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What world can teach U.S. about entitlements April 27, 2014

Posted by Terrys Terryorisms in Economy & Business, News and politics, philosophy & politics.
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Entitlement Lessons From Abroad A new report, by the Center for Strategic and International Studies, notes that many countries have recently enacted reforms that have trimmed benefit formulas, raised retirement ages, and put in place new funded pension systems that supplement or partially substitute for pay-as-you-go government systems.

Several countries – including Germany, Italy, Japan, and Sweden – have gone further and introduced “automatic stabilizers” into their public pension systems that, directly or indirectly, index benefits to the growth in the payroll tax base. These stabilizers may differ in design, but they have two crucial characteristics in common. First, they are all expressly designed to offset the full impact of demographically driven cost growth. And second, they are all self-adjusting. In effect, they put entitlements on a new kind of autopilot – one that is preprogrammed for cost constraint rather than for cost growth.

ChangeInEntitlementBenefits 2010to2040It’s ironic that other developed countries, most of which have faster-aging populations and more expansive welfare states than the United States, are leading the way on entitlement reform.  Part of the explanation may be that, until recently, America’s age wave still loomed over the horizon, while in Europe and Japan aging populations have been burdening public budgets, forcing up payroll tax rates, and slowing economic growth for decades.

Part of the answer may also lie in America’s peculiar entitlement ethos.  In Europe, government benefit programs may be fiercely defended, with the opponents of reform manning the barricades and calling general strikes. But in the end, everyone understands that they are part of a social contract that is subject to renegotiation and revision.  In the United States, much of the public views Social Security and Medicare as quasi-contractual arrangements between individuals and the state.  This mindset, which is encouraged by the misleading insurance metaphors in which the programs are cloaked, may make old-age benefits more difficult to reform in the United States than in Europe’s large welfare states.

via What world can teach U.S. about entitlements – Global Public Square – CNN.com Blogs.

The Canadian AMA Wants To Add Private Option August 17, 2009

Posted by Terrys Terryorisms in health.
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The incoming president of the Canadian Medical Association says this country’s health-care system is sick and doctors need to develop a plan to cure it.

“We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize,” Doing said in an interview with The Canadian Press.

The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there’s a critical need to make Canada’s health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.

His thoughts on the issue are already clear. Ouellet has been saying since his return that “a health-care revolution has passed us by,” that it’s possible to make wait lists disappear while maintaining universal coverage and “that competition should be welcomed, not feared.”

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This “activity-based funding” would be an incentive to provide more efficient care, he has said.

via The Canadian Press: Overhauling health-care system tops agenda at annual meeting of Canada’s doctors.

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