Long ago in 2009, I wrote about a PBS special hosted by Journalist T. R. Reid, in which Reid analyzed the health care systems in five other countries: The UK, Japan, Germany, Taiwan and Switzerland. Reid had spent a full year in those five countries trying to figure out how they provided universal health care at much lower cost than the U.S. with better results. He later published a book about it, The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care (available on Amazon).
The good news is Reid did a wonderful job, both in his book and on his PBS special. The bad news is things in the U.S. have only gotten worse since then. Health care costs as a percent of GDP have increased three percentage points since 2009 to about 20% (the Opioid epidemic and COVID haven’t helped), and our health care outcomes have remained sub-par to the rest of the Organization for Economic Co-operation and Development (OECD), the 38 country organization of which the United States was a founding member 60 years ago.
I was reminded of Reid’s work while preparing my two-part Medicaid expansion series published over the last two days, and I couldn’t help thinking the ACA’s Medicaid expansion provision, for all the good it has done, only aims to put a band-aid on a mortally wounded patient.
In America, health care has become a commodity, a market-driven enterprise. Throughout the rest of the developed world, it is an essential human right; something governments were created to provide and protect. In America, 55% of us have earned the right to health care by working for an employer who provides it. Another 18% of us have earned health care by reaching the age of 65. A further 3.7% have earned it by serving in the military. The remaining 23.3% are on their own, which is where Medicaid comes in. Sadly, it appears many powerful people resent that final group and our inclination to provide them what the rest of the world views as a moral duty.
In America, legend, myth and vulnerable gullibility influence many of our citizens, who have been led to believe any government intrusion into health care will lead to draconian tactics typical of a fascist state (remember Sarah Palin’s death panels?). They don’t seem to realize that health care provided by our Veterans Administration, treating millions of our veterans every year (including this one), is a direct copy of Britain’s. Or that Medicare, our largest insurer with more than 62 million members who, in poll after poll, report high satisfaction with their health care, is modeled on the health care system of Canada.
Maybe American health care is just too big to be redesigned into something that would make us all proud. Too many vested interests, each making boatloads of cash. Each saying they support creating a better system ― just as long as we don’t touch their sacred slice of the profitable pie.
But when I’m tempted to say, “A plague on their houses,” I think of the Taiwanese, who went from nothing to one of the most technologically advanced, yet inexpensive, health care systems in the world in just fourteen years. And I think of the Swiss, the bureaucratic, economically driven, bankers-of-the-world Swiss, who took off their stuffed shirts and came to see high-quality, affordable health care as the absolute right of every Swiss citizen.
The health care systems in Taiwan and Switzerland have flaws, but, even so, they are light years ahead of the U.S. in terms of quality, cost and universal coverage. If these two totally different countries can do that, I ask you, why can’t we?
Eventually, America is going to have to decide if good quality health care is a basic human right, or a privilege to be earned.
Tags: health policy
