T.R. Reid has done a service to his nation by showing in his latest book just how uninformed this conventional wisdom is. Based on his own experience and research, "The Healing of America" is both readable and informative.
During last year's Republican presidential primary season, candidate
Rudy Giuliani succinctly captured what millions of Americans think
about health care abroad. "These countries that say they provide
universal coverage -- they pay 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 should 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 conventional 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 increasingly bothersome as he aged. During his long
career working as a foreign correspondent for The Washington Post, he
and his family received high-quality, routine care from doctors in
places like 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
systems would approach treating his shoulder pain, and in the process
he searched for insights to cure the U.S. health care crisis.
Reid checked himself into the famous Arya Vaidya Chikitsalayam, an
institution that he describes as the Mayo Clinic of traditional Indian
medicine, and was surprised 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 assortment 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. Yet
perhaps more helpfully, strong, skillful therapists went to work three
times a day slathering him with spiced sesame oil and messaging his
whole body, with special attention to his sore shoulder. After weeks of
this treatment, Reid lost nine pounds and became a very mellow man. He
also discovered that the pain in his shoulder was gone and that he had
much greater 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 recommended by Reid's American doctor, who
couldn't say what replacing his shoulder might cost after the various
insurance adjusters were done. Reid would have paid even less had he
purchased Indian insurance, which typically covers the treatment that
fixed his shoulder, including the cost of the astrologer.
Elsewhere on his journey, Reid discovered other curious truths about
health care abroad that Americans don't know. For example, Germany and
Switzerland manage to provide universal coverage while preserving a
greater 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; some even make house calls.
Reid learned that Britain's National Health Service would not pay for
the anthroplasty his American doctor recommended unless he was in acute
pain, but as his Indian experience proved, he didn't need the
operation.
Similarly, in France and Japan, consumers have quicker access to a
broader range of providers than most Americans do (no cost for going
"out of network"). And no one is ever denied an insurance claim 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 providing quick access to specialists.
Reid was able to make an appointment with one of Japan's top orthopedic
surgeons the same afternoon he made his first call.
Reid acknowledges that the health systems in the countries he
studied have their own problems. He also admits that none has figured
out how to contain the global long-term trend toward higher costs as
populations age, the spread of Western lifestyle and diet causes an
epidemic of chronic illness, and as expensive new medical technologies
become available. But he does demonstrate that Guiliani and like-minded
Americans put forward a distorted image 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 advanced countries easily
combine universal coverage and government regulation with
entrepreneurialism and respect for market forces to produce high
quality, low cost health care -- a simple empirical truth we can no
longer afford to ignore.
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