About this title: "New York Times"-bestselling author Reid shows how all the other industrialized democracies have achieved something the U.S. can't seem to do: provide health care for everybody at a reasonable cost.
Note: This is a general synopsis. Each listing is described below.
Edition: 1st edition
Binding: Hardback
Publisher: Penguin Group Usa
Date Published: 2009
ISBN-13:9781594202346ISBN:1594202346
Description: "New York Times"-bestselling author Reid shows how all the other industrialized democracies have achieved something the U.S. can't seem to do: provide health care for everybody at a reasonable cost. read more
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"An informative and entertaining look at the health systems around the world that consistently rank higher than the US and are often the subject of political rants here in the US.
It was interesting to see the variety of approaches taken by countries such as Germany, England, Canada, France and Japan. Regardless of the system, at the core of eachis a belief in universal coverage/access, health care financing as a non-profit venture and a drive to maximize efficiency. Also, each nation had a cultural basis for pursuing a national health system. Whether it was Otto Von Bismark using a national health system to help form a united Germany or Taiwan creating one to help show it's people why it was a better nation than that "other" China, you can not separate the origins of the system from the culture of the society as a whole.
It turns out that we are familiar with a few of these systems as Medicare is based on the Canadian system (including the name), the VA resembles the English model and Germany uses an employee/employer system.
I think most Americans would be surprised at the level of innovation, efficiency and (dare I say it!!!) market competition that exists in the various healthcare systems.
The author spends some time covering the failure of Bill Clinton to achieve universal healthcare in the US in 1993 (and contrasting it with two nations that did pass universal healthcare at the same time). His criticism falls on Clinton's push for the plan on economic reasons rather than moral reasons. In other words, saving money instead of saving lives.
But I had some disagreement with this part of the book. I don't think you'll every sell the idea of a national health system in the States based on the moral idea of "we are the richest country in the world and should provide for the poor and downtrodden.....etc." America is far to individualistic and socially fragmented for that to happen. Plus, there are other factors which would have to radically change in order for it to work. For example, almost every physician at every level in these systems makes far less money than physicians in the United States (the strange exception being primary care docs in the UK). That loss of income is offset somewhat by medical school being free in most of these nations and malpractice insurance costing 1/10th to 1/400th of what in costs in the States. Those differences make it much more difficult for a doctor in the US to work under a national system unless we pay them back for medical school and do away with malpractice. No, the only way you'll see a National Universal system in the US is if there is a complete and utter economic collapse of the current system....and let's hope that never happens.
Regardless, it is worth reading and informative. If nothing else, you'll know whats what the next time a colleague or talk show host starts ranting on !!!!!!European Socialized Medicine!!!!!ARGGGG!! OBAMACARE!!!!."
"I wish I could force every member of Congress to read this book right now. It is an excellent fairly unbiased look at American health care compared to other mostly successful health care models from around the world. Reid makes no qualms about the fact that he thinks that American health care is broken and that it is a moral travesty that the United States does not provide universal health care coverage, something I am in complete agreement with. He however does not espouse any one model over another.
He begins the book with a look at how the American health care system currently stands and how we spend more on health care than almost any other developed nation in the world with much worse result and the reasons we have these issues.
He categorizes health care models into 4 types.
The Bismarck Model found in countries such as Germany, France, Japan, and Switzerland has both private providers and private payers with insurance plans usually financed jointly between employers and employees through a payroll deduction. This is similar to what we currently have in the United States with the major difference being that in these other countries the insurance companies are non-profit charities that are required to cover everyone.
The Beveridge Model found in Great Britain, Italy, Spain, and Hong Kong involves the government providing a health care system that is financed through tax payments. Most doctors are government employees working in government owned facilities. Americans use the Beveridge model to run health care through the U.S. Department of Veterans Affairs and the Indian Health Service, which provides government run health care for Native Americans.
The National Health Insurance Model found in countries such as Canada and Taiwan combines elements of the Beveridge and Bismarck models. The health care providers are private entities, but the payer is a government run insurance program that all citizens contribute to. This type of system is used in the United States for Medicare.
The Out-of-Pocket Model is found in the worlds poorer nations. Citizens of these countries have minimal access to health care and the health care they receive must be paid out of their own pockets. Thus generally the only the rich are able to receive medical treatments. For millions of Americans who cannot afford health care or who have been denied access to health care by insurance companies, the out-of-pocket model is the health care system they are living under.
