Let's Read a Book!

There is very little upside to a missed flight connection and 24 hours of stand-by hell, but one important benefit of this recent unscheduled trial for me was time to read, specifically The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care.  The book follows reporter T.R. Reid and his bum shoulder joint on a search through all the major health systems on the planet for adequate care and relief.  His account is instructive to the non-economist (like me) and simply told for non-medical personnel (like me).  I highly recommend.


The story of his travels parallels his investigation of health care delivery and financing in a personal and a national way, in the U.S., Canada, Britain, France, Germany, Japan and India.  What he details for us in this MUST READ are that most of the wild accusations and dubious claims about health care in other countries over the past 18 months of echo are based on elements of truth.  Put another way, both sides of the argument have legitimate points to support their positions and to discredit the opposition.  Both sides.  That's what makes this such a vexing issue.

The key takeaway from this book for me was an understanding of the four major health care systems in the world, how they operate, and why they operate in that fashion:
The Beveridge Model:  Free health care for all, financed by taxes.  Classic "socialized medicine".  Countries that uses this model, or a variation, include Great Britain, Italy, Spain, and most of Scandinavia.
National Health Insurance Model:  Providers are all private, but the government runs the insurance side of the business.  Single payer system.  This is the program in Canada, as well as Taiwan and South Korea.
The Bismarck Model:  Health care providers and payers are all private, and the program is usually financed through employer and employee contributions.  There is choice and competition in this model, but the system operates as a non-profit.  Germany, France Japan, Belgium, and Switzerland fall into this category.
Out-of-Pocket Model:  The rich gets care.  The poor get sick and die.  This is the program in the Third World, and the United States.

All 4 models exist in one way or another within our hodgepodge delivery system.  According to Reid:
If you are a working person under 65, we're most like Germany.
If you are a member of the military, a veteran, or a Native American, we're Great Britain.
If you are over 65, we're Canada.
If you are among the 45 million uninsured, we're Cambodia.

Throughout the recent rancor and angst over health care reform, I often wondered why 3 points were not emphasized with more passion:
1.  Access to health care for all citizens of the world's richest nation is a moral imperative.  Profiting from the denial of treatment is evil.
2.  Our country spends 17% of its' GDP on health care, and yet does not deliver the best results in the world OR cover everyone.  Our global competitors spend less and have a healthier workforce.  Health care access is an economic imperative, and we are LESS competitive in a global economy without universal coverage.
3.  We are foolish jingoists not to openly embrace the successful elements of the models in place in other countries, be they friend or foe.  In fact, for our elderly, government workers, and military members, we have already enacted "foreign" non-market based programs.

I do not know if the recently passed health care reform will work, or be embraced by the populace.  I do know that the debate and the resulting legislation would be healthier and more based on facts than fictions if everyone had read this book.

I recommend picking it up at your local library, and don't wait until your next canceled flight.