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

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

by T.R. Reid

4.22 · rating details · 908 ratings · 311 reviews

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 reasonabl...moreBestselling 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.(less)

Hardcover, 277 pages

Published August 20th 2009 by Penguin Press HC, The (first published 2009)

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Sep 23, 2009

Bram rated it

Shelves: 2009, medicine

As I set out to write something about this book, I realize that I don't have much input or interest in reviewing nonfiction books. Or maybe just nonfiction books whose primary goal is to educate the reader on some specific issue. That's what The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care is, and Reid does an excellent job of achieving this goal. And by the way, when are we going to decide whether health care is two words or one? This indecisiveness, simila...moreAs I set out to write something about this book, I realize that I don't have much input or interest in reviewing nonfiction books. Or maybe just nonfiction books whose primary goal is to educate the reader on some specific issue. That's what The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care is, and Reid does an excellent job of achieving this goal. And by the way, when are we going to decide whether health care is two words or one? This indecisiveness, similar to America's own inability to conclude whether we actually care if tens of thousands of people die every single year because (and only because) they didn't have health care, frustrates me. To paraphrase Princeton health care economist Uwe Reinhardt, "Each country's health care system reflects a nation's basic cultural values." Reading this book and seeing the comparisons to other rich countries, I suddenly realized that the United States is holding onto a fundamental cultural/political/moral/economic viewpoint on health care that is simply out of date, particularly on moral grounds. This probably won't become truly obvious to Americans for a couple of decades (probably around the same time that we realize how ridiculous it is that we still discriminate willy-nilly based on sexual orientation), but let's just say that history won't look unfavorably only at our ridiculous warmongering.

So we're just about almost maybe kinda sorta at the point where we have the political will to cover all Americans with health insurance. That's a start, I suppose. Reid's book examines the health care systems of a number of rich, developed countries to see what we can take from them and also to break up a few myths along the way. The countries he looks at are the UK, France, Germany, Japan, Canada, Switzerland, and Taiwan. All of these countries cover everybody, and only the UK (and maybe Canada, as long as you also call American Medicare "socialized") is really "socialized medicine"--as in, the government pays for and delivers the the health care (insurance and docs are government employees). These countries also spend about half as much on health care as the US (17% of GDP; Switzerland is second in spending at 11%). In many cases they are more privatized than the US, which has public (or partially public) systems for Native Americans, the elderly, (some of) the poor, veterans, those with end-stage renal disease, et al. Needless to say, this doesn't add up--we spend much more to get much less. The US does worse than almost every other developed country in every single measurable health care criterion except for delivery (i.e. our medical professionals give great care as long as you have good insurance and good access--here, we're number 1 according to the WHO).

Reid shies away from outlining solutions, and surprisingly, I found this to be a strength of the book. By just setting out the facts about the health care systems of the US and other rich countries, some of the conclusions become OBVIOUS. For example, 20 cents on every dollar we spend on health care (our premiums) does not go to purchasing actual health care. A small portion (3-5%) is for administrative costs, and the rest goes to insurance company profits (to pay CEOs millions, please shareholders, etc.). Yes, we are the only country with for-profit insurance (even Switzerland gave this up in the 1990s). Baucus's health care plan would mandate that Americans buy insurance…from for-profit insurance companies. Let that sink in for a minute, and this should piss you off regardless of your political bent. Now, a public option (with, say, 5% overhead) would obviously force these companies to clean up their act, but why not just follow the German/France/Japan model (all of whom have only private insurance and private doctors) and mandate that insurance companies be non-profit? Otherwise, we will continue to have insurance companies whose modus operandi is to screw people over (i.e. it saves money to drop people with chronic conditions or to refuse to pay for certain procedures). To have a system set up where health care payers are incentivized to NOT pay for your health care needs is simply perverse. And if you cut this out, you get the added benefit of lowering health care costs significantly (premiums will automatically drop 15%). Add a real choice option, where Americans can pack up and move companies at will, and you suddenly have a privatized system with greater cost-containment and universal coverage. If insurance companies must cover everyone, then suddenly they'll actually start caring about preventative medicine and keeping their customers healthy, and they'll also have incentive to wrestle with technology/pharmaceutical companies to cut prices on prescription drugs. Everybody wins (except for-profit insurance companies/Pharma) and you never have to hear the term "socialized medicine" again. Obviously there are lots of details to be dealt with (such as cutting down on unnecessary procedures/tests), and it's almost impossible to convince our politicians to go against big business at this day and age, but there are good options on the table if we have the political will.

Well, I started out saying I didn't know how to review this book, and I guess that's still true. While this ended up taking the form of a sermon, the background information, numbers, and basic ideas came out of Reid's book at least. If you've been wanting to get a better understanding of this issue for a while, you can't go wrong here--this book is clear, succinct, and highly readable. The only down side is that it will increase your frustration with health care politics ten fold. (less)

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Nov 17, 2011

Anna rated it

Reid examines America's health system within the context of the health systems of France, Germany, Japan, the UK and Canada (all universal systems). He also briefly looks at out-of-pocket systems, i.e. the third world and uninsured Americans. As a political scientist, my take on these issues is pretty much always institutional and political culture. Reid's jumping off point is the moral question "Should we guarantee medical treatment to everyone who needs it?" The answer to this qu...moreReid examines America's health system within the context of the health systems of France, Germany, Japan, the UK and Canada (all universal systems). He also briefly looks at out-of-pocket systems, i.e. the third world and uninsured Americans. As a political scientist, my take on these issues is pretty much always institutional and political culture. Reid's jumping off point is the moral question "Should we guarantee medical treatment to everyone who needs it?" The answer to this question in a first world modern country should always be yes. It depresses me that the US should answer no to this question. Reid argues that public opinion shows that people in the US believe that all Americans should have access to medical care and that most people believe that everyone does have access (ERs for example). Personally, I don't believe that. From what I see around me there are plenty of people who believe in an old-fashioned concept of deserving and it really pisses me off.

Reid does a nice job of comparing spending costs (the US, in 2005, spent 16.5% of GDP on health care compared to 11% in France, 10.4% in Germany, 10.1% in Canada, 8.4% in the UK and 8.1% in Japan) even though the US has a huge number of uninsured folks. Americans are not healthier nor do they live longer despite the huge expenditures. He also shows that administrative costs in the US are something close to 20% compared to about 6-7% in those other countries. Reid is clear that these other health systems are not socialized - doctors, hospitals, insurance companies are also likely to be private, and many countries include out-of-pocket costs to consumers too. And the most perfect socialized medical system in the world? Veterans in the US.

