T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," to be published Monday. In this book, he punctures the myth that America has "the finest health care" in the world...
Typical myth: Overseas, care is rationed through limited choices or long lines.
What's the truth? In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.
Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.
As for those notorious waiting lists, studies by the Commonwealth Fund and others report that many nations - Germany, Britain, Austria - outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan, waiting times are so short that most patients don't bother to make an appointment. The author notes, that he called a prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about his aching shoulder. The response from the receptionist: "Why don't you just drop by?" The doctor recommends an operation for his shoulder... "When could we do it?" the author asks. The doctor checks his computer and sayes, "Tomorrow would be pretty difficult. Perhaps some day next week?"
Another myth: Foreign health-care systems are inefficient, bloated bureaucracies.
In fact, all the other payment systems are more efficient than ours. U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.
The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
And the most persistent myth of all: America has "the finest health care" in the world.
In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.
Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. But to get there, our country needs to stop drinking Republican koolade and opening our eyes as to the realities of healthcare administration at home and in from the other industrialized democracies.
See: Washington Post article. You can buy the book here: Amazon.





