Thursday, December 10, 2009

Healthcare for everyone?

When and if health care reform legislation is passed by Congress and signed by the President, it will not be the last word on health care in America. We have much to overcome to achieve a system that comes close to the fairness, quality, and cost-effectiveness of systems in other wealthy nations.

In his book, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, T.R.Reid describes our flawed system of health care (if it can even be called a "system") and compares it to health care in other countries where he has lived and worked, including Germany, Japan, France, England, and Canada. He not only seeks a solution to our health care problems as a country, but is personally looking for the best treatment for a bum shoulder. (Surprisingly enough, the most successful treatment yet for his shoulder injury he finds in India where he checks himself into a clinic for several weeks. After consulting with an astrologer, he goes through a rigorous program of exercise, reading of Hindu scriptures, massage, and a restricted dietary regimen. All this results in less pain, a greater range of motion in his shoulder, and a 9-pound weight loss. He compares this to the prospects of surgery for a complete shoulder replacement, recommended to him by an American orthopedic surgeon.)

The strength and weakness or our own system of care is its diversity: we provide socialized medicine to the military, veterans, and native Americans; a single-payer system of health insurance through Medicare and Medicaid to people over 65 and those who are poor and disabled; employer-based health care insurance to others; and for the uninsured, an out-of-pocket system resembling that of the poorest countries where medical care is based entirely on the ability to pay.

All the other industrialized countries that Mr. Reid covers in his book have certain characteristics in common: each has come to the conclusion that providing basic health care to everyone is a moral obligation and this achievement is the source of national pride; private health insurance is provided only on a non-profit basis; and health insurance and health care are heavily regulated and controlled by the government. All health care systems, including ours, rations care. No matter how good health care is in a particular country, people complain about it. All systems have their flaws and all are threatened by rising costs.

T.R. Reid has been interviewed many times on TV and radio. To get an idea of what he has to say about health care systems and what works and does not work, listen to an interview he did on August 24, 2009 with Terry Gross on Fresh Air, a National Public Radio show.