Profit-making insurance companies are pointed to as much of the cause of the craziness of the American system - the bottom line is not treating people, it is not treating people because every procedure denied helps the profit and makes shareholders happy. It's infuriating that neither culture nor political institutions in the US deal with the inequity and expense of such a stupid system. Finally, as a person who believes that institutions matter, I was interested to read about Taiwan developing a new universal health care system and Switzerland reforming theirs to ensure universal coverage.(less)

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Nov 06, 2009

Julie rated it

Recommended to Julie by: Fresh Air podcast

Shelves: social-political-commentary, best-of-2009, read-2009

The upside of reading this book is that you will walk away with a clearer understanding of how different models of health care work, how massive reforms in health care have been undertaken recently and with success, and you will have the knowledge to debunk myths many Americans hold about health care systems outside of the United States.

The downside of reading this book is that you may walk away and want to keep on walking- directly north to Canada, or to don your fins and cross the...moreThe upside of reading this book is that you will walk away with a clearer understanding of how different models of health care work, how massive reforms in health care have been undertaken recently and with success, and you will have the knowledge to debunk myths many Americans hold about health care systems outside of the United States.

The downside of reading this book is that you may walk away and want to keep on walking- directly north to Canada, or to don your fins and cross the Atlantic or Pacific to join the ranks of those who receive excellent health care at minimal or no out-of-pocket costs.

All of this, offered in 275 pages of succinct, clear and fascinating text. Anyone familiar with T.R. Reid's NPR commentaries as a correspondent in Japan and the U.K or his articles in the Washington Post will recognize his warm, engaging, self-effacing tone that is both professional and inclusive.

Rather than prescribing solutions, Reid's central theme is that we can and must learn by example. There is nothing in universal coverage that precludes competition, choice, and access. It is highly probable that universal coverage would result in the United States spending less and providing better care, while increasing the quality of life and life expectancy of all. As a portion of GDP, the US spends significantly more than the nations featured in this book, yet ranks well below in life expectancy, and measures of quality, fairness and progressive financing of health care.

Reid demonstrates again and again that the primary difference in the approach to health care between the United States- the only free-market, industrialized nation that relies on an out-of-pocket model- and those which offer universal coverage is a moral one. The countries he features have made the decision that access to health care is a basic human right and that government has a moral imperative to provide the same standard of care to all of its citizens, regardless of economic status.

On the other hand, the United States has determined that only those who can afford health care have a right to it. We continue to support systems (insurance companies) that ration care, cherry-pick their consumers and routinely deny coverage to those who pay into their system, all while placing the burden of coverage on employers. Reid posits that medical facilities and the training of medical personnel in the United States are the best in the world. Too bad over 20,000 Americans die every year because they cannot access this superiority.

We are foolish enough to listen to the pundits and talk-radio celebrities who decry "socialized medicine" without acknowledging that our nation's soldiers, veterans, Native Americans and those over 65 are all provided for by government-run, government-funded health care systems, one of which (Medicare) is a replicate of the Canadian system from which it takes its name.

To those who may think that Reid is preaching to the choir, be assured that he paints a "fair and balanced" picture. The long waiting lists for specialized care in Canada and the underfunded facilities in Japan are two examples of significant stumbles in universal coverage.

There is a bitter irony in pointing out that the same fearmongerers who warned that American life as we know it would be jeopardized if we did not pursue war in Iraq and continue it in Afghanistan are the same voices who cry out that the sky will crash down if we restructure our system to provide an equal standard of and access to health care for all our citizens. The immorality of these brutal stances makes me sick.
(less)

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Aug 26, 2011

Ken Deshaies rated it

What an awesome book. Reid has done what many of us wish we had the time and money to do – investigate the health care systems in many of the industrialized nations. The book is full of statistics and charts. The one thing that makes the U.S. so different from EVERY other developed nation is that we have not considered it a moral obligation to provide health care to every citizen. We spend anywhere from 40% more to three times what all the other countries pay for health care. In 2005 numbers, we...moreWhat an awesome book. Reid has done what many of us wish we had the time and money to do – investigate the health care systems in many of the industrialized nations. The book is full of statistics and charts. The one thing that makes the U.S. so different from EVERY other developed nation is that we have not considered it a moral obligation to provide health care to every citizen. We spend anywhere from 40% more to three times what all the other countries pay for health care. In 2005 numbers, we spent 17% of our GDP on health care, France spends 11%, the U.K. and Japan are at 8% and Taiwan is at 6%.

In addition, we rate lowest or near lowest among developed nations, in the queue with the undeveloped and under-developed nations in every measure of quality. (think African countries), and leave a significant portion of our population uncovered. We are the only nation that has decided that the provision of health care should be a profit making endeavor. If anything is a demonstration of the failure of capitalism, this is it. [And I believe in capitalism, but this is one area where it should not be applied.] We are the only nation that allows its citizens to get into financial trouble, and even bankruptcy over health care costs. And believe it or not, we are the only one that seriously rations health care delivery – it’s done primarily via insurance company denial of claims and of coverage. And for our pharmaceuticals, we pay in this country anywhere from twice to 10 times what other companies pay for the same pill made in the same factory.

Only a couple of the countries operate health care delivery as a socialist system – the U.K. and Canada, for example. Most are hybrids or privatized systems. In France, for example, there are dozens of insurance companies (everyone has to have insurance coverage – the government covers premiums for the poor), and all doctors, clinics, hospitals and anything related to health care delivery is privately owned and operated. The government simply sets the premiums and the reimbursement levels for all procedures. And the ways they save money (read, keep costs under control) are innovative and effective. In Japan, for example, doctors went to companies that make MRI scanners and got them to develop scanners that cost one-tenth of what we pay in this country. The scanners just don’t have all the bells and whistles that a full featured scanner has. In France, doctors do not have administrative assistants or records rooms. Every citizen carries a health card, called the Vital Card, that has every visit, every procedure, every pill and medication that you’ve ever had. When you visit the doctor, they simply swipe the care through a reader and voila, your health history is at hand. A study by the Bank of America concluded that if we could get our spending down to the French level, we’d save over $600 billion a year, enough to cover every citizen in this country.

