The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care [Hardcover]

T. R. Reid (Author)

Book Description

Release date: August 20, 2009 | ISBN-10: 1594202346 | ISBN-13: 978-1594202346 | Edition: 1

Bestselling author T. R. Reid guides a whirlwind tour of successful health care systems worldwide, revealing possible paths toward U.S. reform.

In The Healing of America, New York Times bestselling author T. R. Reid shows how all the other industrialized democracies have achieved something the United States can’t seem to do: provide health care for everybody at a reasonable cost.

In his global quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own—including France, Germany, Japan, the U.K., and Canada—where he finds inspiration in example. Reid shares evidence from doctors, government officials, health care experts, and patients the world over, finding that foreign health care systems give everybody quality care at an affordable cost. And that dreaded monster “socialized medicine” turns out to be a myth. Many developed countries provide universal coverage with private doctors, private hospitals, and private insurance.

In addition to long-established systems, Reid also studies countries that have carried out major health care reform. The first question facing these countries—and the United States, for that matter—is an ethical issue: Is health care a human right? Most countries have already answered with a resolute yes, leaving the United States in the murky moral backwater with nations we typically think of as far less just than our own.

The Healing of America lays bare the moral question at the heart of our troubled system, dissecting the misleading rhetoric surrounding the health care debate. Reid sees problems elsewhere, too: He finds poorly paid doctors in Japan, endless lines in Canada, mistreated patients in Britain, spartan facilities in France. Still, all the other rich countries operate at a lower cost, produce better health statistics, and cover everybody. In the end, The Healing of America is a good news book: It finds models around the world that Americans can borrow to guarantee health care for everybody who needs it.

Editorial Reviews

From Publishers Weekly

Washington Post correspondent Reid (The United States of Europe) explores health-care systems around the world in an effort to understand why the U.S. remains the only first world nation to refuse its citizens universal health care. Neither financial prudence nor concern for the commonweal explains the American position, according to Reid, whose findings divulge that the U.S. not only spends more money on health care than any other nation but also leaves 45 million residents uninsured, allowing about 22,000 to die from easily treatable diseases. Seeking treatment for the flareup of an old shoulder injury, he visits doctors in the U.S., France, Germany, Japan and England—with a stint in an Ayurvedic clinic in India—in a quest for treatment that dovetails with his search for a cure for America's health-care crisis, a narrative device that sometimes feels contrived, but allows him valuable firsthand experience. For all the scope of his research and his ability to mint neat rebuttals to the common American misconception that universal health care is socialized medicine, Reid neglects to address the elephant in the room: just how are we to sell these changes to the mighty providers and insurers? (Sept.)
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Review

"Important and powerful... a rich tour of health care around the world." --Nicholas Kristof, The New York Times

"You don't necessarily realize it while you're reading, but you're talking Comparative Health Economics 101. With a really fun professor." --Daily Kos

"Not many writers of any ilk... can match T.R. Reid's ability to bring a light, witty touch to really serious topics--like health policy around the globe." --New America Foundation

--This text refers to the Paperback edition.

See all Editorial Reviews

Product Details

• Hardcover: 288 pages
• Publisher: The Penguin Press; 1 edition (August 20, 2009)
• Language: English
• ISBN-10: 1594202346
• ISBN-13: 978-1594202346
• Product Dimensions: 6.4 x 1 x 9.4 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 4.7 out of 5 stars  See all reviews (267 customer reviews)
• Amazon Best Sellers Rank: #150,032 in Books (See Top 100 in Books)
  • #88 in Books > Medical Books > Administration & Medicine Economics > Health Policy

More About the Author

T. R. Reid is a longtime correspondent for The Washington Post and former chief of its Tokyo and London bureaus as well as a commentator for National Public Radio. His books include The United States of Europe, The Chip, and Confucius Lives Next Door.

