Status
Available
Call number
Collection
Publication
Penguin Books (2010), Edition: Reprint, 304 pages
Description
"New York Times"-bestselling author Reid shows how all the other industrialized democracies have achieved something the U.S. can't seem to do: provide health care for everybody at a reasonable cost.
User reviews
LibraryThing member goose114
Reid is able to take the current issue of health care and explain it in a manner that is easy to digest. He discusses his travels through foreign health care systems with his own injured shoulder. By doing this he is able to be a real life example of how each system deviates from the other.
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Comparing each system illuminates the problems with each. I recommend this book to anyone interested in learning about the American health care system as well as others. The reader is able to see that there is no truly perfect health care system and that even the most respected systems have flaws that jeopardize the nation. Anyone who wants to gain an educated opinion on this health care debate should read this book. Show Less
LibraryThing member GoofyOcean110
At last I've read something rather timely! Over Passover I finished up Healing of America - overall I would recommend it. TR Reid travels to various countries (US, France, Germany, Japan, UK, India) to complain about an ailing shoulder as an excuse to discuss and compare health care systems. The
I learned a lot about heath care (both providers and insurers) in the US and many other countries. I think I have a clearer understanding of the very basics. Which is not saying much considering where I was starting from! But now I recognize why health care and health insurance are so complicated in the US - there are so many different systems all at once for different demographics - Medicare, Medicaid, veterans system, dialysis patients, health insurance tied to employee benefits, and pay-out-of-pocket insurance for those in between the cracks. No wonder it's a mess! So in terms of informing the general reader, this book was very successful at its mission.
TR Reid, the author, used his shoulder and journey to explore what's going on elsewhere and to see if we can use some ideas from other countries in the US to reduce costs and improve the product that we get: the overall health of Americans. Many countries use models that are similar to portions of the US health care system. Several have private health care providers and/or insurers while others have public run systems (like the US system for veterans) and others pay out of pocket (like those in the US who fall through the cracks). He makes some good arguments, sets up a few straw men, and personalizes the story with his shoulder and a few anecdotes. Overall a compelling read, whatever one thinks about what the US should be doing.
But I think the one take away message of the book, and one that is correct, is that fundamentally, the question of health care is a moral/ethical question: what do you do if someone gets sick or worse?. The way health care systems are set up (both insurers and providers) is a country's answer to that question.
Often, its these questions of morals, principles and ethics that are thornier, more vitriolic, and at the root of big issues. Once answered one way or another, setting up the system to reflect that answer is (while not trivial) perhaps somewhat more straightforward.
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personal story is appropriately secondary to the description and discussion of different modes of practice, care, insurance, etc. One main argument is that there are elements of many different systems that may be useful to incorporate to cover more people and lower overall costs. He states at the outset that the healthcare system choices made by a country are a reflection of and directly related to the moral choices that country makes regarding its citizens.I learned a lot about heath care (both providers and insurers) in the US and many other countries. I think I have a clearer understanding of the very basics. Which is not saying much considering where I was starting from! But now I recognize why health care and health insurance are so complicated in the US - there are so many different systems all at once for different demographics - Medicare, Medicaid, veterans system, dialysis patients, health insurance tied to employee benefits, and pay-out-of-pocket insurance for those in between the cracks. No wonder it's a mess! So in terms of informing the general reader, this book was very successful at its mission.
TR Reid, the author, used his shoulder and journey to explore what's going on elsewhere and to see if we can use some ideas from other countries in the US to reduce costs and improve the product that we get: the overall health of Americans. Many countries use models that are similar to portions of the US health care system. Several have private health care providers and/or insurers while others have public run systems (like the US system for veterans) and others pay out of pocket (like those in the US who fall through the cracks). He makes some good arguments, sets up a few straw men, and personalizes the story with his shoulder and a few anecdotes. Overall a compelling read, whatever one thinks about what the US should be doing.