And other countries are smart enough to also look at long term savings. Our insurance companies consider preventive care a cost they can avoid (heck, you’ll probably be with a different company, or on Medicare, when you really get sick), so most of our preventive care is government sanctioned (think smoking warnings and education). Other countries recognize the value of keeping people healthy and encouraging healthy lifestyles. They spend significant amounts to insure that you have regular physicals, that you are coached about healthy living, and understand that the savings in the future will pay the cost of preventive care many times over.

The rules of U.S. insurance companies are criminal at best. They are happy to take your premiums as long as you don’t need them. But they will spend tons of money to deny your claim or terminate your coverage when you need them most. It’s a shell game where only they know the rules. You are, in every case, the mark. They initially deny about 30% of all claims. Americans under 65 cannot get health coverage that is permanent.

The lies of the Republicant pertaining to our health care system are designed to confuse the public and protect the profits of the insurance companies, big pharma and health care conglomerates. In fact, the GAO has estimated that if we could get the administrative costs under control (down from the 20% margin enjoyed by private insurance companies to the less than 4% that is costs Medicare) the savings would pay for health care for all. And that is the truth they don’t want you to hear, or understand or believe.

Get this book. It will be one of the most important you’ve ever read.(less)

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Aug 16, 2011

Sarah rated it

I convinced my book club to read this some months (years) ago. I feel like it should be required reading for any thinking American. It's actually quite an entertaining book, though you'd think a journey through the world's health care systems would be a snore. T. R. Reid, a longtime journalist with an affable, slightly rumpled on-air persona (the book was also reshaped as a Frontline special) takes an ailing shoulder to numerous countries for possible treatment. In very accessible terms, he desc...more

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Jun 28, 2011

Bill rated it

Shelves: non-fiction

This is the most accessible, readable and accurate general audience book I have ever read on comparative health systems. Though focused on the absurdity of the U.S. health debates, it provides a great introduction to the range of health systems around the world. He tells the story at two levels: his personal search for treatment for his injured shoulder in the U.S., France, Japan, the UK, India, and Canada; and his research into the personalities, economics, and ethics of comparative health syst...moreThis is the most accessible, readable and accurate general audience book I have ever read on comparative health systems. Though focused on the absurdity of the U.S. health debates, it provides a great introduction to the range of health systems around the world. He tells the story at two levels: his personal search for treatment for his injured shoulder in the U.S., France, Japan, the UK, India, and Canada; and his research into the personalities, economics, and ethics of comparative health systems.

I was impressed with the lightness of the writing while getting across all the key distinctions, for example, between health financing and health provision, between for-profit and non-profit insurance, between public health and personal health care services. also gets across the economic and public health advantages of compulsory and universal participation, but gives largest emphasis to the moral debate - should everyone have access to basic health care services whether they are rich or poor?

If I were teaching an undergraduate or graduate course, I would use this as the first reading to give students an overview. I'm wondering why it didn't get more discussed in the U.S. health policy debates - it would make a great book group read. What if Oprah had picked it? Some of the book's effectiveness is the way it anticipates a lot of objections - like the U.S. tendency to claim that we don't have anything to learn from other countries. He counters this directly with a fabulous story about how Eisenhower modeled the U.S. interstate highway system on the German Autobahn - conceived and built by the Nazis. He also counters the pessimism about making changes in the face of interest groups by describing how Switzerland and Taiwan made significant reforms in the 1990s despite serious political resistance.

I have a few small quibbles about his characterization of the Beveridge Report or the way he uses PSA tests to make a few points (the points are generally accurate but the PSA test isn't the right example). But these are extremely small quibbles and none of them take away from the clarity and strength of the argument.

If you don't know much about health care systems in other countries, read this today so you can be an informed citizen. If you're a health system expert, read this today so you can better explain what you know to a general audience.(less)

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Dec 07, 2010

Alex Templeton rated it

This was one of the most infuriating books I've ever read. This was not because the book was bad, but because the points it laid out were so smart that I can't believe our policy makers and our population can really be so ignorant as to, well, ignore them. Reid visited different countries around the world that offer universal health care to their citizens. He discovers, in a nutshell, that not only are these systems not "socialist", but that they are far more efficient and cost-effecti...more

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Sep 19, 2010

Sarah rated it

Shelves: general-nonfiction, political

For those of us who have already reached the conclusion that the health care system in this country is laughable (in a devastating way), this little masterpiece beautifully clarifies what we already know. Our system is overly complex, sickeningly unequal and discriminatory, and grossly expensive. As a wealthy country in the industrialized world, we are the only nation that has not adopted universal health care of some kind. We are the only nation that allows for-profit insurance companies result...more

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Aug 24, 2010

Jonna rated it

Reid researches how universal health care works in half a dozen different countries, exploding the myth of "American exceptionalism." The U.S. does NOT have the "best health care in the world" by any measure: not outcomes, not life span, not cost, not number of people covered. Reid points out that every other developed country except the US has answered the question: is health care a human right? with "yes."

In the US, about 20,000 people a year die of...more

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Jul 15, 2010

Jessi rated it

Shelves: non-fiction

I was on a role of not finishing books for several weeks and this was one of them. Unlike others I quit on, there wasn't a specific reason to stop reading. The writing was interesting and well paced for nonfiction. The topic was relevant to today's world and one I feel strongly about. However, I just wasn't in the mood for reality. I got far enough to learn a great deal from this book and felt satisfied with that. The author analyzes health care in a variety of countries. Although they are all v...more

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Jun 19, 2010

Lara rated it

It has been a monumental week, no matter what side of the political fence you sit on. This week, the President of the United States signed healthcare reform into law. Now, I am not here to debate arguments, the situation or the yet-to-be-seen outcomes. I think we can all agree that our system is not a perfect one and it's one that could benefit from some form of redesign. So that's what I took a look at this week, turning to a non-partisan, highly informative and tremendously fascinating book: T...moreIt has been a monumental week, no matter what side of the political fence you sit on. This week, the President of the United States signed healthcare reform into law. Now, I am not here to debate arguments, the situation or the yet-to-be-seen outcomes. I think we can all agree that our system is not a perfect one and it's one that could benefit from some form of redesign. So that's what I took a look at this week, turning to a non-partisan, highly informative and tremendously fascinating book: THE HEALING OF AMERICA: THE GLOBAL QUEST FOR BETTER, CHEAPER, AND FAIRER HEALTH CARE by T.R. Reid.