Most Helpful Customer Reviews

280 of 297 people found the following review helpful

5.0 out of 5 stars BEST WRITTEN MOST INFORMATIVE August 25, 2009

By cebepe

Format:Hardcover|Amazon Verified Purchase

I bought this book after reading Jacob Weisberg's review in Newsweek. It is the best thing on the subject for the following reasons: 1. It is well written even funny in places. 2. It is very informative. 3. It presents comparative data both as to health outcomes and also ways of paying for health care 4. It is non-partisan, even though by the end one wonders why we Americans are paying so much for health outcomes that are actually worse than any comparable country. 5. It is revealing as to the complexity of the US; for example, I didn't know that as many as 80 million Americans are already covered by systems nearly identical to the British or Canadian, i.e. medicaid, medicare, military, veterans and Department of Indian Affairs - who would have thought that? But 45 million others are not covered at all. Everyone else is covered, more or less, by insurance and so are the Germans, French and Japanese etc. But what a difference in the insurance systems! In the other countries you get insurance just like here EXCEPT THAT 1. you cannot be denied 2. you cannot be cancelled 3. everyone is covered and 4. your premiums are regulated by government which of course is what the entire debate is about. Because here the insurance industry is for profit and the premiums reflect that fact, the amazing fact that US health is the USA's largest industry by far, larger that the State of California, four times larger that the military, in fact US health would be the world's 8th largest country. No wonder the debate is so fierce. This excellent books set it all out readably and comprehensively.

124 of 137 people found the following review helpful

3.0 out of 5 stars Important voice in the health care debate September 17, 2009

By P. J. Owen

Format:Hardcover|Amazon Verified Purchase

In `The Healing of America' TR Reid gives a tutorial on the basic types of health care systems in place around the world, and then tries to give an evenhanded analysis of what works in these systems and what doesn't. What gives the book its teeth though is his first-hand experience of health care systems in six different countries. In his quest, Reid brings a bum shoulder to these countries to find, as he puts it, `two cures': one for himself and one for the US health care system.

There's no question something needs to be done to fix the US health care system. The idea that the richest and most technologically-advanced country would let people die because they can't get the care they need or go bankrupt because they get sick is absurd. That is why the current debate about health care reform is needed. The problem though is that's it's hard to know what we're looking at when filtered through politicians and the majority of the media coverage. They focus on the extremes, especially those opposed to reform who mischaracterize the systems in other countries as `socialized medicine'. In this context, Reid provides a useful voice to the debate- whether you agree with his prescriptions or not. He de-stigmatizes the systems of other countries and explains why we're not as far removed from them as we think.

He shows us how other countries' systems are different, but also alike. Some `socialist' countries have private insurance and private doctors. In fact, Reid demonstrates how some countries actually have more choice than the US. In Germany for example, one can choose from hundreds of different insurance plans and go to any doctor, whereas US citizens are generally limited to one employer's plan and only `in-network' doctors.... Some countries, like Britain, have government-run hospitals but private GPs. Some are single-payer, but most have multiple payers. Some plans are funded by private insurance, some by a government-run insurance fund, and others by general taxation. What is striking about these different variants though is that while some Americans rip these other systems, we here in America have forms of each of them. Medicare is run like Canada's system. Veterans are put through a system like Britain's. Americans with employee-sponsored plans are in a similar system as people in Germany. The difference is that those other countries provide health care more economically and more effectively than we do in America.

Why? The answer lies in what they have in common. They all have a single, unified system, which allows administrative efficiencies. Ours is fragmented and riddled with administrative costs and perverse economic incentives. Their programs are all non-profit, so there's no need for insurance to cut coverage to maintain the bottom line as ours do. And they all provide universal coverage, which provides the economic incentive for preventative medicine. As Reid points out, the first question we need to ask ourselves is, do we think people should die due to lack of coverage? Or should people go bankrupt because they get sick? These are moral questions, and the US is the only rich developed nation that has so far said yes to them.

Reid does gloss over some things though. He pays little attention to costs, seeing it as a problem solved once the profit motive is gone, universal coverage is agreed upon, and government price controls are in place. Besides showing a complete lack of economic understanding, this also skirts the fact that costs in other countries are also increasing. He does point this out but only says that their costs are so much lower than America's they can afford to let them rise. (For a more intelligent and nuanced analysis of the problem of cost in the US health care system and a unique idea for reform, see the article by David Goldhill in the September issue of `The Atlantic'.) He also polarizes the debate (like it needs more polarization) by getting into the `health care as a civil right' question. He was better-off sticking with his stronger, moral point because it's not at all inconsistent to think health care is NOT a civil right, but still have the moral conviction that everyone should have coverage. By putting these in black and white terms, he sounds like the European Socialist Liberal he had managed to avoid sounding like up to that point.

