The Healing of America

Last updated
The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care
The Healing of America.jpg
First edition
Author T. R. Reid
LanguageEnglish
SubjectHealth care policy
Publisher Penguin Press
Publication date
August 31, 2010
Publication placeUS
Media type paperback
Pages304
ISBN 978-0-14-311821-3
OCLC 875533650

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care is a New York Times bestseller from journalist T. R. Reid. Reid compares health care systems in a half-a-dozen wealthy nations with the health care models followed in the United States, in a straightforward, easy to read narrative. [1] [2] The countries whose systems are discussed are: France, Germany, Japan, the United Kingdom, Canada and a specific example from India. Reid visited all these countries personally and claims to have chosen them since they exemplify specific kinds of health-care system models. The book also discusses transitions in the health care systems of Taiwan and Switzerland.

Contents

The major theme of the book is the contrasting of health care in other developed countries with health care in the United States. Reid is critical of the United States for not being able to provide guaranteed health services to all its citizens as is done in virtually all developed countries. Along with the study of various health systems, Reid also documents his attempts to get treatment for his shoulder during the journey described in the book. Reid finds suitable treatment in India, which has an out-of-pocket model, the only one Reid considers to be worse than the American system of health care.

Major forms of international health care systems

The Bismarck Model

This is the model followed in Germany and in its rudimentary form was laid out by Otto von Bismarck. The system uses private initiatives to provide the medical services. The insurance coverage is also mainly provided through private companies. However, the insurance companies operate as non-profits and are required to sign up all citizens without any conditions. At the same time all citizens (barring a rich minority in the case of Germany) are required to sign up for one or the other health insurance. The government plays a central role in determining payments for various health services, thus keeping a decent control on cost.

The Beveridge Model

This model adopted by Britain is closest to socialized medicine, according to the author. Here almost all health-care providers work as government employees and the government acts as the single-payer for all health services. The patients incur no out-of-pocket costs, but the system is under pressure due to rising costs. The author, Reid, was told by a British doctor to live with his shoulder problem. The system would not treat it, and that every other British doctor would tell him the same thing.

The National Health Insurance Model

The Canadian model has a single-payer system like Britain; however, the health care providers work mostly as private entities. The system has done a good job of keeping costs low and providing health care to all. The major drawback of this system comes from the ridiculously long waiting times for several procedures. The author, Reid, would have had to wait 18 months for his shoulder treatment in Canada.

The Out of Pocket Model

This is the kind of model followed in most poor countries. There is no wide public or private system of health insurance. People mostly pay for the services they receive 'out of pocket'. However, this leaves many underprivileged people without essential health care. Almost all countries with such a system have a much lower life expectancy and high infant mortality rates. The author gives his experience with the system in India, and a brief description of the ancient medical system of Ayurveda.

American Model for Health

According to the author the United States follows many of the international systems in bits and pieces, yet he concludes that in the US there is rather a healthcare market than an actual healthcare system.

Related Research Articles

Socialized medicine is a term used in the United States to describe and discuss systems of universal health care—medical and hospital care for all by means of government regulation of health care and subsidies derived from taxation. Because of historically negative associations with socialism in American culture, the term is usually used pejoratively in American political discourse. The term was first widely used in the United States by advocates of the American Medical Association in opposition to President Harry S. Truman's 1947 health care initiative. It was later used in opposition to Medicare. The Affordable Care Act has been described in terms of socialized medicine, but the act's objective is rather socialized insurance, not government ownership of hospitals and other facilities as is common in other nations.

A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations.

<span class="mw-page-title-main">Publicly funded health care</span> Form of health care financing

Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population contributing to the fund or receiving benefits from it.

<span class="mw-page-title-main">Healthcare industry</span> Economic sector focused on health

The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.

Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity.

Universal health care is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized around providing either all residents or only those who cannot afford on their own, with either health services or the means to acquire them, with the end goal of improving health outcomes.

Single-payer healthcare is a type of universal healthcare, in which the costs of essential healthcare for all residents are covered by a single public system. Single-payer systems may contract for healthcare services from private organizations or may own and employ healthcare resources and personnel. "Single-payer" describes the mechanism by which healthcare is paid for by a single public authority, not a private authority, nor a mix of both.

The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.

...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.

