Healthcare: What Other Countries Do Better

Monday, August 24, 2009

T.R. Reid, veteran foreign correspondent for The Washington Post and the author of The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care (Penguin Press, 2009), follows up on his Frontline reporting with a book about what the U.S. can learn from other industrialized countries about healthcare. Plus: Freelance journalist Erica offers her first-hand account with the health care systems in the U.S. and U.K.


Erica and T.R. Reid

Comments [44]

Chris from England

I live in Britain and I think the thing that would surprise us Brits most of all is that the US " doesn't " have universal healthcare -how is that possible ? How can a modern country function without universal healthcare? I think, if they heard about it, it would dissuade a lot of Brits from ever contemplating moving to or working in the United States.

Mar. 10 2013 10:17 AM
Carmen Pinto from NY

No, it would not cut on innovation. Pharmaceutical companies only put about 1/3 of profits into research and 2/3 in marketing. In addition, many of the innovative meds are developed by government and university labs.

Sep. 07 2009 04:19 AM

The U.S. does not cover mental health well at all, no matter what insurance plan you have.

Aug. 25 2009 11:29 AM
pielouka from upstate

I give up on America. It's that special combination of just too many ignorant people who consistently vote against their own interests, coupled with a political system that is corrupt and rotten to the core because of political donations and lobbyists.

You'd think that HealthCare reform was a no brainer, right?

#1 The costs are a major, and ever-increasing problem for both the country and many of its citizens.

#2 There's numerous examples of other states doing HealthCare cheaper and better.

So what gets in the way of a speedy yet thorough analysis and plan to remedy our problem along the lines of a more successful system in other states? See first paragraph.

Aug. 24 2009 02:05 PM
Elvin from The Garden State

I agree with Artista (commenter 30). While I may joke around and call someone a left wing (or more often right wing) nut, it was quite unprofessional for Andrea Bernstein to use this term. Also, it's incredible that if you push for universal health care you are labeled a nut. Yep, just like those nuts trying to end war and death by preventable diseases, or get education for kids, or promote fair wages and working conditions. How dare they get in the way of those corporations that profit off of human misery!

Aug. 24 2009 01:56 PM
hjs from 11211

i've done it.

Aug. 24 2009 12:11 PM
Kelli from Queens

Please don't tell me you can get free health care at the Emergency Room if you don't have healthcare unless you've tried this yourself. First off, they will only treat the emergency. They will stabilize you so that you can leave as soon as possible. Two, then you have your emergency rooms full of non-emergency illnesses. Taking up time that could cost you your life.

Any concern that the system would be awful is up to us to ensure that we hold all politicians accountable.

The people against this are the same people that wanted us to privatize social security. Where would the millions of senior citizens be right now if they invested their social security in the stock market? We privatized prisons and are return rate for prisoners went from 35% to 85%.

I worked with drug reps. And there are companies that reward doctors who write prescriptions to their clients who pay with cash - they give these doctors cash, trips, all kinds of things. I have a business card from a guy in health care product sales and he rewards each of his doctor's with a $1,000 per month for each referral!!! The kickbacks and amount of waste that pharm companies pay is astronomical. The advertising and stupid gifts with their names on it - are worth billions each year. I've seen doctors write a RX because they liked the rep and not because it was the best things for their client.

Aug. 24 2009 12:08 PM
Elaine Richard from Manhattan: Upper West Side

Sadly, my two oldest friends in England (I'm English originally; though a seasoned New Yorker after 38 years here) have cancer. They are both in their mid-sixties. One is dying; the other has a reasonable prognosis. The care they've both received from the NHS has been more than wonderful. And they both get very upset when the system is put down by people here who know little or, worse, nothing about it. As do I. I know no-one, my own father included, in England who hasn't been extremely happy with their care under the NHS. One small detail that reflects the quality of that care (aside from the excellent actual medical/surgical aspects): the second day after major stomach cancer surgery, one friend realized she was being visited by nurses and caregivers about every 20 minutes. She mentioned this and was told that it's hospital policy as patients tend to get depressed after the euphoria of surviving the operation has passed. So they were coming to check on her state of mind with a kind word, a gentle touch on her hand, a smile and, sometimes, a cup of tea. When I tell them of my own lack of decent insurance and the dreadful experience I once had at St. Luke's-Roosevelt, they ask why I stay. And I tell them I love New York too much to leave. And that Mr. Obama needs all the support he can get in his extraordinarily patient (the other sort) and levelheaded battle to get help for us all (including the loudmouthed, the don't-give-a-damns, and the ignorant).

