A timely survey—filled with important lessons for the United States—of how other nations have created systems that provide universal health care for their citizens.
Washington Post correspondent and NPR commentator Reid (The United States of Europe: The New Superpower and the End of American Supremacy, 2004, etc.) sees the health-care issue as a moral question to which all other technologically developed countries have responded well, creating affordable, effective systems. The author outlines four basic models: the Bismarck, in which both health-care providers and payers are private; the Beveridge, in which “health care is provided and financed by the government, through tax payments”; the National Health Insurance (NHI) model, in which the providers are private but everyone pays into a government-run insurance program; and the out-of-pocket model, in which the patient pays with no insurance or government help. Elements of all four are present in the United States. The author took his own health problem—a stiff, painful shoulder—to doctors in France, Germany and Japan to see how the Bismarck model worked; to Great Britain to assess the Beveridge model; to Canada to look at the NHI model; and to India, where the patient pays out of pocket. He also went to Switzerland and Taiwan, two countries that have recently reformed their health-care systems, to see how they accomplished major overhauls. Reid’s personal experiences with doctors and hospitals make for entertaining reading—especially his encounter with Ayurvedic medicine—and his stories of patients who have been unable to get necessary health care are moving. More important, these anecdotes are embedded in solid research. The author provides a capsule history of each system, discusses its drawbacks as well as benefits and destroys some popular myths about so-called socialized medicine. Though he offers many image-shattering statistics that reveal how poorly the United States stacks up against other countries, the author’s message is essentially optimistic: We can learn from the experience of other countries and use that knowledge to create a more efficient and humane system.
A reasoned, well-balanced, highly readable account, especially welcome as the national debate over health care gets underway.