Still, assuming he hasn't misrepresented anything in this book or provided inaccurate facts, this is important stuff. The health care debate is vitally important and I think every American should be armed with as much information as possible. That said, many articles by Reid and about this book have been published that will give you the basic facts outlined here. For most people, those articles should be enough. Only shell out for the book if you're interested in a deep dive on the subject. Read more ›

127 of 144 people found the following review helpful

5.0 out of 5 stars Our Congress Needs to Read This August 23, 2009

By P. T. Benghauser

Format:Hardcover

I can't vouch for the accuracy of all of Reid's accounts, but as an American expat who lived in Germany and the UK for a total of 28 years, I can confirm that his descriptions of the health care systems in those two countries are both accurate and fair.

The timing of this book is uncanny. Everyone who cares one whit about health care in the US should read it... and LISTEN to what it has to tell us.

28 of 30 people found the following review helpful

4.0 out of 5 stars Thought-provoking comparative analysis August 31, 2009

By Sreeram Ramakrishnan VINE™ VOICE

Format:Hardcover

Ever since the PBS documentary mentioned Reid's characterization of the different healthcare systems, I have been waiting anxiously for this book. Was well worth the wait.

The fundamental thesis of the book is that the US healthcare system can and must learn and adapt ideas from various other healthcare systems - the idea is not radical at all. What is unique about this book is that Reid systematically and convincingly disproves the common arguments centered on the notions of "socialized medicine". A sub-text of this thesis is perhaps a bit more novel than his original thesis - US doesn't have a healthcare delivery problem, but has a significant problem financing it. This re-framing of the problem, clearly and deliberately divorcing the clinical resources/processes from the administrative (non-clinical) processes, is very helpful in focusing the arguments Reid wants to make. While one could argue that this re-framing is oversimplification and too biased against payers, it becomes to a open-minded reader that, at least in the US context, it is absolutely critical to view the economics side of healthcare first. Reid convincingly makes an argument that the "capitalistic" idealism US markets crave for and swear for are not channeled appropriately or are in fact, have the wrong incentive structure.

Whether you agree with that viewpoint or not, the detailed global journey of Reid and his quasi-functional shoulder, helps a reader lead a vicarious patient life in a wide variety of settings, some more similar to the US than others. (Having grown up entirely in India, I certainly can relate to and think that the author's portrayal of India's healthcare system is accurate and presented in a matter-of-fact manner).... The discussions often tends to be on administrative issues - getting an appointment, scheduling surgeries, who bills whom for what, and whether a patient ever sees a bill, etc. For each of the country discussed, Reid also provides a fairly good summary of the historical context of the healthcare systems and sometimes (a little bit tangentially) profiles of key persons involved in shaping that country's system.

While such a narrative is very informative, I think the author missed an excellent opportunity to provide his thoughts on potential solutions (for example, from an information technology perspective - while he lauds the usage of health cards in Taiwan, Germany etc as key to cutting admin costs, he does little to highlight the significant clinical advantages that can be gleaned from the huge database). His focus on addressing the "that's socialized medicine" argument left him little room to take on another common argument theme - patient privacy. A reader would also have significantly benefited if the author had spent more time on analyzing the transformation challenges that countries that adopted significant reform went through and how they addressed them. The policy/ethics framing of the problem and the discussion with the renowned William Hsiao is very informative and thought-provoking. The discussion on the role of preventive medicine is insightful in that Reid makes a convincing argument as to why a healthcare economy with fractured for-profit players has no incentive in preventive medicine. The chapter "apple a day" is in itself well-worth the read.

For a more enterprising reader, a thought exercise centered on the applicability of the ideas from this book with the hypotheses/assertions of The Innovator's Prescription: A Disruptive Solution for Health Care will be rewarding.

Nevertheless, the book, provides a reader engaged in the current (directionless) debate in US on healthcare "reform", an excellent source of providing an unbiased, well-informed context with a very powerful nudge in trying to re-frame the discussion. The book will perhaps be best remembered for its systematic destruction of the "socialized medicine" arguments wide-spread in the US. An excellent read. Read more ›