Ried, a former Princeton graduate, naval officer, reporter having covered four presidential campaigns and chief of the Washington Post's Tokyo and London bureaus is taking on the U.S. healthcare system and attempting to find solutions--by looking at the World Health Organization's top-ranked countries for health care (we aren't one of them). He hits the road with his bum shoulder and the knowledge that we have the highest percentage of deaths that are cureable with medical intervention and some 22,000 Americans die annually due to lack of medical coverage. How will treatment and cost differ between the U.S., France, Germany, Britain, Japan and Canada, and what best and worst practices will he identify in the process?

I found the individual country case studies fascinating. France has successfully converted to a completely digitized medical record all contained on a microchip that is affixed to a credit-card sized piece of plastic (a system, ironically enough, that was created by Americans). Preventive care is the focus of many of our European counterparts. Japanese citizens have access to over 2,000 health plans and can see a specialist immediately - often without an appointment.

Now, I am touting the pluses; but Reid goes into an objective analysis showing the successes and failures of each country's system. He speaks to top health officials, health reformers and providers along the way creating a full picture of how other comparable nations are managing and providing health care. He breaks down a number of different models (of which the U.S. uses a little bit of every kind), myths (it's not all socialized medicine outside of our contiguous 50 states) and realities (we are the only industrialized nation that doesn't hold health care as a basic right for all its citizens).

Reid's research found that American's aren't cold hearted. When polled, the vast majority are in favor of everyone having access to health care and think that most do. Unfortunately, there is a significant number of Americans who are uninsured, underinsured and unable to obtain health care. There is so much we can learn when looking at how others not just provide health care, but finance its delivery. There is tremendous opportunity to arm ourselves with information and knowledge to understand what we really have available and use that information to create a better, cheaper and fairer system.

I think Reid's book is one tool to do just that.(less)

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Mar 31, 2010

Sophia rated it

Shelves: 2010, how-to, medicine, non-fiction

When I was taking a Comparative Health Policy course at the London School of Economics, being American meant I was on the receiving end of a lot of snide remarks from classmates from all over the world. The Healing of America: A Global Quest for Better, Cheaper, and Fairer Public Health very succinctly explains why: compared to other wealthy industrialized democracies, American health care ranks near the bottom in terms of coverage, quality, and cost. Washington Post correspondent T.R. Reid argu...more

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Mar 27, 2010

Karen rated it

There's a lot of information in this book, and I read it too fast so now I don't remember that much detail. But I came away with the following, for what it's worth:

The French "carte vitale" sounds like a WONDERFUL innovation, as long as data security is tight and the potential harm done by data breaches is limited. In a system where you can't be penalized for having a health condition, having the whole world know you do is mainly just embarrassing. But it could still aff...more

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Mar 14, 2010

April Gustafson rated it

A couple of years ago I saw the PBS Frontline show _Sick Around the World_, and was converted to the idea of universal access to health care for this country. This book, written by the same guy who did the PBS special, former NY Times and NPR correspondent T.R. Reid (who lives in Denver now, I think), further reinforced my opinion. I've started proselyting the idea. More than a little bit of my feeling comes from the understanding that most wealthy countries provide universal health care access ...more

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Feb 25, 2010

Maya Bohnhoff rated it

Recommends it for: anyone who cares a hoot about healthcare

Recommended to Maya by: NPR interview

This is an eye-opening book.

In it, journalist T.R. Reid does what I have been hoping for some time that our national leaders would do: he undertook to study (through first-hand experience), contrast and compare the healthcare systems of other “first world” nations. (He included a couple of developing countries in his study as well.)

In the book, he details the main features of each system profiled, and shows how the systems compare. He looks at the upsides and downsides of eac...moreThis is an eye-opening book.

In it, journalist T.R. Reid does what I have been hoping for some time that our national leaders would do: he undertook to study (through first-hand experience), contrast and compare the healthcare systems of other “first world” nations. (He included a couple of developing countries in his study as well.)

In the book, he details the main features of each system profiled, and shows how the systems compare. He looks at the upsides and downsides of each system and even walks through the process by which the representative countries came by the systems they have. He also profiles how two other countries (Taiwan and Switzerland) recently made drastic changes to their healthcare—basically redesigning it from the ground up based on a study of what other countries were doing that worked and didn’t work. Mr. Reid lays out his findings clearly in plain English, without polemics or hyperbole. That, in itself, was refreshing.

I’d like to share some of what I learned from his book, but first I want to make something absolutely clear: This is not a political issue to me, it is a moral issue. It is not about capitalism or the free market; it is not about conservatism or liberalism; it is about being human. I am a Bahá’í. This means I do not belong to a political party and don’t give a rat’s patoot for anybody’s party line. It also means that my feelings about my fellow human beings are informed by the teachings of Bahá’u’lláh. To wit: "The remedy the world needeth in its present-day afflictions can never be the same as that which a subsequent age may require. Be anxiously concerned with the needs of the age ye live in and center your deliberations on its exigencies and requirements."

So here’s what I learned from The Healing of America:

* Of all the wealthy nations, the United States is the only one that does not provide medical care for all the people who live there.  
* The USA is also the only developed nation with a healthcare system that has, as its purpose, paying dividends to shareholders rather than insuring healthcare to its citizens. 
* The World Health Organization has ranked the nations based on such key indicators as infant mortality, life-expectancy and the number of people who die of preventable or treatable diseases. The US—the richest nation on earth—ranks 37th. That puts us behind Dominica and Costa Rica and just ahead of Cuba. (You may ignore this appeal to national pride if that’s not what motivates you. If that’s what motivates you, feel free to be appalled.) 
* In the US every year, around 20,000 people die because they do not have access to healthcare and thousands go bankrupt because of medical expenses. That does not happen in any other developed country. 
* Nations that have created universal healthcare systems provide care to ALL of their citizens for far less than we spend to insure only some of ours. To put this into perspective, the USA spends 17% of its Gross Domestic Product on healthcare. Taiwan, which revamped its “out-of-pocket” non-system in 1994-1995, spends 6% of its GDP. To look at a it a different way, France spends a little over $3,000 annually per capita for healthcare; we spend over twice that.  
* Though most universal healthcare systems are struggling with the rising cost of care (as are we), the problems they’re having are less complex than ours because their systems are already doing what they’re designed to do—insuring everybody. Here’s what this means “on the ground”: My family spends hundreds of dollars per month on insurance premiums, yet still has to cover things out-of-pocket. I just paid over $700 for dental work. I almost didn’t get it done because we really couldn’t afford it. Our health plan is considered excellent, but it paid only 50% of the most expensive work. Our co-pays range from $20 for office visits to $60 for prescriptions. In Taiwan, for example, monthly premiums are $150; co-pays are $7 and there is no other out-of-pocket expense. Taiwan could raise its outlay to 8% of its GDP and double premiums and co-pays to save its admittedly under-funded system and still not come anywhere close to what we spend. 
* Most universal healthcare systems are NOT “socialized” (be that good, bad or indifferent). The German system—whose founder, Otto Von Bismarck (yes, THAT Bismarck) referred to it as “applied Christianity”—relies on about 200 private “sickness funds” that German citizens can choose from. They compete for those citizens, too, because the more they have the more they earn. The Taiwanese didn’t like the inefficiencies of that—they opted for a single National Health Fund. It’s true, the German system is more expensive—11% of their GDP (reminder: we spend 17%).  
* Not all universal healthcare systems ration healthcare—at least not in any way that compares with the rationing that I’ve experienced: We don’t cover that. Or We only cover 50% of this. Either translates to: I can’t afford it.  
* Not all universal healthcare systems involve long waits for healthcare and none make people wait for urgent care. German citizens, for example, wait no longer for any treatment than US citizens do (that is, the citizens who can afford coverage). 
* Malpractice insurance is a major cost in our system. Doctors in the universal systems pay annually for malpractice insurance what our doctors pay in a week. And law suits are vanishingly rare. I have my own theories about why that is.

I think all government policy makers should be required to read this one.(less)

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Feb 23, 2010

Jeremy rated it

(Review from forthcoming issue of World Medical & Health Policy)
The Healing of America, by TR Reid, is a deceptively simple, readable, and even entertaining book that contains within it vast and complex truths about global health policy. It belongs on the bookshelf of every health care expert, and indeed, every medical practitioner.
What makes this such a compelling and strong book is the mixing of persuasive data with pungent anecdotes. Reid, who suffers from a painful and limiting...more(Review from forthcoming issue of World Medical & Health Policy)
The Healing of America, by TR Reid, is a deceptively simple, readable, and even entertaining book that contains within it vast and complex truths about global health policy. It belongs on the bookshelf of every health care expert, and indeed, every medical practitioner.
What makes this such a compelling and strong book is the mixing of persuasive data with pungent anecdotes. Reid, who suffers from a painful and limiting shoulder condition, uses this chronic malady as a prism through which to examine health care systems in Canada, Britain, Taiwan, Japan, France, Germany, the United States, and India. In each country, Reid walks into a doctor’s office and sees what happens when he presents with the same symptoms. In the U.S., a high tech, expensive, and very invasive surgery, total shoulder arthroplasty, is recommended. In Britain, arthropolasty is out of the question, although other care would be free. In many other nations he visits, arthroplasty is available, and would be free to any citizen. In Canada, it might be, after significant wait. And in India, the health professionals don’t find it necessary and prescribe surprisingly efficacious and cheap traditional medicine remedies. The way in which each medical system handles one case illustrates strengths and weaknesses in every country.
Readers are given a crash course in the history of each nation’s health care system. Few in health policy will leave this book without learning a vast amount of relevant information about global health policy. The range is extraordinary. Reid shows how the ardent capitalism of the Swiss can successfully coexist with universal coverage, and how the resilient egalitarianism of Canada affects the structure of care there. A key theme of the book is that a nation’s health care system ultimately reflects its values. Reid comes to this knowledge not only through first hand experience but also by interviewing some of the top health policy experts in the world. There could be no more pleasurable way to study health care financing systems around the globe than diving into this book.
In every doctor’s office, the reader is given a vivid portrait of medical care in that country, and enough statistics to be confident about the broader truths revealed. Reid provides a rough snapshot in every country of comparative rates for malpractice insurance, office overhead, medical education, and salary in each country. One gets a sense of how doctors live and work in much of the industrialized world. And while Reid acknowledges that American doctors make more than their counterparts around the globe, most U.S. physicians will be overcome with envy to learn that doctors elsewhere don’t have to hire a hive of office workers to handle twenty or more different billing systems, insurance protocols, and lab paper work. Nor do international doctors graduate from medical school facing massive debt. American patients will be stunned by how many other industrialized systems feature house calls by doctors, and how many “socialized” systems deliver health care faster and far more efficiently than in the U.S. Non-American readers will also get a sense of how utterly inhuman and impenetrable the American health insurance industry is to gravely ill and dying patients.
And Reid also shows the link between the unimaginably low (to an American doctor) malpractice insurance costs overseas, and universal health care. By reserving malpractice only for true cases of malfeasance and recklessness, overseas medical systems free their physicians from the crushing psychic and financial burden of medical litigation.
Even casual observers of American health policy know that the US allocates a much higher percentage of its gross national product to medical costs than any other country, and that we get worse outcomes than many who spend half of what we do. But Reid shows why, at the macro and the micro level. One key problem is that the American system isn’t really a system at all. Instead, the U.S. has elements of all major world systems. The British system, with doctors working for the state in state-owned hospitals, is what American veterans and Native Americans receive. The elderly get Canadian style care via Medicare. The majority of Americans get their care in a German fashion, from their employers, although a revealing difference is that the German health care market is at once more regulated, more competitive, and not nearly as profit-driven. And it doesn’t abruptly end when a worker is fired. Finally, the estimated 47 million Americans without health coverage are in a fee-for-service system common in the Third World, with the caveat that medical care in the United States, particularly for the uninsured, is the priciest on the globe.
Reid hopes to cut through much of the empty political rhetoric on health care. Most countries that have national health care do not have “socialized medicine” and only a fool would proclaim that the U.S. has the best medical system in the world. Indeed, one revealing anecdote is that at international medical policy conferences, calling a reform “American-style” is an epithet. Nor does access to emergency room care provide anything like a realistic alternative to medical coverage.
The book is remarkably fair, and appropriately critical of each nation’s health care system. Relatively minor differences in health policy, such as methods of record keeping, co-payment levels, and referral practices, are addressed. Reid does not ignore the looming fiscal problems facing many universal coverage countries, although he notes the same is true for the U.S. But in total, this book is an eloquent plea for America to copy what works overseas as it reforms its health care sector. Given how badly the Obama administration has done in selling reform to voters, they would have been far better off simply distributing this book to every American, particularly every member of Congress. Every chapter contains an irrefutable reason to reject the current American system. Reid points out several times that 700,000 Americans go bankrupt every year due to medical bills, and not a single other industrialized democracy would allow such cruelty. But the book is no paean to Democratic health care proposals, which fail to follow most of the exemplary practices Reid finds working all over the globe.
Reid starts and finishes his book with another anecdote that reveals the tragedy of American health care. A young woman loses her health care when lupus forces her to quit her job. Unable to consistently afford health insurance, her condition gradually worsens, and she becomes one of the 22,000 Americans who die every year from illnesses that would be successfully treated in thirty other countries. These deaths do not even save money, as the woman’s final three months of life were spent undergoing more than 25 operations, at public expense, in a fruitless effort to repair the damage caused by lack of health insurance. If there is a fault of this book, it is that it does not have a chapter showing why the American political system is uniquely unable to deliver what the rest of the industrialized world enjoys. But that might require a separate book, given how deep the problems run. It is enough that we have this extraordinary snapshot of global health policy in the first decade of the 21st century.
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Feb 20, 2010