But I think the one take away message of the book, and one that is correct, is that fundamentally, the question of health care is a moral/ethical question: what do you do if someone gets sick or worse?. The way health care systems are set up (both insurers and providers) is a country's answer to that question.
Often, its these questions of morals, principles and ethics that are thornier, more vitriolic, and at the root of big issues. Once answered one way or another, setting up the system to reflect that answer is (while not trivial) perhaps somewhat more straightforward.
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LibraryThing member TheAmpersand
I mostly sat out the Great Health Care Debate of '09, largely because, as Reid's book points out, American conversations about health care seem to focus on ideologically charged technicalities, not societal values. For folks like me, who read the paper but still can't get their heads around the
In the end, Reid's book isn't about the healing of America; it's about how sick America is, and why. He doesn't propose any specific solution to America's health care mess, but instead hammers home the point that America does health care less efficiently and effectively than just about every other nation in its weight class.Capitalism is an essential part of the American experience, but when it comes to health care, the free market seems to deliver goods more expensively and less efficiently than many supposedly socialist systems do. To his credit, Reid knows that he's writing for an American audience and works to show how health care seems to run against the grain of American assumptions about how everything works. Still, this book might reach across partisan lines, since the rancor and indignation that colored so much of the health care debate a couple of years ago are absent here. What's missing from it, perhaps, is an insurance-free trip through America's own dysfunctional health care system. It might have provided a useful, if saddening, point of comparison to the author's generally satisfactory experiences elsewhere.
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issues surrounding national health care policy, "The Healing of America" is a pretty good place to start. Reid's book has a fine hook – he takes the same physical problem to doctors in a variety of countries – and the author writes entertainingly about a subject that can sometimes get pretty dry. Reid does a good job of showing national character traits and value systems influence how each of the countries he visits handles health care, and some of his experiences, such as the week he spent in an Ayurvedic spa in India, are even pretty interesting from an anthropological perspective. In the end, Reid's book isn't about the healing of America; it's about how sick America is, and why. He doesn't propose any specific solution to America's health care mess, but instead hammers home the point that America does health care less efficiently and effectively than just about every other nation in its weight class.Capitalism is an essential part of the American experience, but when it comes to health care, the free market seems to deliver goods more expensively and less efficiently than many supposedly socialist systems do. To his credit, Reid knows that he's writing for an American audience and works to show how health care seems to run against the grain of American assumptions about how everything works. Still, this book might reach across partisan lines, since the rancor and indignation that colored so much of the health care debate a couple of years ago are absent here. What's missing from it, perhaps, is an insurance-free trip through America's own dysfunctional health care system. It might have provided a useful, if saddening, point of comparison to the author's generally satisfactory experiences elsewhere.
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LibraryThing member gsatell
Excellent and highly readable. If you are at all concerned about health care in America, read this book!
LibraryThing member literarylioness7777
This was a poorly researched book. According to the author one can "contract" lupus and ovarian cancer. Also the author used very little statistical evidence to support his points. I would not recommend this book to others in the healthcare field. What a waste of money from the Kaiser Family
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Foundation! Show Less
LibraryThing member kaulsu
Wanting to sort the hype from the substance in our national debate on health care, I purchased this book. Reid carefully outlines the major types of health care offered by the nations of the world and surprise! The US uses the entire variety when we look at VA health care, medicare/medicaid/
Reid makes an interesting case that both the previous Clinton plan and Obama's present plan base the case on the [very real] economic incentives Americans have to change the insurance methodology--which hasn't seemed to resonate much with the American people. Probably because we are all so tired of politicians telling us and telling us stuff that turns out to be untrue (but hey! don't let my cynicism get you down :). In Europe, changes were made from a moral and ethical position that every person should be granted equal medical care.
Wow. What an idea, that even the poorest should be able to go to the doctor for preventive care.
Very well written and quite readable.
