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Swiss Health Care Krugman

Bestselling author T. R. Reid guides a whirlwind tour of successful health care systems worldwide, revealing possible paths toward U.S. reform.

In The Healing of America, New York Times bestselling author T. R. Reid shows how all the other industrialized democracies have achieved something the United States can't seem to do: provide health care for every one at a reasonable cost.

In his international quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own-including France, Germany, Japan, the U.K., and Canada-where he finds inspiration in example. Reid shares proof from doctors, government officials, health care experts, and people who are in need of medical care the world over, finding that alien health care schemes give everyone quality care at an lowcost cost. And that dreaded monster "socialized medicine" turns out to be a myth. Many formulated countries provide universal coverage with private doctors, private hospitals, and private insurance.

In addition to long-established systems, Reid likewise studies countries that have carried out major health care reform. The firstborn question facing these countries-and the United States, for that matter-is an ethical issue: Is health care a humane right? Most countries have already answered with a resolute yes, leaving the United States in the murky moral backwater with nations we distinctively think of as far less just than our own.

The Healing of America lays bare the moral question at the heart of our bothered system, dissecting the misleading rhetoric surrounding the health care debate. Reid sees difficultnesses elsewhere, too: He finds poorly remunerated doctors in Japan, endless lines in Canada, mistreated people who are in need of medical care in Britain, spartan facilities in France. Still, all the other rich countries operate at a lower cost, develop better health statistics, and cover everybody. In the end, The Healing of America is a good news book: It finds models around the world that Americans may borrow to guarantee health care for everyone who needs it.

From Publishers WeeklyWashington Post correspondent Reid (The United States of Europe) explores health-care systems around the world in an crusade to grasp why the U.S. remains the only basi world nation to refuse it is citizens universal health care. Neither financial discretion nor concern for the commonweal explains the American position, according to Reid, whose determinations divulge that the U.S. not only spends more cash on health care than any other nation but likewise leaves 45 million residents uninsured, permitting regarding 22,000 to die from effortlessly treatable diseases. Seeking treatment for the flareup of an old shoulder injury, he visits doctors in the U.S., France, Germany, Japan and England—with a stint in an Ayurvedic clinic in India—in a quest for treatment that dovetails with his search for a heal for America's health-care crisis, a narrative device that once in a while feels contrived, but allows him valuable firsthand experience. For all the scope of his exploration and his capacity to mint neat rebuttals to the mutual American misconception that universal health care is socialized medicine, Reid neglects to address the elephant in the room: just how are we to trade these changes to the mighty suppliers and insurers? (Sept.)
Copyright © Reed Business Information, a section of Reed Elsevier Inc. All rights reserved.

About the AuthorT. R. Reid is a longtime correspondent for The Washington Post and former chief of it is Tokyo and London bureaus as well as a commentator for National Public Radio. His books include The United States of Europe, The Chip, and Confucius Lives Next Door.