Aug. 24 2009 12:04 PM
Kelli from Queens

People are not getting this right. What it really comes down to is the belief of "Not with my money". People don't want to help out others in this Country yet when they lose their job, encounter a flood, or have their own emergency they want to know why the government isn't helping them more.

My best friend's family has over $50 million in assets and has paid not one dollar in taxes in the past 20 years.

This plan won't take away your Aetna, United Healthcare or Blue Cross. This plan would provide healthcare for the millions that don't have it. And when people have healthcare they can get better jobs, make more money and spend more money. They will invest in the stock market and buy your products. Instead of being a drain on our economy they will be a part of increasing wealth.

Don't even start on the abuse of the poor in this system because it wasn't the abuse of the poor that brought down Wall Street or caused each of us to spend an extra thousand or more on gas these past eight years.

When you mention abuse of the poor you need to also indicate the abuse of the rich. It goes both ways. And if we want prayer in our schools, "In God We Trust" on our money and posted in our Post Offices then where is the support for our fellow Americans?

Aug. 24 2009 11:58 AM
Carol from Garrison NY

I agree with every word spoken by the English woman caller to the prog. The phobia expressed in this country against a single payer system "socialist medicine' is appallingly uneducated. For 50 years I received wonderful healthcare from the British National Healthcare service. For the past 19 I have struggled with the beaurocracy of this country's archaic system. I pay far more in terms of premiums (2 oldest children have jobs with no healthcare so my husband and I have to pay out of pocket) than I ever did in taxes in UK. Here my insurance company will NOT let me have the gatekeeper doctor I want, only the one they choose. We wrangle with the company constantly over payments - so many manhours spent by the insurance company making mistakes, incorrectly denying coverage and then re-instating, wrong payment demands etc. etc., doctors not billing correctly. There is massive waste of time and money. How can this beaurocracy possible be worse? There is just an unreasoning, unreasonable fear of 'government' as though it were something other. Government is us, we the people are government and if we just become a little more active in our democracy and engage our brains a little, the government can be made to act on our behalf as it should and not just respond to big donor interests.

Aug. 24 2009 11:52 AM
mc from Brooklyn

Reid's book should be required reading for everyone working on health reform.

JJ: Pharma companies spend far more on advertising and marketing than on R & D.

Dan from Munich: This is what is missing from our debate now. What is a fair percentage of your income to pay?

Nancy from NYC: He is talking about average insurance cost, which is subsidized by an employer.

woman from Inwood: France rates the highest according to the WHO in health care delivery, satisfaction and patient outcomes.

Aug. 24 2009 11:50 AM

Thanks for a healthcare discussion without the hyperbole.

Aug. 24 2009 11:49 AM
Sandra from Astoria, Queens

I gotta quote travel writer Rick Steves: "The Danes are highly taxed and highly content." Europeans pay higher taxes and get a much better, healthier, and happier society and populace (anyone who's travelled there can attest to that).

The working class pays taxes here but gets nothing in return--basically our taxes go to subsidize the taxes that the rich AREN'T paying. I work for a living and pay a higher tax rate than some trustfund brat who doesn't work and sits around collecting dividends on their stocks.

Aug. 24 2009 11:47 AM
Jacqueline Snyder

In any medical care, accurate, insightful diagnosis is the most important first step. In the U.S., I prefer to see specialists, because they are often better diagnosticians than are GPs. Specialists often have completed research fellowship(s), in addition to their medical residencies, and this may account for their greater ability to diagnose.

My question relates to health care systems that rely heavily on GPs, such as the UK system: If these GPs are acting as triage--deciding whether a patient may or may not see a specialist--do these GPs have though training in diagnosis?

Aug. 24 2009 11:45 AM
artista from greenpoint

very nice segment, along with anthony Wiener earler.

what does it mean that Andrea Bernstein, a trained journalist, refers unbidden to the news of 20,000 uninsured deaths by wondering--out loud--if the writer is some left-wing nut? I love you andrea, and missed you while you were in J school, but please rethink your own assumptions!

Aug. 24 2009 11:44 AM
K. Hughes from NJ

The woman who is moving to England had an interesting comment about GPs. This leads to my own observation that GPs/internists do less today than years ago. Anything out of the ordinary and you are sent to a specialist! Is that because of health insurers? I would think that it drives costs up and is part of the problem?

Aug. 24 2009 11:42 AM
Loretta from Manhattan

Response to first caller this morning:
My friend's mother was turned away at a Jersey City hospital on Friday because she had no health insurance. She was admitted to the emergency room two weeks ago with a foot sprain and sent home. Her foot made a turn for the worse, and she cannot get a appointment to see a doctor because she has no insurance. The law does not always apply in practice!

