The health care debate has made T.R. Reid a very popular person.  He’s appeared on numerous talk shows, news broadcasts, and podcasts to discuss his new book about health care in the United States.  In one of those podcasts, he said he wanted to answer the question: “How come all the advanced democracies manage to provide high quality health care for half of what we spend?”  “It’s not all socialized medicine” in those other countries, Reid said. 

The book analyzes four models of health systems.  Reid writes, under the National Health Service in Britain, people may go their whole lives without paying a doctor bill.  He said taxes are high there.  But, Brits pay half of what we pay for health care.

Then, there’s the Bismarck Model in Germany.  It’s an insurance system with roots in the 1870s.  In this approach, Reid said doctors, hospitals, and insurance plans are private.  Employers and employees divide the cost of health  insurance premiums.

Reid described Canada’s National Health Insurance model as a blended system.  He acknowledged some points made by Canada’s critics.  He said there are limitations on the number of specialists and operating rooms and machines.  He also said that people are likely to wait, if they want attention for non-emergency medical care.  But, apparently, Canadians accept that.  Reid described a conversation with the Canadian Health Minister who told him the people “don’t mind waiting that much, as long as the rich Canadian and the poor Canadian have to wait almost the same amount of time.”

Then, Reid described the “Out of Pocket” model which he said is, in short, if you can’t pay, you don’t get care.

In Reid’s analysis, the United States’ model combines all of the above.  He said some Americans get the finest care and “millions of others never even get in the door.” 

Reid concluded insurance companies bear some responsibility for the complexities of our system.  He told one interviewer the insurers stay with one company only 4.8 years on average.  So, they — the insurers — assume the expensive diseases will fall on a customer’s next insurance company.

By now, you might have guessed where Reid falls in this debate.  He said the United States needs to make a moral commitment.  “If we Americans could find the political will to cover everybody,” he said, “if we had the will, all the other countries could show us the way.”