From The Washington PostFrom The Washington Post's Book World/washingtonpost.com Reviewed by Phillip Longman During last year's Republican presidential crucial season, prospect Rudy Giuliani succinctly captured what millions of Americans think regarding health care abroad. "These countries that say they provide universal coverage -- they compensate a price for it, you know," Giuliani told his audience. "They do it by rationing care, by long waiting lines, and by limiting, or I will have to say eliminating, a patient's choice." T.R. Reid has done a service to his nation by showing in his latest book just how uninformed this traditionalisti wisdom is. Based on his own experience and research, "The Healing of America" is both readable and informative. Many decades ago, Reid suffered an accident while in the Navy that left him with a bum shoulder, a condition that, while not acutely painful, became more and more bothersome as he aged. During his long career as a alien correspondent for The Washington Post, he and his family received high-quality, procedure care from doctors in places such as Tokyo and London. These two circumstances provided Reid with the inspiration for his book and set him off on "a quest for two cures." He traveled around the world, visiting doctors in places as diverse as Taiwan, France and India to see how their health-care schemes would approach treating his shoulder pain, and in the procedure he searched for perceptivities to heal the U.S. health-care crisis. Reid checked himself into the widely known and esteemed Arya Vaidya Chikitsalayam, an establishment that he describes as the Mayo Clinic of traditionalisti Indian medicine, and was astonished when a haughty astrologer and her retinue used a collection of shells, rocks and statuettes of Hindu gods to divine whether the stars were aligned to favor his treatment. It turned out they were. Reid then underwent a regime that involved drinking "a vile potpourri of herbal medicines, most of which tasted like spoiled greens or aging mud," as well as a diet of gruel and performance of poojah, or reverence, to the Hindu god of healing, Dhanwanthari. Perhaps more helpfully, strong, skillful therapists went to work three times a day slathering him with spiced sesame oil and massaging his whole body, with particular attention to his sore shoulder. After weeks of this treatment, Reid lost nine pounds and became a very mellow man. He likewise came across that the pain in his shoulder was gone and that he had much dandier mobility in his arm. The cost of this therapy came to $42.85 per day -- far less than that of the invasive total-shoulder anthroplastic surgery commended by Reid's American doctor, who couldn't say what replacing his shoulder might cost after the respective insurance adjusters were done. Reid would have salaried even less had he purchased Indian insurance, which quintessentially covers the treatment that fixed his shoulder, including the cost of the astrologer. Elsewhere on his journey, Reid ran into other curious truths when it comes to health care abroad that Americans don't know. For example, Germany and Switzerland manage to provide universal coverage while sustaining a more outstanding role for competing private-sector doctors and insurance companies than the United States does. In those countries, it is true that government regulation and price controls also play a big role. However, in Britain, a supposed bastion of "socialized medicine," most doctors are in business for themselves and are often highly entrepreneurial in seeking new patients; galore even make house calls. Reid learned that Britain's National Health Service would not pay for the anthroplasty his American doctor commended unless he was in acute pain, but as his Indian experience proved, he didn't need the operation. Similarly, in France and Japan, buyers have rapidly and without delay access to a broader range of suppliers than most Americans do (no cost for going "out of network"). And no one is ever refused an insurance assert or thrown into medical bankruptcy. What's more, per-capita health-care costs are far lower than in the United States and health-care outcomes better. Canada does have long waiting lists for elective procedures, but other nations such as Germany, France, Sweden and Denmark outperform the United States in supplying quick access to specialists. Reid was capable to make an appointment with one of Japan's top orthopedic surgeons the same afternoon he made his basi call. Reid acknowledges that the health schemes in the countries he studied have their own problems. He likewise admits that none has figured out how to comprise the global long-term trend toward higher costs as populations age, the disseminate of the Western modus vivendi and diet causes an epidemic of chronic illness, and highpriced new medical technologies become available. But he does demonstrate that Guiliani and like-minded Americans put forward a distorted effigy when they contend that other industrialized countries ration health care and constrain patients' choice of doctors, deny effective care and, in essence, provide socialized medicine. Reid shows us how other modern countries effortlessly combine universal coverage and government regulation with entrepreneurialism and respect for market forces to create high-quality, low-cost health care -- a simple empirical truth we may no longer afford to ignore.
Copyright 2009, The Washington Post. All Rights Reserved.

Most helpful client reviews

258 of 274 persons found the following review helpful.
BEST WRITTEN MOST INFORMATIVE
By cebepe
I purchased this book after reading Jacob Weisberg's review in Newsweek. It is the best thing on the subject for the following reasons: 1. It is well written even amusive in places. 2. It is very informative. 3. It presents comparative selective information both as to health outcomes and also ways of paying for health care 4. It is non-partisan, even even though by the end one wonders why we Americans are paying so much for health outcomes that are in truth worse than any comparable country. 5. It is revealing as to the complexity of the US; for example, I didn't know that as numerous as 80 million Americans are already covered by schemes closely identical to the British or Canadian, i.e. medicaid, medicare, military, veterans and Department of Indian Affairs - who would have thought that? But 45 million others are not covered at all. Everyone else is covered, more or less, by insurance and so are the Germans, French and Japanese etc. But what a divergence in the insurance systems! In the other countries you get insurance just like here EXCEPT THAT 1. you can not be refused 2. you can not be cancelled 3. every one is covered and 4. your premiums are regulated by government which of course is what the entire debate is about. Because here the insurance industry is for earnings and the premiums reflect that fact, the awful fact that US health is the USA's biggest industry by far, more prominent that the State of California, four times more spectacular that the military, in fact US health would be the world's 8th biggest country. No wonder the debate is so fierce. This splendid books set it all out readably and comprehensively.

201 of 215 persons found the following review helpful.
This book will have to be required reading for each American
By Michelle Long
I am a nursing student. I returned to college after 20 years in hospitality and project management in order to realize my dream of a career concentered not on cash but on providing care to the most vulnerable. One disturbing pattern has cropped up in my education- the special importance and significance (when studying the importance of avoiding potentially life threatening errors) placed more on avoiding liability than on the well-being of the patient (or "client" as we are now taught, in this money-driven society). It likewise strikes me that I have never heard it suggested that a health care professional will have to be painstaking in her work in order to prevent avoidable faults that would fetch dishonor to herself or her profession. The focus is on avoiding "costly" errors.

