Nearly all of the world’s advanced industrialized countries provide health care to all of their citizens, achieve better health outcomes and spend less, according to TR Reid, a well-known journalist, author and documentary filmmaker.
The lone exception: the United States.
“Approximately 40 million people nationwide, or about 20 percent or 1 million people in Alabama, don’t have health insurance,” Reid said during a talk to the Tuscaloosa community Nov. 13 at Tuscaloosa River Market. “Every day somebody in America dies because they don’t have insurance and can’t get care. We could do better.”
Reid’s talk, “Better Health, Lower Costs: One Man’s Global Quest to Fix a Bum Shoulder,” was hosted by UA’s College of Community Health Sciences, College of Communication and Information Sciences and Culverhouse College of Commerce and Business Administration. The presentation was based, in part, on Reid’s New York Times bestseller, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, which documented his travel to various countries to learn about their health-care systems – and to try and “fix my bum shoulder.” In addition to books, Reid writes for the Washington Post newspaper, is a commentator on NPR’s Morning Edition and makes documentaries for PBS’s Frontline.
During his community talk, Reid outlined health-care models used by different countries, starting with England. The country believes keeping people healthy is the responsibility of government, much like providing for trash pickup and funding libraries, he said. While Reid acknowledged that people in England pay taxes to fund the country’s socialized system of medicine (their sales tax is 20 percent) “since no one pays insurance premiums, deductibles or co-pays, they still pay half of what we do for health care.”
The German model has its roots in efforts to bring citizens together as a single country using the provision of social services, including “the most radical idea, that this new nation should provide health care for everyone,” Reid said. Today, there are 220 insurance companies operating in Germany, all hospitals are private and citizens split the cost of their insurance premiums with their employers. But there is some government control with regard to cost of health services and when physicians must be paid. “This is a private system with some government control,” Reid said.
A marriage of the England and German models can be found in the Canadian approach – government payment of private providers, similar to the US Medicare program, which provides health care for older citizens. In fact, the United States used the Canadian model when setting up its own Medicare program, even borrowing the name.
Finally, Reid touched on the model used by many of the world’s underdeveloped countries. He called it the Out-of-Pocket Model: “If you have no money, you don’t see a doctor and you don’t get care.”
All four models are in use in the United States, Reid said. Care provided by the Veteran’s Administration mirrors England’s socialized system of medicine. Many US citizens are similar to those in Germany, who share the cost of insurance premiums with their employers, while older US citizens are similar to those in Canada, who receive their care through Medicare programs. “And if you’re the 40 million Americans without insurance, you’re in the Out-of-Pocket Model,” Reid said.
“I learned that every country’s health system reflects its values,” Reid said. “If you make that commitment (to cover everyone), you can create the system. In the United States, we haven’t done that. I don’t think we’ve ever had that conversation.”
He continued: “If we could find the political will to provide health coverage for everyone, the other rich countries can show us the way.”