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The Healing of America: A Global Quest for…
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The Healing of America: A Global Quest for Better, Cheaper, and Fairer… (original: 2009; edição: 2010)

de T. R. Reid

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5472034,067 (4.36)9
"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.
Membro:MariposaFJAR
Título:The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care
Autores:T. R. Reid
Informação:Penguin Books (2010), Edition: Reprint, Paperback, 304 pages
Coleções:Resource Library
Avaliação:
Etiquetas:health care, public health, non-fiction, health care reform, international comparison, universal coverage

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The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care de T. R. Reid (2009)

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An ounce of prevention is worth a pound of cure.

An enlightening book about Health Care around the world, that will make you question your own country’s system and learn how other people use it.

Ask yourself: do you believe health treatment is a human right? Is being healthy a right or a privilege? Would you want to pay taxes to have access to free care? Does one’s rich kid have the same right to care as a poor kid?
To each his and her own answers.

However, despite anyone’s political and religious stance, American healthcare system is a pretty good example of a kind of Social Darwinism.

Introductions

Published in 2009, T. R Reid is a journalist who traveled around the world with two main goals: one, was to report on the healthcare systems of various countries from Europe to Asia, then find a “cure” to America’s system by taking ideas from foreign ones; two, was to find a cheaper and efficient way to fix his shoulder problem that has been nagging him for years, barely able to move it properly, much less take a swing at golf.

USA fears socialism, even more nowadays. Anything too much on either side, according to abstract measurements, its scary. But where health funds are concerned, anything the government provides to people for free, is called “Socialized Medicine”.

As a European, I laugh at this. We are pretty aware our right wing politics are almost heretical when heard of in the US, specially when even our most capitalist models make sure everyone is covered and does not receive a medical bill after any doctor’s visit or operation.
For example, free nationalized health care is such a basic part of the British, not even our dear Iron Lady, Margaret Thatcher, dared touch it. She was our (conservatives) capitalist conservative ideal: privatized everything! Except health care. Health care is considered a moral obligation.

Curiously, the author argues the problem is not even about socialism. Not really at least. Its rather because free healthcare is Un-American. These systems are foreign and adopting them is like treason to Uncle Sam’s patriotism. With this also indicates writing this book in memory and honour of President Dwight D. Eisenhower, who learned some things about public service during the Great Wars. So much, he imported the Interstates System with miles of roads, bridges, interchanges and no stoplights, eventually opening way to suburbs, motels, etc.

This system was originally made by the Nazis.

Health Care Models in a Nutshell

Bismarck Model - Coined by, you guessed it, Otto von Bismarck. Hospitals and doctor services are private, but everyone is covered by insurance that covers all citizens. Its financed by deductions in payroll from employers and employees. Switzerland, France and Germany for example, use this model.

Beveridge Model - Created by Lord William Beveridge, is the closest to “socialized medicine” that we can get. Provides healthcare to all citizens, financed by government through tax payments. Portugal, Spain and Great Britain use this model.

National Health Insurance - has elements of both. It uses private-sector providers, but payment comes from a government-run insurance program that all citizens fund through a premium or tax. These universal insurance programs tend to be less expensive and have lower administrative costs than American-style for-profit insurance plans. National Health Insurance plans also control costs by limiting the medical services they pay for and/or requiring patients wait to be treated. Used in Canada.

Out of Pocket Model - Found in majority of the world and in countries too poor or disorganized. Those who can pay for services get a chance at life, those who can’t pay get sick and die.

Americans use all of them

For most people under sixty-five: Bismarck - worker and employee share premiums for insurance. Insurer picks up most of the tab for treatment, with patient making co-payments or a percentage of it.
Native Americans, military personnel and veterans: ’socialized medicine’ - doctors who are government employees working in government-owned clinics and hospitals. They never get a medical bill.
Over sixty-five: Canada - U.S Medicare is kind of a National Health Insurance. Near universal participation and low administrative costs.
For over 45 million uninsured Americans (27,5 million as of 2018) they’re Out-of-Pocket - You pay, you have a chance. You don’t pay, you die. You are employed, you get insurance. You lose your job, you lose it and no one covers you.

What are your values?

Tsung Mei Cheng says:

1. No matter how good health care in a particular country is, people will complain.
2. No matter how much money is spent on health care, doctors says its not enough.
3. Last reform always failed.

Conclusion: People just like to complain. The Fairest assessment, I guess.

Lets use my country, Portugal, as an example.

We use the Beveridge Model, here. Rich or poor, you’re covered. Whether we ever truly had a right wing party in power, its debatable, but we always were SNS’s (National Health System) bi*ch. Its not just part of the government core values to provide health care. We are an old country with people more keen on YOLO than making babies, so our old people feel the need to be supported and agree its the moral obligation of a government to provide them with it. They won’t take any truly conservative plan on healthcare system seriously.

