I finished my book for our Capstone course today, entitled "The Healing of America; A Global Quest for Better, Cheaper, and Fairer Health Care" by T.R. Reid. Reid travels the world with a two goals: A personal goal of finding the best treatment for his shoulder injury, and secondly, a goal of gaining an understanding of healthcare across the globe. Reid reports on his experiences with other healthcare systems; it was an easy read, informative and intriguing. Reid describes four types of health systems, which include:
1)
The Bismarck Model:
- found in Germany, Japan, Belgium, Switzerland
- key aspects: providers and payers are private entities, cost-control
- population of the U.S. this applies to: <65 years old, working population
2)
The Beveridge Model:
- found in Britain
- key aspects: healthcare provided by the government as a public service, funded by taxes
- population of the U.S. this applies to: Native Americans, military, veterans
3)
The National Health Insurance Model:
- found in Canada
- key aspects: government-run insurance program, all citizens pay into the program, longer wait times for procedures
- population of the U.S. this applies to: >65 years old
4)
The Out-of-Pocket Model:
- found in countries without a health system
- key aspects: the patient pays the entire bill
- population of the U.S. this applies to: 45 million uninsured; those patients who do not qualify for Medicaid, cannot obtain health insurance because of pre-existing conditions, the unemployed, and others.
So, the U.S. encompasses all four models, creating the most complex, least cost-efficient, and most unaffordable healthcare system in the world (for most). Administrative costs for operating this system are outrageous compared to any other country in the world. Insurance companies can delay their claims processing to turn out bigger profits; patients rarely have a choice of insurance provider if their employer offers benefits. When it comes to healthcare, the U.S. is mocked by other countries.
The U.S. does, however, have the most well-trained healthcare professionals, newest and most innovative technologies, and procedural and diagnostic expertise that is unrivaled by other countries. The paradox of the situation our country has created is astounding. One would think we should lead healthcare in the world; but this is only true for citizens who can afford the luxuries we have available.
Shocking statistics about the U.S. from the WHO:
- 16.5 % of GDP is spent on healthcare, more than any country in the world (2005)
- U.S.'s infant mortality rate is 6.37/1000, ranking us 23rd out of 23 industrialized countries (2009)
- the Disability-Adjusted Life Expectancy (an index indicating a disease-free life) in was 74.5 years, ranking the U.S. 24th (2000)
The main question Reid presents in this book is: Does the U.S. believe that all citizens have a right to receive medical care? The way our healthcare system is set up now, the answer is a glaring "no". Even after healthcare reform sets in, 23 million Americans will remained uninsured.
This book is a must-read for students, in my opinion. It provides a great overview of several of the world's leaders in healthcare, and informs the reader about healthcare reform in the U.S. as well.