Leah Petersen rated it

Recommends it for: Americans

The Healing of America is a book every American needs to read. Period.

Truthfully, I finished the book last night and my head is spinning from it. The sad thing is, I was aware of most of the information in it, I guess having it all in 256 pages is a lot for even forward thinkers to handle. The thing about America that always puzzles me is the amount of "curtains drawn shut." Growing up on a farm and being intimately close to the earth and how things grow and develop, I alw...more

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Jan 23, 2010

Kimberly rated it

This is VERY informative on how our country could stand to learn about other industrialized countries that do better than the U.S. on basic measures of health system performance: coverage, quality, cost control, choice. The author visited and studied the health systems of Germany, Japan, Great Britain, Canada, Taiwan, Switzerland.

The risk of financial ruin due to medical and pharmaceutical bills is a uniquely American problem. In Britain, France, Japan, Germany, the Netherland...more

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Jan 08, 2010

Kelly rated it

I have watched a young man suffer because he is incapable of affording the medications he needs. He doesn't fit the criteria for Medicare, Medicaid, nor is he a government official or a military man in the service. He is just a young man trying to make it on his own, trying to work hard, trying to go to school, trying to make ends meet, trying to have the American dream, but can't because his health is failing him and the health care system in America is, too.

If you ask me, healt...more

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Oct 05, 2009

Jon rated it

If you care about the current health care mess at all, you have to read this book. It gives a great overview about how several other countries have solved (or not solved) this problem. It also reminds us that the question of health care is first and foremost a moral question -- to what extent do we as a nation value the lives of our citizens? Once you answer that, the rest is simply details.

The author visits several different countries with different health care plans:

...more

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Sep 29, 2009

Elaine Nelson rated it

Shelves: economics, history, non-fiction, politics, health

Fascinating overview of health insurance systems around the world...Reid uses the treatment of his shoulder as a trope for seeking care in several different countries, but ranges all over the history, politics, and economics of these systems.

Really, what he does is clarify the whole debate with a straightforward description of options and maybe more importantly, illuminates the underlying issue, beyond the technocratic questions of how. Do we believe that everyone deserves basic heal...more

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Sep 20, 2009

Catherine rated it

Shelves: 2009, england, france, india, mainstream-us, medicine, scotland

The Healing of America is a short, pithy, well-researched introduction to the question of how best to provide healthcare in an industrialized nation. Reid, a correspondent for The Washington Post took his bum shoulder around the world to gather opinions on the best treatment for the pain and limited motion he suffered as a result of an injury sustained thirty years before. Along the way he compared both costs and treatments - how did other developed nations suggest he deal with his injury, and...moreThe Healing of America is a short, pithy, well-researched introduction to the question of how best to provide healthcare in an industrialized nation. Reid, a correspondent for The Washington Post took his bum shoulder around the world to gather opinions on the best treatment for the pain and limited motion he suffered as a result of an injury sustained thirty years before. Along the way he compared both costs and treatments - how did other developed nations suggest he deal with his injury, and what does that tell us about the way a developed nation might best provide healthcare for all its citizens?

It quickly becomes clear that the major divide between the United States and all other developed nations on this issue is a moral one - nowhere else in the developed world is it considered acceptable to let people die from treatable diseases for lack of health insurance, or to go bankrupt trying to cover their bills. (It's not considered morally okay in developing nations either (I hate the terminology of 'developing nations'; is there a better descriptor?), but there the issue is a baseline lack of money to pay for many things, health care and public health among them, and systems are generally pay-as-you-go, which means rarely seeing a western-style doctor or receiving rudimentary drugs.) It's considered absolutely okay in the United States for health care to be a profit-driven industry, and the more Reid describes systems of care in other places, the more this is revealed as completely ludicrous, prioritizing shareholder dollars over people's lives.

The book is a primer - there's a denser, richer book to be written about these issues, and I often had the sense that Reid was preaching to the choir (and expecting the choir to be the only people reading the book). I also wish that he was less dismissive of non-western medicine. There is no question that people the world over should be able to receive HIV drugs, treatment for measles, malaria, and polio, protection from bad water and the effects of raw sewage. But promoting these measures does not automatically mean that all non-western medical ideas are cuckoo, or that the solution to every medical problem is in throwing drugs or surgery at it (as the author discovers when it's Indian massage and meditation that best helps his shoulder). There's a temptation to denigrate non-western medicine because it is most widely used, I think, in areas lacking access to western medical treatment. Surely the point is that all medical wisdom should be available to everyone, and that no one should be forced to make a choice of either/or because of financial concerns and availability, not that non-western ideas are completely baseless?