Aug. 24 2009 11:41 AM
Tara from New York, NY

Um....if I had a serious health problem I would want to be treated and monitored by someone who is
specialized in that area of medicine NOT my GP!

Aug. 24 2009 11:40 AM
Liz Levey from Jerusalem, Israel

I live in Israel and have MS. I formerly lived in the US and had an excellent insurance policy and health care. But in Israel my care is equally good, perhaps better, because I see my neurologist more frequently. My major MS medication, Rebif, is covered 100%. Full price is over $1000. I don't know where Israel falls within the different categories, but the care I receive is excellent. I should also say that my GP is very strong on preventive medicine.

Aug. 24 2009 11:39 AM
Moiz Kapadia from Newark, NJ

We hear a lot about the monetary index of health reform, but we never hear about a quality of life index.

What about the value of not having to be stressed about paying for health care, what about the value of knowing that if something ever happened to you, your family, or friends - that they would be OK.

Start talking to the people in words and terms that aren't monetary, and they'll start thinking that way.

Aug. 24 2009 11:36 AM
the truth from bkny

wow this guy...village healer?

Aug. 24 2009 11:36 AM
Che F. from Soho

i'm sorry if i missed it, but can the speaker speak more to the Japanese health-care system. Particularly to the combination of Indian, Chinese and Western Medicine and how they intermingle in their healthcare system.

Aug. 24 2009 11:33 AM
Konstantin Doren from Boiceville, NY

I had to wait for four weeks when my employer paid for my health care for just a general checkup.

Uninsured pay for the insurance of their older and poorer neighbors. Why should they pay for this and not have health care themselves?

Plus everyone pays for the health care system that the government regulates and supports. Thus, uninsured are subsidizing the costs for private health insurance.

Aug. 24 2009 11:31 AM
hjs from 11211

thanks for the info!!

Aug. 24 2009 11:31 AM
a woman from inwood

BY the way, in France, every (rare) time I, an american, visited a doctor or a dentist I was so amazed at how cheap and efficient and high quality the care was, I didn't file for the reimbursements of the cost (at the time you had to file for reimbursement, but now they use a digital system). I could afford not to! I preferred to leave my money in the system. That was my vote of support. You know why it's cheaper there? Because everyone is paying into it. Not just those lucky few who can afford to pay high premiums.

When I came back to the states, my first doctor's visit ended with the receptionist saying a word I'd never heard before, that sounded like, "selpé?" She had to repeat it several times before I realized she was saying "self-pay?" I said, of course. I'd pay myself. I'd rather pay full price now and then for my rare medical visits here, than buy into the corrupt, greedy private health plans here.
I have a friend who lost her job, and went over 90 days without paying health insurance premiums. She was diagnosed with breast cancer. She was out of luck.

If I come down with something like cancer, guess what my health plan is? Go back to France and pay full price there. Still cheaper than being here under private health insurance.

Aug. 24 2009 11:30 AM
a woman from inwood

Randy, I lived in France for 12 years. For six of those years I was not a legal resident. So I paid full price for any visits I made to the clinics available under national health insurance there. I had originally dreaded going because I was very low on money. But to my surprise it was CHEAP compared to the USA. About twenty bucks for the visit. If I'd been a legal resident, I could have asked for a reimbursement of the cost, under the terms of national health. The quality of my care was excellent.

When I got a legal job there, I paid into the national health system. I could see, when I paid my taxes, something called "charges sociales" which I was told was for health care. It was a little steep, but considering that I could be reimbursed for my medical costs now that I was in the system, I didn't object.

So, yes, Randy, they pay higher taxes, but consider what you pay for health insurance. In France you pay what you'd pay for private health coverage to the government instead, at tax time. In fact, it seems steep because you pay it all at once, but what you pay in higher taxes is less than what you pay in regular taxes plus health premiums added up here. And nobody can say, "sorry, you have a pre-existing condition."

Aug. 24 2009 11:29 AM
Nancy from NYC

Wait, Mr. Reid estimated people pay $500 per month here for health insurance? I'm on COBRA, paying SEVENTEEN HUNDRED DOLLARS PER MONTH to cover one adult and one child. Health care reform NOW!