With the increase in extremes in the political spectrum, the right and libertarians took opportunity to finally take advantage of the attention they getting, good or bad, and shift mentalities to more liberal ways of thinking. More parties around Europe also want to take a step back and give the patient a choice to bail out on the System and be able to choose private services without penalties, which are at this point, better equipped to deal with waiting lists. Our public service got to a point our waiting lists are huge and people can die on the hallway, yet our public hospitals have up to date technology and great professionals. So, people of all classes, just go to private hospitals to get it all done.
Government complains about the lack of doctors in the public sector and now they want to force public service on them for a few months or years before being able to choose where they want to work.

This don’t sound like freedom to me, ya’ll.

Plus our taxes are at all time high every year yet we’re not getting what we’re paying for.
This being the case, the shift tends to call for an adoption of the Bismarck Model like Switzerland.

This means, even at our worse, we make sure everyone is covered by healthcare, specially the poor, but gives freedom to those who want to choose their doctor or their clinic, creating competition, dynamic visits and shortening waiting lists with quality consultations. Private Insurance Companies exist but the government simply makes them compulsory.

My point?

We ought to know a country’s ethical values when applying a healthcare system. Study the lay of the land properly. A well meaning, totally legitimate and correct group may want to privatize more a system but if most of the population feels its going to suffer with it or agrees its the right of a higher authority to provide such commodities, then that’s the county’s moral compass to follow.

At the end of the day, its a game of ethics and it takes an immense amount of convincing to show one system is better than the other and its going to benefit everyone in the long term. “Going private gives freedom” or “stop sucking the tit of the government” make great posters but are politically vague.

In America, there has to be lengthy discussions about it. The population apparently believes health care is a basic human right, yet remain unaware how to make it so. “Socialized medicine”, “big government mandates”, “caring for our children”, its all about the economic initiative.

What are USA’s values?

A moral caveat

Are our ailments our fault?

You pay taxes for it, you deserve it, right? In America everyone pays taxes, but only a select few benefit from them. This means if an unemployed bloke gets sick he must pay from his own pocket, because the soldier benefiting from government doesn’t have to pay for one random person’s irresponsible acts.
In a National Insurance like the one in Europe, the cost is shared. We all pay taxes so everyone can benefit. You pay your taxes but only need the doctor once a year, although for free; meanwhile some unfortunate bloke is using his and everyone’s taxes to cure his illness.

This may create a Nanny State: a state so overprotective and interferes so much in the personal choice of the patient, you’ve become your own thought and acts police on top of the government’s restrictions. That’s because if you’re paying taxes for others to use, then you virtually have the right to nag your neighbors to adopt healthy lifestyles and stop wasting money. Same for everyone else, so you better watch your own habits too!

Final Thoughts

Article 35 of the Charter provides for a right to health protection as the “right of access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices”. Article 35 specifies that the Union must guarantee “a high level of protection of human health,” meaning health as both an individual and social good, as well as health care. This formula sets a guiding standard for the national governments: do not stop at the floor of the “minimum guaranteed standards” but aim for the highest level, notwithstanding differences in the capacity of the various systems to provide services. - European Chapter of Patient’s Rights, Rome November 2002, Final Draft

As you see, its part of the European ethic to provide healthcare and its a powerful Soft Power.
America has a lot of talk to do, and all this drama around identity politics is nothing but smoke screen for actual important issues such as these. Occupies time and wastes money and clout.

T. R Reid made something very good to Americans but also to everyone outside of it. As I like to say: puts things into perspective. Maybe his perspective, but its a legitimate one. He didn’t simply experience and made his mind about it. He interviewed ministers, doctors, staunch entrepreneurs and patients of each country he visited. Its an extraordinary reported piece giving the reader a holistic view of the Health System around the world by reading detailed descriptions of these specific systems in various and even culturally different countries.

If you’re looking to know more about Health Care and give more meaning to whatever vote you cast in the next elections, I recommend this book. Be mindful of its objective but also ask yourself the questions it raises.

Addendum: After this odyssey, his shoulder got much better and has much better range of motion, all thanks to cheaper, quality massages.

The United States of America says a foreign model doesn’t work here, but the truth is they can work, because in part they're already using it. ( )
  Igor_Veloso | Dec 16, 2019 |
This is a book that every American should read. Reid compares health systems of many of the advanced countries of the world and shows how and why the United States falls short of countries like France, Japan, the UK, and Canada in terms of percentage of citizens covered by insurance and how efficiently healthcare is delivered. In the process, he debunks many misconceptions that Americans have about the choices citizens of other countries have in their healthcare and which ones practice the dreaded "socialized medicine." For the US to catch up to the world's leaders in efficiently delivering quality healthcare for all its citizens, Reid asserts that the US must first reach a national consensus that there is a moral imperative to do so. He cites the example of Taiwan as a country with a well-developed capitalistic economy that in the 1990's made that national commitment and implemented the changes necessary in its healthcare structure to satisfy that commitment.

I hasten to add that Reid conducts his discussion of this most important of topics in a wonderfully clear and engaging way and amply documents the research that led him to his conclusions. ( )
  bookishblond | Oct 24, 2018 |
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 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. ( )
  larryerick | Apr 26, 2018 |
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. ( )
  Lisa02476 | Jan 17, 2017 |
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 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. ( )
  Miro | Apr 25, 2016 |
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"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.

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