Sunday, September 20, 2009

Book Review:T. R. Reid’s "The Healing of America"

For people like me, who see universal coverage as a moral and economic imperative, and who think nuance, detail, and pragmatics matter, T. R. Reid’s "the Healing of America" is required reading, imo. In analyzing the different health systems of the world, Reid digs below the rhetoric and into the substance. In the process, he obliterates common myths held by Americans about other delivery systems, while also showing that all models carry unique problems. The big takeaway is that the U.S. should learn from this reality and adopt an approach that’s consistent with our needs.
So it’s clear there’s a lot of variety out there, and the blanket "socialist" label neglects the fact that typical systems include a mix of public and private entities. Further, we shouldn’t arrogantly assume that nothing works in other countries; the truth is that other industrialized systems cover everybody for much less than we spend, and their populations are healthier overall as a result. That doesn’t mean the U.S. should emulate entire frameworks -- it’s more that we should learn about what works, and make smart decisions here with that knowledge.

For instance, we spend 30 for 40% on healthcare administration, while France and Taiwan keep it near 5%, largely through standardized electronic record-keeping and "smart" cards that centralize patient history. Why wouldn't we want to mimic that (assuming privacy is protected)? Great Britain religiously focuses on prevention to keep costs down. Why shouldn't we create a public option based on the "medical home" model to do the same (rewarding quality, not quantity and churn)? If it works -- there are already smaller-scale success stories in the U.S. -- Medicare will also adopt it, generating massive cost savings. And private insurers might follow suit as well.

Read the entire review here.

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