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Bestselling author T. R. Reid guides a whirlwind tour of successful health care systems worldwide, revealing possible paths toward U.S. reform.
In The Healing of America, New York Times bestselling author T. R. Reid shows how all the other industrialized democracies have achieved something the United States can’t seem to do: provide health care for everybody at a reasonable cost.
In his global quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own—including France, Germany, Japan, the U.K., and Canada—where he finds inspiration in example. Reid shares evidence from doctors, government officials, health care experts, and patients the world over, finding that foreign health care systems give everybody quality care at an affordable cost. And that dreaded monster “socialized medicine” turns out to be a myth. Many developed countries provide universal coverage with private doctors, private hospitals, and private insurance.
In addition to long-established systems, Reid also studies countries that have carried out major health care reform. The first question facing these countries—and the United States, for that matter—is an ethical issue: Is health care a human right? Most countries have already answered with a resolute yes, leaving the United States in the murky moral backwater with nations we typically think of as far less just than our own.
The Healing of America lays bare the moral question at the heart of our troubled system, dissecting the misleading rhetoric surrounding the health care debate. Reid sees problems elsewhere, too: He finds poorly paid doctors in Japan, endless lines in Canada, mistreated patients in Britain, spartan facilities in France. Still, all the other rich countries operate at a lower cost, produce better health statistics, and cover everybody. In the end, The Healing of America is a good news book: It finds models around the world that Americans can borrow to guarantee health care for everybody who needs it.
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T. R. Reid is a longtime correspondent for the Washington Post and former chief of its Tokyo and London bureaus as well as a commentator for National Public Radio. His books include The Chip and Confucius Lives Next Door.From The Washington Post:
From The Washington Post's Book World/washingtonpost.com Reviewed by Phillip Longman 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 as a foreign correspondent for The Washington Post, he and his family received high-quality, routine care from doctors in places such as 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. Perhaps more helpfully, strong, skillful therapists went to work three times a day slathering him with spiced sesame oil and massaging 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 the Western lifestyle and diet causes an epidemic of chronic illness, and 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.
Copyright 2009, The Washington Post. All Rights Reserved.
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