Living and working in NYC I don’t often listen to the radio. This week I’m house sitting and dog sitting in New Jersey for my partner’s cousin and her family. And today I had lunch with my aunt, uncle, and cousins on the Jersey Shore in Long Branch. When I do have an occasion to drive, it’s always tuned to NPR and I’m always pleased by the quality of coverage as I was today. On my way “home” to Edison NJ, I listened to Terry Gross interview Washington Post writer T.R. Reid about his new book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care.
Would the U.S. as a nation ever consider actually looking at other countries as examples? Could systems and processes actually work better than they do in the absolute “best” country in the world? There is no question that health care systems in other countries do work better than ours. If Fox News-watching constituents of Republican congressmen could read this book (or even listen to this interview), maybe they might change their mind and fear change less than what we’re witnessing today. Well maybe not those constituents that are not on the insurance and pharmaceutical companies’ payrolls.
I’ll update this post after I actually read this book but if it’s nearly as intriguing as it sounds after listening to this interview, I’m sure I’ll have a lot to say. As the former chief of The Washington Post‘s London and Tokyo bureaus, Reid has had first hand experience with the health care systems of England, Japan, and France. His research for the book also led him to other European countries, Canada, India, and other countries. I suggest reading his article for The Washington Post entitled 5 Myths About Health Care Around the World.
He breaks down the worlds’ health care systems into 4 models and informs us that the U.S. actually employs each of the 4 models, depending on the person.
- Native Americans and veterans have what is commonly referred to as the “William Beverage Model” (The government provides the care and the government pays for the care.), which is what they have in Great Britain, Spain, Italy and some other European countries. It’s paid for by taxes and what many Americans refer to pejoratively as “Socialized Medicine”.
- “The Bizmark Model” (Private hospitals provide the care and private insurance companies pay) is what’s employed in France, Germany, Japan, and others. The insurance companies are like community organizations with the goal of keeping people healthy. They are non-profit organizations and Switzerland was the last country to have for-profit insurance companies. A referendum changed this when up to 5% of people in Switzerland were left uninsured when certain for-profit companies In most of these countries, people have the choice of many plans. This model is closest to what most Americans have (people who receive their insurance via their employers’ group insurance plan). The big difference is the non-profit nature of insurance companies in Europe and Japan.
- “National Health Insurance Model”(A blend. Private doctors and private hospitals but the government pays). This is the system used in Canada. Because of recent cut backs due to the government trying to save money, there has been an increase in waiting time. Canadians do not want what they call a “two-tier system”. You can operate privately as a doctor, but then you relinquish your right to provide care through the national system. In the U.S., The National Insurance Model is like our Medicare, which pays most of the care for seniors over 65.
- “Out of Pocket Model” (If you can pay, you get treatment. If you can’t pay, you don’t get treatment.) This is what most countries outside of the 40 richest nations have, along with to the millions of uninsured Americans, which make up approximately 17% of our population.
For more interesting details, listen to this great NPR interview with T.R. Reid:
So why is having 4 models a bad thing? After all, we’re all about choice here in the land of plenty. Well, aside from the fact that so many Americans are currently uninsured and that the status quo is failing, the administrative efforts associated with having so many different models create inefficiencies and higher costs. Our system is the least efficient system. In the U.S. 18-20% of health care costs are administrative as opposed to 4 – 5% in many European countries and Japan.
Right now, we’re at a critical crossroads in American history. We’ve got to decide as a people if we want to continue with the status quo (a system that is failing) or if we want to really create change. According to Reid, Taiwan decided to create a health care system that actually takes care of its people. The conservative party in Tawain conceded to public opinion and actually voted in and implemented a Canadian-like system. This concession came because of public outcry. Change is what we elected Obama for but we have to take part in implementing it. Make sure your voice is heard. Here’s a list of ideas of simple things you can do.
Also, I didn’t realize what I was missing by not getting more news and information from NPR, which I’ve always loved. So today, I joined their site and community online. What a great source of information NPR is.