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Sep 17, 2009

Ernie rated it

Anyone who wants to go beyond the jingoistic rhetoric of the current political season (Fall 2009-- Health Care)should read this book. TR Reid writes well and has performed a nice survey of health care throughout the world. He breaks the offerings of the different governments into 4 or 5 options... he said 4 but I think there were 5. The basic question that he says we must first ask is: "What are our basic ethical values? Do we believe that every American has the right to health care when...moreAnyone who wants to go beyond the jingoistic rhetoric of the current political season (Fall 2009-- Health Care)should read this book. TR Reid writes well and has performed a nice survey of health care throughout the world. He breaks the offerings of the different governments into 4 or 5 options... he said 4 but I think there were 5. The basic question that he says we must first ask is: "What are our basic ethical values? Do we believe that every American has the right to health care when it is needed?" Okay, technically those are two questions but the first only serves to frame the second as an ethical question. Reid makes the case that world ethics has led to thinking that health care is a basic right during the 20th century. The US approaches health care as a market commodity. --- I think that is the crux of the argument.

Good information. The shortcomings of our American system are tragically portrayed in the true story of Nikki White, from Tennessee, who contracts SLE around 2001 and loses health insurance because she the condition lead to loss of her job and hence her health benefits. She is not poor enough for government programs. She is untreated until she has a seizure and goes to the emergency room. Emergency rooms are required to treat everyone until they become stable. Nikki White had many surgeries but never became stable. She died at the age of 32. --- This is particularly tragic because, in the US, SLE may not be curable but neither does it cause death when people get routine health care. People with SLE live a full lifespan. If they have routine healthcare.

Reid writes well, tells the story well and presents the options in a way that is most constructive. At the same time, it is not a comprehensive treatise. There are some facts that we will find useful in our discussions on this topic. His approach is one that we might imagine ourselves taking were we to investigate in a casual fashion. Indeed, the vehicle for his book is a travel journal as he visits different countries to see how they would treat an old shoulder injury that is beginning to cause problems. Its charming.

But it is more important than that, too. He is telling us that the question before us is not whether we should modify our health care system... but how... and that the issue is too important to let die for political expediency.(less)

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Aug 25, 2009

Nancy marked it as to-read

Okay, I fess up--I haven't read this book yet, but I heard Terry Gross interviewing the author on NPR's Fresh Air last night, and it sounds fascinating. Reid, a Washington Post correspondent, set out to examine health care systems around the world to demystify American fears of socialized medicine, health care rationing, and lack of choice.

Using his bum shoulder as an example (he broke it many years ago in the Navy, had it surgically repaired with a steel pin, and is now suffering p...more

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Apr 10, 2010

Istop4books rated it

Shelves: non-fiction, library-book

Finished this non-fiction book on Health care around the world, what works, what doesn't, and how each country got to where they are. The author decided to take on industrialized countries and figure out what health care system they use and how is compares to the system used in the USA - which is the only industrialized country without universal health care - or was, until it passed under Obama's administration and under increasing criticism from the right.

I wish I had read this b...more

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Mar 29, 2010

Rebecca rated it

Read. This. Book.

It's a quick read, so quick you won't believe the amount of information it contains. It's also an easy read. With the central framing device of visiting individual countries to see their recommended course of treatment for a bum shoulder, Reid avoids a lot of dry fact-finding that might plague other books of its kind. Along the way he recounts the health care history of each country (France, Germany, England, Japan, Canada, and India) as well as outlining major poin...more

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Oct 19, 2009

Mike Angelillo rated it

An informative and entertaining look at the health systems around the world that consistently rank higher than the US and are often the subject of political rants here in the US.

It was interesting to see the variety of approaches taken by countries such as Germany, England, Canada, France and Japan. Regardless of the system, at the core of eachis a belief in universal coverage/access, health care financing as a non-profit venture and a drive to maximize efficiency. Also, each nati...moreAn informative and entertaining look at the health systems around the world that consistently rank higher than the US and are often the subject of political rants here in the US.

It was interesting to see the variety of approaches taken by countries such as Germany, England, Canada, France and Japan. Regardless of the system, at the core of eachis a belief in universal coverage/access, health care financing as a non-profit venture and a drive to maximize efficiency. Also, each nation had a cultural basis for pursuing a national health system. Whether it was Otto Von Bismark using a national health system to help form a united Germany or Taiwan creating one to help show it's people why it was a better nation than that "other" China, you can not separate the origins of the system from the culture of the society as a whole.

It turns out that we are familiar with a few of these systems as Medicare is based on the Canadian system (including the name), the VA resembles the English model and Germany uses an employee/employer system.

I think most Americans would be surprised at the level of innovation, efficiency and (dare I say it!!!) market competition that exists in the various healthcare systems.

The author spends some time covering the failure of Bill Clinton to achieve universal healthcare in the US in 1993 (and contrasting it with two nations that did pass universal healthcare at the same time). His criticism falls on Clinton's push for the plan on economic reasons rather than moral reasons. In other words, saving money instead of saving lives.

But I had some disagreement with this part of the book. I don't think you'll every sell the idea of a national health system in the States based on the moral idea of "we are the richest country in the world and should provide for the poor and downtrodden.....etc." America is far to individualistic and socially fragmented for that to happen. Plus, there are other factors which would have to radically change in order for it to work. For example, almost every physician at every level in these systems makes far less money than physicians in the United States (the strange exception being primary care docs in the UK). That loss of income is offset somewhat by medical school being free in most of these nations and malpractice insurance costing 1/10th to 1/400th of what in costs in the States. Those differences make it much more difficult for a doctor in the US to work under a national system unless we pay them back for medical school and do away with malpractice. No, the only way you'll see a National Universal system in the US is if there is a complete and utter economic collapse of the current system....and let's hope that never happens.

Regardless, it is worth reading and informative. If nothing else, you'll know whats what the next time a colleague or talk show host starts ranting on !!!!!!European Socialized Medicine!!!!!ARGGGG!! OBAMACARE!!!!.(less)

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Dec 15, 2009

Emily rated it

Shelves: non-fiction, meridian

One of the best, most clear, accessible and succinct analyses of foreign health care systems I have read. The author visits and personally experiences health care in France, Germany, Japan (which all use variations of the Bismarck Model), the United Kingdom (the Beveridge Model), Canada (the National Health Insurance Model), and India (the Out-of-Pocket Model). He also looks at two countries who only fairly recently adopted universal health care (Taiwan and Switzerland) to show how it was done...moreOne of the best, most clear, accessible and succinct analyses of foreign health care systems I have read. The author visits and personally experiences health care in France, Germany, Japan (which all use variations of the Bismarck Model), the United Kingdom (the Beveridge Model), Canada (the National Health Insurance Model), and India (the Out-of-Pocket Model). He also looks at two countries who only fairly recently adopted universal health care (Taiwan and Switzerland) to show how it was done. I was amazed at the variety - like many Americans I had foolishly assumed that all foreign health care systems were very similar. Not so in the slightest. In addition to Mr. Reid's own experiences, he has done his homework regarding the systems in place in each of these countries. He does a good job describing the pros and cons of each system, neither sugar-coating nor black-balling any system.