This is where Mr. Reid's book is a most welcome addition to the speech on health care in America. He shows us that it is possible to have an magnificent health care system that is focalized on the well-being of the patient and not the all-mighty dollar. He also breaks down a elaborated subject into an gratifying reading experience, with prose that is clear and intellectual and ofttimes humorous.

I find it exceedingly disappointing that so a great deal of Americans blindly buy into the myths in regards to the "poor" health care available in other rich, formulated nations (every one of which, with the sole exception of the U.S., provide universal health care) while touting untrue grandiose affirmations in regards to the superiority of American medicine.

Mr. Reid explains the reality of the better and for less health care schemes of nations like Switzerland and Japan in terms (to paraphrase Thomas Jefferson) "so plain and firm as to command their assent." He likewise introduces us to health care pros who are driven not by monetary motivatings but by a desire to heal and prevent illness.

If you believe that access to health care (note, I did not say free health care) is a basic humane right, then buy this book. Actually, if you are merely mesmerized in learning the honorable facts on the ground- buy this book.

97 of 107 people found the following review helpful.
Important voice in the health care debate
By P. J. Owen
In `The Healing of America' TR Reid gives a tutorial on the basic types of health care schemes in place around the world, and then tries to give an evenhanded analysis of what works in these schemes and what doesn't. What gives the book it is teeth altho is his first-hand experience of health care systems in six dissimilar countries. In his quest, Reid brings a bum shoulder to these countries to find, as he puts it, `two cures': one for himself and one for the US health care system.

There's no question something needs to be done to repair the US health care system. The idea that the richest and most technologically-advanced country would let people die because they can't get the care they need or go bankrupt because they get sick is absurd. That is why the current debate in regards to health care reform is needed. The problem even though is that's it's hard to know what we're looking at when filtered through politicians and the majority of the media coverage. They focus on the extremes, peculiarly those opposed to reform who mischaracterize the systems in other countries as `socialized medicine'. In this context, Reid provides a utile voice to the debate- whether you agree with his prescriptions or not. He de-stigmatizes the schemes of other countries and explains why we're not as far got rid of from them as we think.

He shows us how other countries' schemes are different, but likewise alike. Some `socialist' countries have private insurance and private doctors. In fact, Reid demonstrates how a heap of countries genuinely have more choice than the US. In Germany for example, one may choose from hundreds of dissimilar insurance plans and go to any doctor, whereas US citizens are in general fixed to one employer's plan and only `in-network' doctors. Some countries, like Britain, have government-run hospitals but private GPs. Some are single-payer, but most have multiple payers. Some plans are furnished by private insurance, galore by a government-run insurance fund, and others by standard taxation. What is striking regarding these dissimilar variants though is that while some Americans rip these other systems, we here in America have forms of each of them. Medicare is run like Canada's system. Veterans are put through a system like Britain's. Americans with employee-sponsored plans are in a similar scheme as humans in Germany. The divergence is that those other countries provide health care more economically and more efficaciously than we do in America.

Why? The answer lies in what they have in common. They all have a single, merged system, which allows administrative efficiencies. Ours is fragmented and riddled with administrative costs and perverse economic incentives. Their programs are all non-profit, so there's no need for insurance to cut coverage to maintain the bottom line as ours do. And they all provide universal coverage, which provides the economic incentive for preventative medicine. As Reid points out, the primary question we need to ask ourselves is, do we think people will have to die due to lack of coverage? Or must persons go bankrupt because they get sick? These are moral questions, and the US is the only rich devised nation that has so far said yes to them.

Reid does gloss over a lot of things though. He pay little attention to costs, seeing it as a problem solved once the earnings motive is gone, universal coverage is consorted upon, and government price controls are in place. Besides showing a finish lack of economic understanding, this likewise skirts the fact that costs in other countries are likewise increasing. He does point this out but only says that their costs are so much lower than America's they may afford to let them rise. (For a more intellectual and nuanced analysis of the problem of cost in the US health care scheme and a distinguishable idea for reform, see the article by David Goldhill in the September issue of `The Atlantic'.) He also polarizes the debate (like it needs more polarization) by getting into the `health care as a civil right' question. He was better-off sticking with his stronger, moral point because it's not at all inconsistent to think health care is NOT a civil right, but still have the moral conviction that everyone must have coverage. By putting these in black and white terms, he sounds like the European Socialist Liberal he had managed to stay clear from sounding like up to that point.

Still, assuming he hasn't misrepresented anything in this book or provided inaccurate facts, this is primary stuff. The health care debate is vitally primary and I think each American ought to be armed with as much data as possible. That said, some articles by Reid and when it comes to this book have been published that will give you the basic facts outlined here. For most people, those articles must be enough. Only shell out for the book if you're mesmerized in a deep dive on the subject.

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