Monday, October 12, 2009

T.R. Reid at MGMA: Why doesn't the U.S. health system cover everyone?

Why doesn’t the U.S. provide healthcare coverage to every citizen?

It’s a question Washington Post correspondent and author T. R. Reid posed as he sought to explore what the U.S. can learn from other countries’ healthcare systems. All the other industrialized counties manage to cover everyone – and spend less money doing so – so why don’t we?

Reid, who spoke this morning at the MGMA annual conference in Denver and recently published his book The Healing of America, concluded with this thought, that seems to get at that vexing question: “If you don’t make a moral commitment (to cover everyone), you end up with a system like ours…. We’ve got to make that commitment to fix our healthcare system.”
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It’s on this point that Reid drops his reporter objectivity. Healthcare coverage, of lack thereof, he said, is a fairness issue, a question of what is decent, humane, and just.

Reid spent about three years traveling the word and exploring the four main models of healthcare coverage that exist, which range from socialized medicine of Britain to the out-of-pocket model (if you can afford it, you get it) of Angola and other poor countries.

The U.S. has all four models, but other industrialized countries – you know, the ones that cover everyone – chose one model and they make it work.

Why one model? It’s “vastly simpler and vastly cheaper,” he said. It’s also fairer. In each country, including the U.S., the design of the healthcare system reflects the values of the countries, he argues. Other countries have sat down and made the decision to cover every citizen. And the U.S. hasn’t. Real reform, he said, won’t be achieved until the U.S. makes that decision.

“If the U.S. could find the political will to provide healthcare for everybody, the other rich countries can show us the way,” he said.

Perhaps unsurprisingly, he wasn’t very optimistic about real reform passing in Congress this fall. The plans would still leave millions of Americans uninsured, which still means a costly, inefficient, and, he argues, unfair system.

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