As is evidenced in the previous descriptions the American health care system combines elements of all the major health care models, which Reid claims is part of the problem. Too much overhead and administrative costs go into reconciling all these different forms of health care causing many of our high health care costs.
Much of the book is spent visiting countries who use each of these models in their health care systems. Reid has an issue with his shoulder that he gets looked at in the U.S., France, Germany, Japan, the United Kingdom, Canada, and India. For each country he describes their health care system, the history and culture of the country that led it to the system it currently employs, and his own personal experience as a patient in that country. He is blatantly honest about the benefits and drawbacks of each model. His main point is that no system is perfect and pretty much every system is dealing with rising health care costs, but that of the systems running in the developed nations all of them are doing better than the U.S.
By the end of the book Reid seems much more optimistic than I am about being able to enact meaningful health care reform in the United States. He thinks one of the major failings of health care reform to date is that it has been framed around economics. He believes that if we reframe the debate as a moral issue than meaningful progress would be made. I however am doubtful.
I thought this was an excellent book and think that it should be required reading for anyone with a stake in health care reform."
"Journalist T. R. Reid traveled the world to learn about how other countries deal with health care. This well-researched book describes that journey and his conclusions.
How does the United States compare to other industrial nations in health care? What different kinds of health care systems exist? Why does ours fail?
Reid answers these questions and more, with non-partisan, cogent analysis that, while not as readable as Malcolm Gladwell, is definitely not dull.
Oh, and brief answers to those questions: (1) The US ranks below all other industrialized nations in nearly every area of health care. Almost 1/6th of our entire population is not covered by any insurance, while 95-100% of people in other countries are. Because 700,000 thousand of our citizens declare bankruptcy each year because of medical bills--while the number of these cases in Britain, France, Germany, Japan, the Netherlands, Switzerland, combined, equal zero. 45,000 people in the US die every year because of inadequate health care. Despite these lapses, the US is by far the most costly, spending 16% of our GDP on health care, between 50% and 150% more than other industrialized nations--all of whom cover every one of their citizens.
(2) There are four different kinds of health care systems, according to Reid. He breaks them down quite succinctly. Most of them use private providers and insurance companies to provide basic health care to the entire population.
(3) The US system fails because, most of all, our nation has not committed to the moral imperative that all citizens deserve basic health care. Because the health care system in the US is not a system; it is a marketplace, in which people qualify based on either their ability to pay, or their ability not to be sick. Because in the United States, insurance companies spend only 80% of each dollar on actual health care, while in other countries, this percentage is between 90 and 95%. Because while health care in every other industrialized nation is organized as a non-profit utility (like schools, fire departments, police departments, local power companies, etc), in the United States, the industry is organized to generate shareholder profit.
The evidence is unassailable: while we have some of the best medical capability in this country, we are not using it effectively to ensure the health of our workforce, our families, and our children. Other countries have figured it out. Reid does a compelling job of mapping how they did it, and what we might do in the US.
It's a timely book, and should policy-makers read it (or citizens advocate for its conclusions), it's a book that could have a real and lasting effect in our nation.
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WHY I READ THIS BOOK: I heard an interview with the author on our local KUOW radio station. He was a good subject over the air, and kept saying how he was a journalist and needed to write a book that would not bore the hell out of readers. Wanting to learn more about the issues, I got this book at Elliott Bay Bookstore a couple weeks ago."
"T. R. Reid offers a prescription for our worst disease...bad health care at a high price. Want to see what our medical history is and our prognosis in the context of the rest of world? This book is the answer without the side effects of political rhetoric and pundit puffery. Reid is informative, witty, and clear sighted. He offers a succinct analysis of other health systems that work better and cost less than ours. It is obvious that we lack any functioning program and that our government has a key role to play...just as it does in regulating commerce, inspecting our food supply, assuring our defense, maintaining civil rights, and protecting all citizens. Health care belongs in one of those categories, and the interests of insurance companies have little to do with keeping us well.
This book offers a balanced view of where we are and what possibilities exist for us to enjoy the level of health care that would raise us above our current Third World level. Actually, even Ghana has a national health system that while lacking medical personnel and facilities is at least comprehensive, accessible, and equal for all. If there is a sickness in America, the source of the disease can be found in the failure of our politicians to offer American their constitutional right to the pursuit of happiness...a benefit of being well."
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