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out-of-pocket uninsured, employee benefit insurance, and Congressional perks. Reid makes an interesting case that both the previous Clinton plan and Obama's present plan base the case on the [very real] economic incentives Americans have to change the insurance methodology--which hasn't seemed to resonate much with the American people. Probably because we are all so tired of politicians telling us and telling us stuff that turns out to be untrue (but hey! don't let my cynicism get you down :). In Europe, changes were made from a moral and ethical position that every person should be granted equal medical care.
Wow. What an idea, that even the poorest should be able to go to the doctor for preventive care.
Very well written and quite readable.
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LibraryThing member jhittner
This is an excellent book showing how other counties around the world provide health care for their citizens at costs much less than what we pay in the US. Each system, including the US system, has positive and negatives. Reforming health care comes down to a basic question, as a country, does the
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US feel it has a moral obligation to provide health care for everybody? Once the US can answer that question, then maybe we can get on the right path to reforming what is a broken system. Show Less
LibraryThing member ThorneStaff
This is a must read for anyone interested in health care reform here in the US. As a conservative, I was challenged to think in terms of the ethical and moral dimensions of not having universal coverage in this country, and of how my self-centered attitude about health care impacts the need for and
A clearly-written look at various types of health-care systems worldwide, and an expose of the false beliefs many of us hold as Americans about the efficacy of our own system.
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ability to get meaningful reform through Congress.A clearly-written look at various types of health-care systems worldwide, and an expose of the false beliefs many of us hold as Americans about the efficacy of our own system.
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LibraryThing member gthomas7224
Very informative book outlining the different methods nations use to administer health care. I wish we would wise up and move more quickly towards one of these systems... preferably one like
LibraryThing member ecw0647
"On September 11, 2001, some three thousand Americans were killed by terrorists; our country has spent hundreds of billions of dollars to make sure it doesn’t happen again. But that same year, and every year since then, some twenty thousand Americans died because they couldn’t get health care.
This is probably a book everyone should read. It's a dispassionate look at health care systems throughout the world as Reid travels from one country to another to see how his shoulder would be treated and under what circumstances. To start a couple of basic facts: "most rich countries have better national health statistics—longer life expectancy, lower infant mortality, better recovery rates from major diseases—than the United States does.Yet all the other rich countries spend far less on health care than the United States does. . . .Among the world’s developed nations, the United States stands at or near the bottom in most important rankings of access to and quality of medical care. The Japanese go to the doctor more often than anyone else, yet their system costs only $3,400 per person; in the United States the cost is $7,400 per person annually. In Canada, the nation has decided that to be the most fair, people should have to wait equally. In Britain, the priority is that all health care should be free to everyone.
He begins by identifying the four basic types of mechanisms to pay for health care in the industrialized world. (He discounts the third world since those are all basically pay-as-you-go and available only to the rich.) Conventional wisdom tells us that these other countries depend on "socialized" medicine, yet that is incorrect. Ironically the only pure socialized medical systems exists in Cuba and the United States' VA system which is totally government funded, doctors are paid and employed by the government and veterans pay nothing for its services. Other countries are all a mix of private and public. How they are structured is related to the country's moral fabric.
The four systems are the Bismarck (a mix of public and private as in Japan, Germany, and Switzerland); in the Beveridge model there are no medical bills; rather, medical treatment is a public service, like the fire department or the public library, hospitals and clinics are often owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government. These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge. The British system is based on the Beveridge model. Canada's system is the third type, a national insurance plan which has elements of both Bismarck and Beveridge. The providers of health care are private, but the payer is a government-run insurance program that every citizen pays into. The last system is the pay-as-you-go in which there is no insurance and people pay for service out of their own pockets.
