Thursday, September 17, 2009

The Healing of America, a Book Presentation

Last night I attended a book presentation at the Tattered Cover, LoDo, a local Denver bookstore. The book was "The Healing of America" by T.R. Reid. The book covers how all rich countries do health care more cost-effectively and with better outcomes than the U.S. mess of a system. It focuses on 5 countries and proves, for the benefit of skeptical Americans, that the equation "government intervention = socialist takeover & death of private insurance" is blatantly false.

It was an interesting lecture/discussion with many profound take-aways, but the single, most important point Reid made is this: We pay so much more than other countries to provide healthcare to a segment of the American population because we are the only country where the middle-man, insurance companies, is allowed to make a profit. Doctors and hospitals in other countries run for-profit operations and compete with each other, but health insurance companies--who can be viewed mainly as administrators and paper pushers--are not allowed by law to make money on basic health care services. They are permitted to make as much money as they are capable of making on supplemental policies, but they cannot profit on the skin of patients for health care that is considered necessary. Instead, they must run a break-even operation. The question I did not hear, and would like to have asked, is how are insurance company employees (particularly executives) compensated in other countries for basic health care? My guess is that limits are set by the government on how much money insurance companies can make and that they need to work within the compensation limits and guidelines set by the government. That is not socialism, it is just a very fair, and very logical way, of addressing the need for everyone to receive affordable health care for non-elective services and procedures.

The other important point to emerge from the evening was that while waiting times are a fact in all systems that aim at controlling costs, it is a meme that no Americans are subjected to waiting to receive health care services. In fact many countries have, on average, shorter waiting times than the United States. The difference is that other countries make a logical and fair distinction between elective and necessary procedures. The latter are handled promptly in all systems, and waiting times apply almost exclusively to the former. The range of what is considered necessary v. elective also varies on a country-by-country basis. For example Viagra is considered non-elective in the U.K. (most likely due to the fact that the fellow who discovered it is a Brit), while in France it is considered elective (Reid reports that a French doctor, when asked why, replied "Ze French men do not need it.")

I am still reading the book and will post my comments about it once I am done.

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