Anger and taunting in the public forum. Accusations of fascism. Rumors of proposed government death panels — rumors that opponents of reform did virtually nothing to quell. Gun-toting men waiting for their congressional representatives in the parking lot. The discussion, if it can be dignified with that word, over the state of the nation’s health care system is scuttling along the slimy sea floor of American politics.
Which is why it’s an ideal time for some actual information. What is it costing us to look after our nation’s sick? Who pays — literally and figuratively — for the threadbare patchwork of American health insurance coverage, a system that drop-kicks 700,000 people each year into bankruptcy because they can’t pay their medical bills? That, because they couldn’t see a doctor, puts 20,000 more in the grave? Are we really faced with a choice between things as they are and that conservative bogey, “socialized medicine”?
For such apt questions, T.R. Reid’s book couldn’t hit the shelves at a better time. “The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care” (Penguin Press) is a look at how wealthy democracies like ours — like France, Japan, Germany and the U.K. — provide health care, and the choices they faced as they constructed systems that are each unique but that all do a better job of keeping their citizens healthy, and they do it for less.
What do those countries have that we don’t? Each has decided that it has a basic duty to look after the health of its citizens.
Reid’s book would be just an exercise in comparative policy studies but for having busted his shoulder while in the U.S. Navy. A military surgeon had bolted the joint back together, but that was way back in 1972. “By the first decade of the 21st century,” writes Reid, “I could no longer swing a golf club. I could barely reach up to replace a lightbulb overhead or get the wine glasses from the top shelf.”
And so, “hoping for surcease from sorrow,” Reid takes his shoulder on the road. The result is a readable, informative, clearheaded look at health care elsewhere in the industrialized world, accompanied by the persistent questioning: Why not us?
Adam Hyla: When did you begin this book?
T.R. Reid: I’d like to say that in the spring of 2006 I knew that in the fall of 2009 our country would be obsessed with health care, but I really can’t say we planned it that way — we really lucked out. The timing worked out fine. I actually delivered the book a year late, and my editor was mad at me for being so late, but now I tell her I planned it like this. (laughter)
A.H.: Eighty-five percent of Americans tell pollsters that health care is a basic human right, yet so far in this national debate, that doesn’t seem to be very well-reflected.
T.R.R.: Yeah, every time we take on this issue the basic moral question gets lost in a discussion of winners and losers, hospital company profits and insurance company earnings. That’s always happened in our country. Every single country I visited made the basic moral commitment that every single person in our rich country who needs access to health care should have access to it. The richest country in the world has not made that guarantee.
I came off my ’round-the-world tour pretty optimistic; I think if we do make that commitment we can provide it for all, because all these other countries have.
A.H.: Why haven’t we made that commitment? Why are we so down in the weeds?
T.R.R.: I don’t know. I really struggle with that. With my book, I had three main tasks: to explain how other countries cover everybody at reasonable costs, and I think I got that; the other was to explain why other countries cover everybody, and I think I got that. That raises the question, why hasn’t the world’s richest country made this commitment? Continue reading