The United States has a mix of all. For those under sixty-five is a modified Bismarckian system for those lucky enough to be employed and have an employer-based system. Those over sixty-five have Medicare more similar to the Canadian system, and for many there is only the pay-as-you-go although most municipalities will not refuse treatment for emergencies which simply means the cost is allocated elsewhere, i.e. everyone else. One of the features of the so-called ObamaCare was to eliminate free-loading and have everyone, or most everyone pay for some form of health insurance. For Native Americans, military personnel, and veterans, we’re Britain, or Cuba. "And yet we’re like no other country, because the United States maintains so many separate systems for separate classes of people, and because it relies so heavily on for-profit private insurance plans to pay the bills. All the other countries have settled on one model for everybody, on the theory that this is simpler, cheaper, and fairer. With its fragmented array of providers and payers and overlapping systems, the U.S. health care system doesn’t fit into any of the recognized models."
A common complaint leveled against government health care programs is they ration, yet all systems ration. In this country it's done by insurance companies, in others it's done by ethical committees. Here, the decisions are applied inequality and depend on one's plan (and the quality of one's lawyer.) "made, often in secret, by scores of different insurance companies. One person may get coverage for a potentially life-saving operation, while the next person doesn’t. This may be a boon to the person with the more generous insurance policy, but it’s not particularly fair." Some form of rationing *must* be done in order to reduce costs. "Should the system spend its money to keep a ninety-five-year-old Alzheimer’s patient alive until he’s ninety-six? Should an ailing eighty-four-year-old get the same intensive treatment for breast cancer that is provided to an otherwise healthy forty-four-year-old? Should the health system, or the insurance plan, pay for Viagra? For Botox? In a health care system that offers universal coverage, these decisions tend to be made uniformly for everybody."
The U.S. spends the most on administrative costs and a system that organized everyone into one plan would clearly cut costs. Ironically, the charge that one system would reduce choice is not true. Other countries, in fact, offer patients more choice. Insurance plans in this country have discourage choice by building preferred networks. In most other countries patients can go wherever they want and see whomever they want since the structure for payment is the same throughout the country.
All countries are faced with rising health care costs and all face complaints about their systems. The grass is always greener.... The one constant is complaining. "The American economist Tsung-Mei Cheng has formulated, with tongue only partly in cheek, the Universal Laws of Health Care Systems: 1. “No matter how good the health care in a particular country, people will complain about it.” 2. “No matter how much money is spent on health care, the doctors and hospitals will argue that it is not enough.” 3. “The last reform always failed.”3 Everywhere I went on my global quest, I found that Cheng’s Universal Laws held true. But for all their problems, the other industrialized countries tend to do better than the United States on basic measures of health system performance: coverage, quality, cost control, choice. This was the most surprising and infuriating discovery of my global quest—that the United States of America performs so poorly in this fundamental area of human life. In industry, finance, music, science, arts, academics, athletics,Americans can match or surpass any other country. Why can’t we do that when it comes to health care?"
Read the book for part of the answer. Fascinating, yet ultimately quite depressing.
Show More
That doesn’t happen in any other developed country. Hundreds of thousands of Americans go bankrupt every year because of medical bills. That doesn’t happen in any other developed country either."This is probably a book everyone should read. It's a dispassionate look at health care systems throughout the world as Reid travels from one country to another to see how his shoulder would be treated and under what circumstances. To start a couple of basic facts: "most rich countries have better national health statistics—longer life expectancy, lower infant mortality, better recovery rates from major diseases—than the United States does.Yet all the other rich countries spend far less on health care than the United States does. . . .Among the world’s developed nations, the United States stands at or near the bottom in most important rankings of access to and quality of medical care. The Japanese go to the doctor more often than anyone else, yet their system costs only $3,400 per person; in the United States the cost is $7,400 per person annually. In Canada, the nation has decided that to be the most fair, people should have to wait equally. In Britain, the priority is that all health care should be free to everyone.
He begins by identifying the four basic types of mechanisms to pay for health care in the industrialized world. (He discounts the third world since those are all basically pay-as-you-go and available only to the rich.) Conventional wisdom tells us that these other countries depend on "socialized" medicine, yet that is incorrect. Ironically the only pure socialized medical systems exists in Cuba and the United States' VA system which is totally government funded, doctors are paid and employed by the government and veterans pay nothing for its services. Other countries are all a mix of private and public. How they are structured is related to the country's moral fabric.
