Friday, May 28, 2010

Reading Reid’s The Healing of America

Evenings have been peaceful this week. (So peaceful, in fact, I forgot to blog last night.) After supper on Tuesday and Wednesday, I went outside and sat reading the library book that is due tomorrow—T. R. Reid’s The Healing of America. The neat green lawn Gerald keeps so perfectly goes down to the lake, and on the other side is the little island he created one summer by cutting a channel. With the coming of spring, our side of the island has large green trees, honeysuckle, and rich green vegetation. In the encircling distance are more green woods. The only sounds are the happy tweeting of the martins swooping and sailing all around me. Above is a huge blue sky filled with marshmallow white clouds, and I wonder why I don’t sit out there every night. I know why, of course. Usually I need to be doing something else.

Tonight I enjoyed the same outdoor scene from the upstairs living room glancing out the windows as I finished the book and watched the sky darken and the rain starting to fall. It rained hard for half an hour, and I found the sight and the sounds of the rain beating the windows made me feel cozy and protected.

Reid’s book is very informative about the various health systems of the world as he goes around the globe exploring them. He points out that though our nation is one of the wealthiest and we spend the highest amount of our Gross Domestic Product on health care, we are the only developed nation with families going bankrupt because of medical bills--around 700,000 a year according to a joint study by Harvard Law and Harvard Medical Schools.

He says that in 2009 there were some 45 million Americans who spent at least part of the year without health coverage and sites the Urban Institute’s estimate that more than 22,000 Americans die annually because they cannot afford health care. Our high infant mortality rate shames us. The other developed nations feel a moral imperative to give health care to all citizens regardless of their economic status. Because of this, they have developed not just universal care but also spend far less of their GDP than we do. As one of many examples of cost control he sites that an MRI scan that costs $1200 in Denver only costs $98 in Tokyo.

Reid knows that those with good insurance have good care and that citizens with low enough income have Medicaid and those of us who are older have Medicare. It is that 15% of uncovered working citizens or citizens who have lost their coverage due to illness that he cares about. The ones who have to be dying or in hard labor to be admitted to the emergency room and then diseases are too for along to be treated cheaply or effectively.

Since Reid’s book was written prior to our newly enacted health care bill, some problems may be solved when it goes into effect. The changes should mean that losing a job or being denied insurance because of bad health will no longer mean loss of health care. Reid believes the very complexity of our present system creates higher costs. Will our new system be less complex?

He greatly admires the French for their “vital card,” which a patient hands his doctor which has embedded a digital record of the patient’s medical history. There is no need for cabinets full of records nor for filling out long forms by hand each time you go to a new doctor. (That card was developed in the United States.)

He emphasizes that the countries having universal coverage do not have socialized medicine, such as our Medicare or care for veterans is. Most do have competing private insurance companies for basic health care but they are non-profit—the way most of our health insurance companies used to be. People who want more than basic care, such as private rooms, are free to take out for-profit insurance policies, but most are content enough not to do so. Most nations with universal care soon see the economic and social value of pushing preventive medicine.

All the universal health care systems are different, and Reid thinks we should thoughtfully adopt the best ideas from each system. He notes that every developed nation constantly refines and reforms their health care programs, and that no one is ever satisfied that it is perfect. I suppose that is what we will be doing in the years ahead.
I didn’t have the business mind to understand much of the debate during our recent debate in Congress, and I did not completely understand the various models that Reid explains. But I do believe good Americans want their families, friends, and fellow citizens to have care when they are sick, and I am sure I am not alone in wanting our babies to live past their first year of life.

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