Explaining foreign health systems
Campaign Desk -- August 28, 2009
For extraordinary clarity in explaining foreign health systems
By Trudy Lieberman
As I have posted many times on Campaign Desk, the
media, for the most part, has hardly touched how health
care works in the rest of the developed world. Special
interests, instead, have filled in the blanks with
shrill and false advertising about socialized medicine
and rationing. The public discussion has become so
polarized and virulently nasty that it's nearly
impossible for any lessons from abroad to gain traction.
In last Sunday's
Post reporter and would-have-been host of Frontline's
about foreign health care, in an article based on
reporting for his new book, The Healing of
Global Quest for Better, Cheaper, and Fairer Health
Care. What's remarkable about this piece is not that he
challenges commonly held beliefs about how bad things
do that), but that he does it with clarity, simplicity,
and honesty--three attributes that have been missing
from much of this year's health care reportage.
Myth one: It's all socialized medicine out there. No,
says Reid. Some countries, like
provide health care in government hospitals with the
government paying the bills. But in other countries,
that is paid for under their national health systems.
"In some ways, health care is less socialized overseas
than in the
Myth two: Overseas care is rationed through limited
choices or long lines. Generally not, Reid points out.
In most places, patients can go to any doctor or have
choices of providers. There are no limits like we have
pre-authorization forms. In
some people wait for non-emergency care, but
to waiting times for appointments and elective
surgeries. Waiting times are so short in
people don't bother making appointments. I know from my
own reporting in
hospital, and pronto, they are seen.
Myth three: Foreign-health care systems are
inefficient, bloated bureaucracies. All other payment
systems are more efficient than ours, Reid writes.
health insurers have the highest administrative costs
in the world, spending about twenty cents of every
dollar for paperwork, marketing, and claims review.
Japan controls costs better than any other country,
even though its population uses more services than
Americans use. Quality is high, and life expectancy and
recovery rates for major illnesses are better than in the
Myth four: Cost controls stifle innovation. That
assertion is just plain false, Reid says. While
groundbreaking research comes from the
comes from other countries with much lower cost
were invented, or
deep-brain stimulation to treat depression was made.
Myth five: Health insurance has to be cruel. In
applicants with preexisting medical conditions, and
rescind policies of those who accumulate big medical
bills. That doesn't happen in other countries, where
all the national insurance schemes must accept everyone
and pay all the bills that citizens present. Reid
observes that the key difference between the
other systems is that foreign health plans exist only
to pay medical bills; they aren't in business to make a profit.
The most persistent myth of all, says Reid, is that
don't." When you compare results, most other
industrialized countries have much better statistics.
For awhile at the beginning of the presidential
campaign, advocacy groups and politicians talked about
mention statistics like how
thirty-seventh in the world in health outcomes. When
spokespeople and politicans stopped talking about
America's bad showing, so did the media.
Reid reminds us why we need to keep reminding audiences
how and why
template for reporters needing help breaking down
health bill complexities, misinformation, and the
half-truths that will keep floating around. We urge
readers of Campaign Desk who are not journalism
professionals to see what Reid has to say. Apparently
Post readers are already doing that: Post ombudsman
Andy Alexander told me that Reid's story was the most
widely viewed story on the paper's Web site Sunday and Monday.