What can America learn from Switzerland and France about healthcare reform?
Quite a lot. T.R. Reid's new book shows that other rich countries have provided quality healthcare to all citizens at a much lower cost.
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We can do better. "What I saw in all the other developed countries," Reid says, "is that they decided that a rich society has an obligation to see to it that anybody who's sick can see a doctor. All of the rich countries have agreed on this except one. The United States has never made that basic moral commitment."Skip to next paragraph
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Reid, a veteran foreign correspondent, spotlights three paths that other countries have taken to walk their talk. A "Bismarck" system of private insurers and providers – financed through payroll deductions, but universal and portable – works for Germany, Japan, and Switzerland. Britain runs a "Beveridge" system (similar to what the US provides military veterans). Taiwan, France, and Canada run national single-payer health plans funded by government through taxes (like Medicare, which we currently provide to 36 million of our own elderly).
What America can't continue to do forever is operate a mishmash of market and government systems that has become the worst of both worlds. Reform will be as simple – and as difficult – as deciding on one approach and executing it.
Notably, once citizens in other nations have agreed that healthcare is a moral imperative and a right, they've found ways to summon an equal measure of individual responsibility for healthcare that sounds … well, pretty conservative.
"In Britain," Reid says, "if some fat guy is sitting at the bar with a pint and a plate of chips, a complete stranger will walk over to him and say, "Hey, mate – go easy on all that. I'm not paying for your heart attack." What true conservative would choose a fat tax over the simple stigma of a snack attack?
Reid wonders aloud whether Britain's peer pressure amounts to a "nanny state." But the effect seems the opposite, and far more effective: a health system where choices are made by individuals held accountable to family and community. Where the irresponsible, rather than being policed by bureaucrats, make a direct impression on fellow citizens, right where it hurts – in their wallets. Sounds more like a "neighbor state."
"I want to see us get this done," Reid says, well after midnight. "If we could find the political will to cover everybody, the other countries can show us the way. They've all done it, for a lot less money than we spend. And they're getting far better health outcomes."
Among all of the issues Americans are struggling with right now, healthcare reform is generating a fearful focus inward.
Let's just take a deep breath, turn our heads, and learn. It won't hurt a bit.
Mark Lange is a consultant and former presidential speechwriter.