The Mudcat Café TM
Thread #123258   Message #2723877
Posted By: Desert Dancer
15-Sep-09 - 12:03 AM
Thread Name: BS: US Health Care Reform
Subject: RE: BS: US Health Care Reform
This looks like a very interesting read on the topic: NY Times review of "One Injury, 10 Countries: A Journey in Health Care" by T. R. Reid (the review is by Abigail Zuger, M.D.)

From the review:

Mr. Reid, a veteran foreign correspondent for The Washington Post, knows from personal experience that there are indeed a dozen better alternatives. International postings from London to Japan familiarized him with many of the world's health care systems. Then a chronic shoulder problem offered the opportunity for an unusually well-controlled experiment: Mr. Reid decided to present his stiff shoulder for treatment around the world.

One shoulder, 10 countries. Admittedly it's a gimmick, but what saves the book from slumping into a sack of anecdotes like Michael Moore's 2007 documentary "Sicko" is a steel backbone of health policy analysis that manages to trap immensely complicated concepts in crystalline prose.

"The Healing of America" blends subjective and objective into a seamless indictment of our own disastrous system, an eloquent rebuttal against the arguments used to defend it, and appealing alternatives for fixing it.

...

Mr. Reid starts with a methodical clarification of terms. First: universal health care. Far from a single socialized system, the various plans other countries use to cover all their residents are quite distinct. Some are as private as our own, and most offer considerably more in the way of choice.

In Japan, and many European countries, private health insurers — all of them nonprofit — finance visits to private doctors and private hospitals through a system of payroll deductions.

In Canada, South Korea and Taiwan, the insurer is government-run and financed by universal premiums, but doctors and hospitals are private.

In Britain, Italy, Spain and most of Scandinavia, most hospitals are government-owned, and a tax-financed government agency pays doctors' bills.

In poor countries around the world, private commerce rules: residents pay cash for all health care, which generally means no health care at all.

Similarly, what Americans often consider a single unique system of health care is an illusion: we exist in a sea of not-so-unique alternatives. Like the citizens of Germany and Japan, workers in the United States share insurance premiums with an employer. Like Canadians, our older, destitute and disabled citizens see private providers with the government paying. Like the British, military veterans and Native Americans receive care in government facilities with the government paying the tab. And like the poor around the world, our uninsured pay cash, finagle charity care, or stay home.

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And, in other news, a poll funded by the Robert Wood Johnson Foundation and published in the New England Journal of Medicine (as reported on NPR) finds that nearly 3/4 of doctors polled would like some sort of public option (for most, a combination of public and private). This is at odds with the AMA position. ("The survey even found widespread support for a public option among doctors who are members of the American Medical Association, a group that's opposed to it. The AMA fears a public option eventually could lead to government putting more limits on doctors' fees.") A followup bit on NPR points out the the AMA is not particularly representative of doctors as a whole in the U.S. any more. And the AMA is careful say, "And so I think that's why we need to be very clear about what does the AMA articulate for," says Rohack. "It's to make sure that everyone has coverage that's affordable, that's portable and that is quality — that is, it covers the things you need to cover because you've got a medical condition or developed a medical illness." (From the NPR story on the poll.)

~ Becky in Tucson