Lynn Eldred (Public Viewpoint, 11/4/09) expresses a desire to learn about the health care plans of other nations. I share her concern. Informed thinking about our current debate on health care reform can be enhanced by knowledge of the health care systems of other countries.
T.R. Reid’s just-published “The Healing of America” answers this need. Reid reports on his visits with doctors, government officials, health care experts, and patients in wealthy democracies like our own (including France, Germany, Japan, the United Kingdom and Canada), and in other countries as well. He discovered that foreign health care systems often provide more choice and shorter waiting times than the U.S. And that dreaded monster “socialized medicine” turns out to be a myth. Many developed countries provide universal coverage with private doctors, hospitals, and insurance plans — insurers who accept every applicant and never deny a claim. Furthermore, all developed countries other than the U.S. have decided that basic health insurance must be a nonprofit operation.
Reid also discovered that the current U.S. system includes elements of numerous foreign models. For most working people under 65, we’re Germany, France, or Japan, where the worker and employer share the premiums for a health insurance policy. The insurer picks up most of the tab for treatment, with the patient either making a co-payment or paying a percentage.
For Native Americans, military personnel, and veterans, we’re Britain or Cuba: The VA and much of the Pentagon’s Tri-Star system involve doctors who are government employees working in government-owned clinics and hospitals. Americans in these systems never get a medical bill The Indian Health Service also provides free care in government clinics.
For those over 65, we’re Canada. Medicare is essentially a national health insurance scheme, with the nearly universal participation and low administrative costs that characterize such systems. Americans with end-stage renal disease, regardless of age, are also covered by Medicare.
For the millions of uninsured Americans, we’re Cambodia, Burkina Faso, or rural India. These people have access to medical care if they can pay for it out of pocket at the time of treatment, or if they’re sick enough to be admitted to the emergency room at a public hospital, or if they have access to a charity clinic.
Reid also reports on how nations such as Canada have carried out major health care reform, and makes thoughtful proposals for reform in the U.S. His book is essential reading for anyone interested in improving health care in our nation.
THOMAS ATWATER
Bentonville
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