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Two-Tiered U.S. Healthcare System Looming

Philip Betbeze, for HealthLeaders Media, October 21, 2011

Admittedly, moving to a two-tiered health system such as we see in the U.K., Canada, and parts of Europe would take time. There will be plenty of opportunities for course correction along the way to avoid it. But given what we know now, a two-tiered healthcare system may be coming.

Some could argue that we have a two-tiered healthcare system right now, and I couldn't argue about that conclusion. We have to decide as a society whether a two-tiered system would be better than what we have now, or if it would be worse.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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7 comments on "Two-Tiered U.S. Healthcare System Looming"


Anna Cox (10/25/2011 at 3:25 PM)
"...worse doctors, and poorer quality institutions..." What a biased and poorly informed statement. I've spent most of my career as a NP working in community outpatient clinics, providing care to those without insurance, or with public health insurance. No, this is not a recipe for getting wealthy, but to suggest that the providers who work to care for these patients are incompetent and offer poor quality care, is beyond the pale. You owe the hard-working men and women of community care a big apology.

Phyllis Kritek (10/25/2011 at 12:05 PM)
I am one of the persons arguing that we have a two-tiered system now, perhaps even more than two tiers. There are hundreds of studies that document that fact, particularly those that address inequity in health care services for the indigent and for some minority populations. It is disingenuous to posit otherwise. And equally disingenuous to posit that the PPACA is going to suddenly introduce inequity in care. Health care in the US has for some time now been better for you as a patient if you are wealthy and meet an array of other less overt criteria. PPACA may simply make that fact more transparent.

Tyco Brahe (10/24/2011 at 1:47 PM)
Of course we already have a two-tiered system: Those who have insurance and those who don't. The free market will never give us an answer as economists all agree that healthcare does not follow free market principles[INVALID]everyone will have to use healthcare sometime. There is no choice. Even Adam Smith, the father of the free market, believed that healthcare may be better served by the government. America will have to do what the rest of the developed world has already done: Universal healthcare, most effectively with a Medicare-for-all single payer system. Any other system just delays the inevitable.