The four systems are the Bismarck (a mix of public and private as in Japan, Germany, and Switzerland); in the Beveridge model there are no medical bills; rather, medical treatment is a public service, like the fire department or the public library, hospitals and clinics are often owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government. These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge. The British system is based on the Beveridge model. Canada's system is the third type, a national insurance plan which has elements of both Bismarck and Beveridge. The providers of health care are private, but the payer is a government-run insurance program that every citizen pays into. The last system is the pay-as-you-go in which there is no insurance and people pay for service out of their own pockets.
The United States has a mix of all. For those under sixty-five is a modified Bismarckian system for those lucky enough to be employed and have an employer-based system. Those over sixty-five have Medicare more similar to the Canadian system, and for many there is only the pay-as-you-go although most municipalities will not refuse treatment for emergencies which simply means the cost is allocated elsewhere, i.e. everyone else. One of the features of the so-called ObamaCare was to eliminate free-loading and have everyone, or most everyone pay for some form of health insurance. For Native Americans, military personnel, and veterans, we’re Britain, or Cuba. "And yet we’re like no other country, because the United States maintains so many separate systems for separate classes of people, and because it relies so heavily on for-profit private insurance plans to pay the bills. All the other countries have settled on one model for everybody, on the theory that this is simpler, cheaper, and fairer. With its fragmented array of providers and payers and overlapping systems, the U.S. health care system doesn’t fit into any of the recognized models."
A common complaint leveled against government health care programs is they ration, yet all systems ration. In this country it's done by insurance companies, in others it's done by ethical committees. Here, the decisions are applied inequality and depend on one's plan (and the quality of one's lawyer.) "made, often in secret, by scores of different insurance companies. One person may get coverage for a potentially life-saving operation, while the next person doesn’t. This may be a boon to the person with the more generous insurance policy, but it’s not particularly fair." Some form of rationing *must* be done in order to reduce costs. "Should the system spend its money to keep a ninety-five-year-old Alzheimer’s patient alive until he’s ninety-six? Should an ailing eighty-four-year-old get the same intensive treatment for breast cancer that is provided to an otherwise healthy forty-four-year-old? Should the health system, or the insurance plan, pay for Viagra? For Botox? In a health care system that offers universal coverage, these decisions tend to be made uniformly for everybody."
The U.S. spends the most on administrative costs and a system that organized everyone into one plan would clearly cut costs. Ironically, the charge that one system would reduce choice is not true. Other countries, in fact, offer patients more choice. Insurance plans in this country have discourage choice by building preferred networks. In most other countries patients can go wherever they want and see whomever they want since the structure for payment is the same throughout the country.
All countries are faced with rising health care costs and all face complaints about their systems. The grass is always greener.... The one constant is complaining. "The American economist Tsung-Mei Cheng has formulated, with tongue only partly in cheek, the Universal Laws of Health Care Systems: 1. “No matter how good the health care in a particular country, people will complain about it.” 2. “No matter how much money is spent on health care, the doctors and hospitals will argue that it is not enough.” 3. “The last reform always failed.”3 Everywhere I went on my global quest, I found that Cheng’s Universal Laws held true. But for all their problems, the other industrialized countries tend to do better than the United States on basic measures of health system performance: coverage, quality, cost control, choice. This was the most surprising and infuriating discovery of my global quest—that the United States of America performs so poorly in this fundamental area of human life. In industry, finance, music, science, arts, academics, athletics,Americans can match or surpass any other country. Why can’t we do that when it comes to health care?"
Read the book for part of the answer. Fascinating, yet ultimately quite depressing.
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LibraryThing member Nomastalgic
A really good read to help you understand why healthcare costs are very high in America, how it got that way, and possibly what the future holds. Good read for those in the Healthcare profession.