One of the more striking revelations to me, was that ironically, we in the U.S. of A. actually already use each of the models mentioned above on some segment of the population: for most working people under 65 we use a version of the Bismarck model; for Native Americans, military personnel and veterans we use the Beveridge Model; for those over 65, we use a National Health Insurance model; and for the uninsured, we use an Out-of-Pocket Model.

I appreciated that Mr. Reid kept the emotional appeal sob stories to a minimum, instead appealing to the reader's intellect and sense of fairness. The one personal story he shares, besides his own, opens the book with a powerful punch. He starts by introducing a 32-year-old American woman with lupus who would have been able to live out a normal lifespan if she had had access to affordable health care. Instead, she lost her health insurance when she became too ill to work and was denied coverage by every individual insurance plan to which she applied, finally being kicked off her state's Medicaid plan due to budget cuts. Consequently, she was unable to receive the treatments and medications which would have allowed her to live fairly normally and died. In a direct appeal to the "American exceptionalism" he details later in the book, he states, "If Nikki White had been a resident of any other rich country, she would be alive today." Ouch.

An interesting chapter on preventive medicine points out that, as opposed to countries with universal health care and especially with a single payer system, there are few incentives for health insurance companies in the U.S. to focus on the preventive side of care. Most people are not on their plans long enough for any preventive measures to make a difference, since the average length of time an individual stays with a certain coverage is only about six years. As for-profit entities answerable to shareholders, U.S. health insurance companies have lots of incentive to reject applicants with preexisting conditions and deny claims to increase their bottom line; they also have correspondingly high administrative costs. In this system, preventive medicine simply will not be a high priority, despite the long-term benefits to individuals.

Absolutely a must-read for anyone who has any stake in the American health care system. And that's just about everyone.(less)

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Dec 06, 2009

Kate rated it

After spending 30 years working in American health care, I realized how little I really knew about how other countries financed their health care system. I knew we missed the mark in the US, that we spend too much money to care for too few people, left too many people out of the system and had uniformly bad health outcomes. This book is a must read for anyone who wants to know how other countries have pulled off what we have failed miserably at doing in the US health care system.

The...more

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Aug 24, 2009

Ernie.tedeschi rated it

The Healing of America is a quick tromp through the health care systems of several foreign countries, including Canada, France, Japan, and Britain. Author T.R. Reid, using an old Navy shoulder injury as a common device for his worldwide tour, seeks to categorize and inform the reader about how every other industrialized country (and he repeatedly emphasizes America's sad exceptionalism in this regard) tackled the problem of universal health care coverage, and the challenges each system will face...moreThe Healing of America is a quick tromp through the health care systems of several foreign countries, including Canada, France, Japan, and Britain. Author T.R. Reid, using an old Navy shoulder injury as a common device for his worldwide tour, seeks to categorize and inform the reader about how every other industrialized country (and he repeatedly emphasizes America's sad exceptionalism in this regard) tackled the problem of universal health care coverage, and the challenges each system will face in the future. We learn about the sickness funds of Germany, the carte vitales of France, the National Health Service of Britain, and the long, long lines of Canada. Along the way, we learn some history (like how Bismarck considered his German health insurance policy "applied Christianity" and how the architect of Canada's Medicare is considered a greater national hero than Wayne Gretzky) and some basic pros and cons for each system.

At its best, The Healing of America succeeds in raising some provocative questions and undermining some widely-held assumptions. We learn rather quickly that not only is the foreign approach to health care more complex than simply "socialized medicine," but also that very few rich countries actually engage in what could accurately be called "socialized medicine." France, Germany, Switzerland, and Japan, among others, all allow for fair amounts of competition and choice, sometimes vigorously so. Even Britain's NHS employs some fiercely entrepreneurial doctors. And many of these countries also rely on employer-offered insurance, another misconception. We also see vividly how the typical state strategy for limiting costs -- fixing prices for each procedure -- is really just a shifting of cost burdens onto doctors and hospitals. As a result, even though the medical professionals are culturally prestigious and respected everywhere, few foreign doctors make as much as their counterparts in America would. This is mitigated by the fact that malpractice insurance costs about a tenth of what it does here, that medical records in France and Canada have been completely digitized, and that foreign doctors don't leave med school with the crippling debt doctors here do. But since differences like med school tuition are probably intractable, it's not clear how America could pursue the exact same strategy. I also enjoyed how Reid contrasted the OECD countries with developing countries, like India and China, who employ an out-of-pocket approach to health care.

About a third of the book delves into the moral case for health care reform, and here the book is at its weakest. T.R. Reid refers repeatedly to the story of Nikki White, a college graduate who died of lupus due to lack of medical insurance, but doesn't delve into the details of her death until the end of the book, where they have less impact. The rest of this "lost third" consists of perfectly respectable moral arguments that nevertheless could have summarized in a page or two. T.R. Reid is a good health care journalist but a weak moral philosopher.

The other main weakness of this work is that the detail is uneven. Reid is generally a balanced observer of the strengths and weaknesses of each system, but France goes oddly uncritiqued. He also spends an inordinate amount of time trying to lump all of America in with the "out-of-pocket" developing countries, even after he makes the insightful point that America is really an amalgamation of several systems: single-payer for the elderly, socialized medicine for soldiers and veterans, employer-based for the employed, and out-of-pocket for the poor. I would have been interested to know how these systems worked, as well. How does America's Medicare compare with Canada's? How good is the care offered at VA and military hospitals? We never find out.

By the last page, I felt like Reid had provoked more questions than he had answered, but at the same time had stimulated my imagination on a topic that, before reading this book, I had little sense of a framework for thinking about. Ultimately, The Healing of America works better as a springboard for the topic than as a piece of advocacy or as an omnibus overview of the issue. (less)

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About T.R. Reid

T.R. