An excerpt—part of the Foreword of the very informative (and often shocking) book, The Healing of America : A Global Quest for Better, Cheaper, and Fairer Health Care by T. R. Reid, Penguin Press, copyright T. R. Reid 2009.

Prologue: A Moral Question
If Nikki White had been a resident of any other rich country, she would be alive today.

Around the time she graduated from college, Monique A. "Nikki" White contracted systemic lupus erythematosus; that's a serious disease, but one that modern medicine knows how to manage. If this bright, feisty, dazzling young woman had lived in, say, Japan -- the world's second-richest nation -- or Germany (third richest), or Britain, France, Italy, Spain, Canada, Sweden, etc., the health care systems there would have given her the standard treatment for lupus, and she could have lived a normal life span. But Nikki White was a citizen of the world's richest country, the United States of America. Once she was sick, she couldn't get health insurance. Like tens of millions of her fellow Americans, she had too much money to qualify for health care under welfare, but too little money to pay for the drugs and doctors she needed to stay alive. She spent the last months of her life frantically writing letters and filling out forms, pleading for help. When she died, Nikki White was thirty-two years old.

"Nikki didn't die from lupus," Dr. Amylyn Crawford told me. "Nikki died from complications of the failing American health care system. It was a lack of access to health care that killed Nikki White." [ . . . ]

On September 11, 2001, some three thousand Americans were killed by terrorists; our country has spent hundreds of billions of dollars to make sure it doesn't happen again. But that same year, and every year since then, some twenty thousand Americans died because they couldn't get health care. That doesn't happen in any other developed country. Hundreds of thousands of Americans go bankrupt every year because of medical bills. That doesn't happen in any other developed country either.

Those Americans who die or go broke because they happened to get sick represent a fundamental moral decision our country had made. Despite all the rights and privileges and entitlements that Americans enjoy today, we have never decided to provide medical care for everybody who needs it. In the world's richest nation, we tolerate a health care system that leads to large numbers of avoidable deaths and bankruptcies among our fellow citizens. Efforts to change the system tend to be derailed by arguments about "big government" or "free enterprise" or "socialism" -- and the essential moral question gets lost in the shouting.

All the other developed countries on earth have made a different moral decision. All the other countries like us -- that is, wealthy, technologically advanced, industrialized democracies -- guarantee medical care to anyone who gets sick. Countries that are just as committed as we are to equal opportunity, individual liberty, and the free market have concluded that everybody has a right to health care -- and they provide it. One result is that most rich countries have better national health statistics -- longer life expectancy, lower infant mortality, better recovery rates from major diseases -- than the United States does. Yet all the other rich countries spend far less on health care than the United States does. [ . . . ]

My global quest made it clear that the other wealthy democracies can show us how to build a decent health care system -- if that's what we want. The design of any nation's health care system involves political, economic, and medical decisions. But the primary issue for any health care system is a moral one. If we want to fix American health care, we first have to answer a basic question: Should we guarantee medical treatment to everyone who needs it? Or should we let Americans like Nikki White die from "a lack of access to health care"?

I think that makes the case better than anything I can say. As T. R. Reid says, it's a moral issue. I must say that there are times when I am not particularly proud to be an American.

Blurb on the back cover of the book: "When the World Health Organization rated the national health care systems of 191 countries in terms of 'fairness,' the United States ranked fifty-fourth -- slightly ahead of Chad and Rwanda but just behind Bangladesh and the Maldives. How is it that all the other industrialized democracies provide health care for everyone at a reasonable cost, something the United Stateshas never managed to do?"

Reid travels to an number of countries around the world to find out how they manage their health care systems and clearly reports the good points of each one he investigated, along with their "warts." Clear, concise, and very much to the point. Highly recommended if you wish to know what you're talking about when you discuss our health care system -- or lack thereof.

Don Firth