Sunday, October 18, 2009

The Healing of America

America has been arguing about health care reform for 100 years. Each time it becomes apparent that “something must be done”, the politicians fail to muster the political will to overcome the heavy resistance of vested interests to reform the system in a meaningful way. It is happening again.

TR Reid, in his new book, The Healing of America, A Global Quest for Better, Cheaper, and Fairer Health Care makes a compelling case that it can be done. Other major, industrialized countries have extended care to all. Surprisingly enough, covering all actually brings down the cost of care for individuals.

Before this can happen, a country must first make the moral decision if health care should be restricted to only the wealthy and fortunate. Only in America, among major industrialized countries, is health care distributed in a market-driven model. The countries which have recently reformed their systems looked at and rejected this model as fundamentally unfair.

Reid reviewed systems in France, Germany, England, Canada, Japan, as well as in the third world, where people use the “pay as you go” system. That is what happens here unless you are employed, covered by Medicare or the VA, the last two being closer to “socialized medicine” than any of the countries Reid reviewed.

If you contract a major disease and must leave your job, you lose your coverage, just when you need it most. If you have any assets at all, you do not qualify for Medicare or Medicaid until it is too late to treat effectively. Listen or read about Nikki White.

I had many misconceptions about medical care in other countries. Reid explodes these myths (see pp 226-232):
1. “Its all socialized medicine out there”: Wrong. European care is actually less “socialized” than ours.
2. “They ration care with waiting lists and limited choice”: In many countries people have quicker access than Americans do. Some countries do, but Americans see the same with their private carriers.
3. “They are wastful systems run by bloated bureaucracies”: Wrong. Americans pay around 20% admin costs. National systems pay less than half that. Tiawan pays 2%.
4. “Health insurance companies have to be cruel”: In countries where private insurance companies administer universal care delivery, they are doing just fine and competing for customers.
5. “Those systems are too foreign to work in the U.S.”: For elderly, veteran and for native Americans, we already use models based on “foreign” countries.

As you listen and watch the process unfolding here, it will be helpful to get a dose of reality instead of the emotionally charged sound bites used by vesting political and business interests. Reid helps shed real light on the process. Don’t be a “ditto-head” and become informed about what the real fight is about.

Read or listen to more about this seminal book:
http://www.powells.com/biblio/9781594202346
http://www.npr.org/templates/story/story.php?storyId=112172939

3 comments:

  1. i've only listened to the first installment, but i think you'd like the "This American Life" shows on this. it helped me see it more clearly, i think. and also, surprisely, ended on a hopeful note. (that's only for the first hour though. who knows if the second is hopeful...)

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  2. The second is good too --I've heard them both. Dad, I do believe real healthcare should be extended to everyone --it's got to be more important than education even which we extend to everyone. However, whenever you say the whole moral decision thing, I think of stuff that people I know have "gotten covered" and a lot of it would really make me mad if it was taken out of Jeff's paycheck to pay for it. There's obviously more to reform than just covering everyone --which I know you didn't mean to imply. We're spoiled here. That's a big part of the problem.

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