LibraryThing member Miro
On page 164, the author T.R.Reid says that, “.....many Americans have concluded that health care reform is beyond the power of a Democratic government.” which sets the fatalistic tone of the book.
He provides an interesting round the world tour of national health care systems (and sometimes
In Canada a single payer national (or provincial) system allows the government to tightly control all medical cost across the country, with the result that Canadians have the same average level of health as Americans at about half the cost per person.
Reid continues with the examples, making it clear that US healthcare is a disaster on any kind of cost/benefit basis, and what is even worse, he shows the US even failing on basic measures of healthcare output such as infant mortality or the DALE rating (How long an average person can expect to live without serious illness or disability) with the US in 24th position behind most developed countries – despite its sky-high spending.
He quotes Henry Aaron of the Brookings Institution who said, “I look at the U.S. healthcare program and see an administrative monstrosity....”, with the reality being a fine collection of medically related special interests snuggly hooked into, and exploiting a corrupt political process.
Like much else to do with the United States government, special interests are looting and impoverishing the country.
So maybe American healthcare is just one example among many, as a well connected élite live in a bubble with world-class service, while the great unwashed (general public) get on a best they can, i.e. T.R.Reid's pessimism is fully justified.
He provides an interesting round the world tour of national health care systems (and sometimes
Show More
non-systems) showing for example how the French “Carte Vitale” carries a citizens entire medical history – cutting out a mass of expensive medical bureaucracy. The doctor simply slips the card into a reader and has access the patients full history right on the screen.In Canada a single payer national (or provincial) system allows the government to tightly control all medical cost across the country, with the result that Canadians have the same average level of health as Americans at about half the cost per person.
Reid continues with the examples, making it clear that US healthcare is a disaster on any kind of cost/benefit basis, and what is even worse, he shows the US even failing on basic measures of healthcare output such as infant mortality or the DALE rating (How long an average person can expect to live without serious illness or disability) with the US in 24th position behind most developed countries – despite its sky-high spending.
He quotes Henry Aaron of the Brookings Institution who said, “I look at the U.S. healthcare program and see an administrative monstrosity....”, with the reality being a fine collection of medically related special interests snuggly hooked into, and exploiting a corrupt political process.
Like much else to do with the United States government, special interests are looting and impoverishing the country.
So maybe American healthcare is just one example among many, as a well connected élite live in a bubble with world-class service, while the great unwashed (general public) get on a best they can, i.e. T.R.Reid's pessimism is fully justified.
Show Less
LibraryThing member Lisa02476
Fascinating and informative. A must read for anyone interested in health care delivery and the state of health care in the US. Quick, enjoyable read.
LibraryThing member larryerick
My first instinct is to summarize this book with examples, but by the time I would be done, you could have read the book. And reading this book is the absolute minimum that every American should do before claiming they have any clear understanding of our health care system. In brief, the author
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reviews America's health care status to other countries, then goes into detail on how several countries distinguish themselves from America. The comparisons are not flattering to the U.S. If you're not going to read the whole book, at the very least read the last chapter, "Major Surgery". Go to the local library or nearest big bookstore and just stand there until you're done reading it. Then have the good sense to go read the rest of it. For me, very little of this was a surprise. I've been working in and around the health care system for decades: providing direct health care, family members doing the same, processing health insurance claims for providers, negotiating health insurance coverage for employees, working in medical labs, managing health and safety programs for employees. I've seen it up close from a number of perspectives. This book is the bare bones of what one needs to know, and it's much more than most people realize. I should also point out that the book was first published just as "Obamacare" was being hashed out in Congress. In the original volume, the author barely mentions the Massachusetts health system upon which the new federal system is based. A later edition has a follow-up that goes into more detail about the new American system and how it measures up. Show Less
Awards
LA Times Book Prize (Finalist — 2009)
Language
Original language
English
Original publication date
2009
Physical description
304 p.; 5.56 inches
ISBN
0143118218 / 9780143118213