Aug. 24 2009 11:29 AM
Jay from NJ

I pay more than $1000 a month for health coverage through my company, and I still pay $20.00 co-pay everytime I visit.
My parents live in South Korea. Even South Korea has national insurance.
When I go to visit them, I sometime go to a doctor office. There is no wait. I see a doctor right away, and the cost without any insurance there, is still about the same as the co-pay I pay here.
The quality of care there is as good as here, if not better.
Why is it that I am paying $1000 a month and still paying the co-pay?

Aug. 24 2009 11:27 AM
Dan from Munich

BUT in Germany the cost of insurance is a fixed percentage of your income that is set by the government and they aren't allowed to make a profit. They compete for insurees by promising better service. And if you can't afford insurance the government pays it for you until you can. If you are going to categorize insurance around the world, do it right.

Aug. 24 2009 11:27 AM
Konstantin Doren from Boiceville, NY

On waiting. When I had health insurance provided by my employer, I had to wait for nearly a month for an appointment to do a general check up.

On paying. Uninsured people are paying for their senior and poor neighbors. Plus, the government on all levels pays for the health care system, including research and for the regulation of a system uninsured cannot use.

Aug. 24 2009 11:27 AM
Nancy from NYC

Health Care Reform RALLY at Times Square, Saturday Aug. 29th, 2 pm! For more info:

Aug. 24 2009 11:26 AM
Christopher Deignan from Middle Village

I think it's very important to point out that there is private insurance available in the U.K. which you can purchase to supplement your NHS coverage if you're unhappy with it.

Aug. 24 2009 11:26 AM
nat from Brooklyn

When we compare ourselves to other rich countries, we often skip the basic premise that underlies our entire system. We believe that it is socially acceptable to profit off of sickness. The demand for health care is constant, and the supply exists; it is an inexhaustible market. However at the end of the day that means treating human beings as though they are any other commodity.

It is a hidden brutality in our culture that we need to face down before we can even move to having a real debate. People need to do decide that medical bankruptcy and death from preventable disease is reprehensible in a civil society.

Aug. 24 2009 11:26 AM
Megan Martin from Brooklyn

I was visiting Northern Ireland a few years ago and had to go to the emergency room for a back injury. I waited 3 hours to be seen and when I went to present my health insurance card they waived me away and said it was free.
I went to the Ryan Nena clinic in the East Village first thing this morning since I'm now uninsured and was turned away because they were too full. They told me to come back on another day to try again even though I have a semi urgent health concern. And it costs me $93 to see a doctor there. Please tell me how this system isn't broken.

Aug. 24 2009 11:26 AM
Matthew from Astoria


What kind of insurance do you have now? Would it cover the major surgery for your shoulder? And - KEY QUESTION HERE - if your insurance company says that it would cover that surgery, is there a danger of the insurance company denying the claim for the operation after you had it?

Aug. 24 2009 11:25 AM
Dan from Munich

The rule in every other country you've been to is BAN PROFIT. Why is this never mentioned? In other countries health insurance providers are not allowed to make a profit selling the basic coverage.

Aug. 24 2009 11:22 AM
Dave Lewis from Free?

Tell your guest that nothing is free, taxpayers end up subsidizing government health care. Make it free and access will be abused.

Aug. 24 2009 11:20 AM
Chris from New York

Common reasons to reject changing healthcare:

~No, leave it alone, I don't want to pay more taxes.
~I already pay enough taxes, I can't afford to pay more.
~I'm sick & tired of paying all these tax hikes to pay for programs for the poor. I'm poor/struggling but because I have a job I don't qualify for anything!!

Taxes are going through the roof but my salary has stayed the same. I can barely afford my rent anymore. No more new taxes!

Aug. 24 2009 11:20 AM
M. L.

Can you comment on whether or not health care leads to most of the bankruptcies in the U.S.? I heard that claim somewhere but some time later heard that statistic was untrue.

Aug. 24 2009 11:20 AM

What about taxes. Don't they have higher taxes?

Aug. 24 2009 11:09 AM

How do these other countries deal with malpractice insurance and the ability of people to sue doctors

Aug. 24 2009 11:09 AM

What about the stories of long waits to see a Dr. or get an operation?

Aug. 24 2009 11:08 AM

My aunt is being treated for cancer in England with the NHS. I think that the treatment she is getting from the doctors is excellent and thorough. However, she is getting a second opinion at a private hospital, and when she went to get her MRI from the NHS hospital, the hospital had lost it! So she can't get it now to show the private hospital.

Aug. 24 2009 11:08 AM

If we go the route of other systems, would that hurt the innovation of our Pharma companies. The reason why I ask is I am under impression there are price controls on pharma in other countries. If you take away their profit motive, would that cut down on innovation?

Aug. 24 2009 11:07 AM

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