National health insurance (NHI), sometimes called statutory health insurance (SHI), is a system of health insurance that insures a national population against the costs of health care. It may be administered by the public sector, the private sector, or a combination of both. Funding mechanisms vary with the particular program and country. National or statutory health insurance does not equate to government-run or government-financed health care, but is usually established by national legislation. In some countries, such as Australia's Medicare system, the UK's National Health Service and South Korea's National Health Insurance Service, contributions to the system are made via general taxation and therefore are not optional even though use of the health system it finances is. In practice, most people paying for NHI will join it. Where an NHI involves a choice of multiple insurance funds, the rates of contributions may vary and the person has to choose which insurance fund to belong to.

<span class="mw-page-title-main">Medicare for All Act</span> Proposed U.S. healthcare reform legislation

The Medicare for All Act, also known as the Expanded and Improved Medicare for All Act or United States National Health Care Act, is a bill first introduced in the United States House of Representatives by Representative John Conyers (D-MI) in 2003, with 38 co-sponsors. In 2019, the original 16-year-old proposal was renumbered, and Pramila Jayapal (D-WA) introduced a broadly similar, but more detailed, bill, HR 1384, in the 116th Congress. As of November 3, 2019, it had 116 co-sponsors still in the House at the time, or 49.8% of House Democrats.

<span class="mw-page-title-main">Health care in Australia</span>

Health care in Australia operates under a shared public-private model underpinned by the Medicare system, the national single-payer funding model. State and territory governments operate public health facilities where eligible patients receive care free of charge. Primary health services, such as GP clinics, are privately owned in most situations, but attract Medicare rebates. Australian citizens, permanent residents, and some visitors and visa holders are eligible for health services under the Medicare system. Individuals are encouraged through tax surcharges to purchase health insurance to cover services offered in the private sector, and further fund health care.

Healthcare reform in the United States has had a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.

<span class="mw-page-title-main">Healthcare in Germany</span>

Germany has a universal multi-payer health care system paid for by a combination of statutory health insurance and private health insurance.

<span class="mw-page-title-main">Healthcare in Taiwan</span>

Healthcare in Taiwan is administered by the Ministry of Health and Welfare of the Executive Yuan. As with other developed economies, Taiwanese people are well-nourished but face such health problems as chronic obesity and heart disease. In 2002 Taiwan had nearly 1.6 physicians and 5.9 hospital beds per 1,000 population. In 2002, there were 36 hospitals and 2,601 clinics in the country. Per capita health expenditures totaled US$752 in 2000. Health expenditures constituted 5.8 percent of the gross domestic product (GDP) in 2001 ; 64.9 percent of the expenditures were from public funds. Overall life expectancy in 2019 was averaged at 81 years.

The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement.

<span class="mw-page-title-main">Healthcare in the United States</span>

Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance. The United States spends more on healthcare than any other country, both in absolute terms and as a percentage of GDP; however, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations. Coverage varies widely across the population, with certain groups, such as the elderly and low-income individuals, receiving more comprehensive care through government programs such as Medicaid and Medicare.

Government-guaranteed health care for all citizens of a country, often called universal health care, is a broad concept that has been implemented in several ways. The common denominator for all such programs is some form of government action aimed at broadly extending access to health care and setting minimum standards. Most implement universal health care through legislation, regulation, and taxation. Legislation and regulation direct what care must be provided, to whom, and on what basis.

Health care finance in the United States discusses how Americans obtain and pay for their healthcare, and why U.S. healthcare costs are the highest in the world based on various measures.

All-payer rate setting is a price setting mechanism in which all third parties pay the same price for services at a given hospital. It can be used to increase the market power of payers versus providers, such as hospital systems, in order to control costs. All-payer characteristics are found in most developed economies with multi-payer healthcare systems, including France, Germany, Japan, and the Netherlands. The U.S. state of Maryland also uses such a model.

<span class="mw-page-title-main">Bismarck model</span> Healthcare system

The Bismarck model is a health care system in which people pay a fee to a fund that in turn pays health care activities, that can be provided by State-owned institutions, other Government body-owned institutions, or a private institution. The first Bismarck model was instituted by Otto von Bismarck in 1883 and focused its effort in providing cures to the workers and their family. Since the establishment of the first Beveridge Model in 1948, where the focus was into providing healthcare as a human right to everyone with funding through taxation, nearly every Bismarck system became universal and the State started providing insurance or contributions to those unable to pay.

References

  1. Horwitt, Sanford D. (August 23, 2009). "'The Healing of America,' by T. R. Reid". San Francisco Chronicle . Retrieved October 18, 2010.
  2. Longman, Phillip (September 27, 2009). "It's Not a Socialized World After All". The Washington Post . Retrieved October 18, 2010.