implementation of universal health care.

Medicynical Note: Americans are outliers in the world in a number of ways. The near religious (read on) notion of “original” intent of the founding fathers, our love affair with guns, our aggressive literal “word of God” religious beliefs, and our non system of health care to name a few.


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