In researching his book The Healing of America, Washington Post correspondent and NPR commentator T.R. Reid said he wanted to find out why the world’s richest country doesn’t provide high quality health care to all its citizens and at half the cost like other developed countries. Reid gave a very engaging and informative discussion on the various healthcare models around the world at a forum held last year before the Commonwealth Club of California. The forum, which can be viewed by clicking on the video below, lasts an hour.
Reid’s talk occurred right in the midst of the healthcare reform battle being waged in Congress and in communities across the United States. He emphasizes that not all countries that have universal coverage operate their systems in the same way. And, he said, these models aren’t all “socialized,” – a word opponents of healthcare reform routinely like to hurl as an epithet (never mind that the Veterans Administration IS socialized medicine).
Reid explains the differences between the four main models of healthcare systems: Beveridge, Bismarck, National Health Insurance and Out of Pocket. Beveridge is basically socialized medicine, where the government both pays for care and employs the providers. The most well-known example is Britain’s National Health Service. In a Bismarckian system, employers provide health insurance, and costs are shared between employer and employee. Insurance plans are private. Germany, the Netherlands and Switzerland have the Bismarck model.
The National Health Insurance model is single payer, in which the government pays for all healthcare costs through taxation, and the providers remain in the private sphere. Canada, Australia, Taiwan and South Korea have single payer systems. The Out of Pocket model is basically what Third World countries have – if you’re lucky enough to see a doctor, you may have to pay an entire year’s salary for the treatment.
Reid points out that the United States has all four models. If you’re a veteran, he says, you live in Britain. If you’re employed, you’re in Germany. If you’re 65 and over, Canada. But if you’re uninsured, Afghanistan. The difference between America and the rest of the other industrialized countries, Reid says, is that the other countries have decided on one system for all their citizens. And, there’s an equally crucial difference in other developed countries – all insurance is not-for-profit. That’s why their systems cost much less than America’s. The other countries’ first priority is preventing illness and providing care, rather than making money. It’s the profit motive among insurance companies in the United States that is ruining lives and destroying health care in this country.
Unfortunately, the Patient Protection and Affordable Care Act, signed into law by President Obama earlier this year, does nothing to rein in the profit motive. Insurance companies will still be for-profit. Worse, the companies have a greater incentive to gouge, since the legislation has no cost containment. And they will reap even more profits once 32 million new customers are required to buy their products.
Reid says a country’s healthcare system reflects that society’s moral values. America’s values – compared with its actions – speak volumes to the rest of the world. We flaunt ourselves in front of other nations, crowing that America is a bastion of opportunity. We purport to be a society that values justice, equality and freedom. But our healthcare system isn’t just, equal or free. We even have the audacity to wag our fingers at the way authoritarian regimes poorly treat their citizens. But who are we to throw stones when our cruel healthcare system clearly shows that our own house is made of fragile glass?