Friday, January 29, 2010

More on health care debate from T. R. Reid (Final)

Here are the final collection of quotes from The Healing of America:  A Global Quest for Better, Cheaper, and Fairer Health Care:

There are useful approaches, ideas, and techniques we could learn from health care systems that are fairer, cheaper, and more effective than ours (pp. 44-45).

Most nations try to drop the Out-of-Pocket Model as they grow richer (p. 151).

In the process (of trying different reforms), the basic moral question that should drive reform --- do we want to give everybody access to health care? – gets swept aide… “The Clinton defeat,” argued political analyst Ezra Klein, “taught many that health care is simply too big, too complicated, and too dangerous to touch” (p. 163).

Both countries (Taiwan and Switzerland) decided that society has an ethical obligation – as a matter of justice, of fairness, or solidarity – to assure everybody access to medical care when it’s needed. The advocates of reform in both countries clarified and emphasized that moral issue much more than the nuts and bolts of the proposed reform plans. As a result, the national debate was waged largely around ideals like “equal treatment for everybody,” “we’re all in this together,” and “fundamental rights” rather than on the commercial implications for the health care industry… President Clinton emphasized economics. The moral issue that drove major change in Taiwan and Switzerland never got really moving in the USA (p. 182).

Whereas all other nations work from the time the line turns blue to introduce a healthy new person into their health care system, the United States first attends to its poorest mothers and newborns in the hospital on delivery day… Until we adopt a health care system that encourages it, preventive health care will remain largely inaccessible to far too many Americans (p. 202).

Which inequalities will society tolerate? Is it acceptable that some people are left to die because they can’t see a doctor when they get sick? That question encompasses a more basic question: Is health care a human right?... Is medicine a commodity to be bought and sold, a product like a car, a computer, a camera?... The creation of a national health care system involves political, economic, and medical decisions, but the primary decision to be made is a moral one (p. 212).

Twenty two thousand Americans (USA) die each year from treatable diseases (because they do not have health care) (p. 217).

Does a wealthy country have an ethical obligation to provide access to health care for everybody? Do we want to live in a society that lets tens of thousands of our neighbors die each year, and hundreds of thousands face financial ruin, because they can’t afford medical care when they’re sick?... Every developed country except the United States has reached the same conclusion: Everybody should have access to medical care. Having made that decision, the other nations have organized health care systems to meet that fundamental moral goal. . . .

At the start of the twenty-first century, the world’s richest and most powerful nation does not have the world’s best health care system. But we could… We can heal America’s ailing health care system – and the world’s other industrialized democracies can show us how to do it (p. 239).

(Though there is legitimate debate re. the health care rankings of countries, this is clear and not in dispute): there is a coterie of developed countries that are providing quality health care, distributing it fairly and equitably – and doing all that for much less money than the United States is spending (from the conclusion, at end of appendix – p. 256).

1 comment:

Anonymous said...

I do not discount the difficulty in changing healthcare in the U.S. What I continue to find hard to understand, as the healthcare debate rages, is the ease with which legislators slash or postpone portions of the bill that will provide healthcare for those who do not have it. I do not want to believe that there are those who don't believe that healthcare is a fundamental right - that it is acceptable for 22,000 people to die because they can't afford to go to the doctor. If we believe, and I do, that everyone deserves the same level of care, how can we ask people to wait? or to be left out entirely. When we do, finally, really believe in the right of every citizen to have access to medical care, we will find a way to accomplish it. Ann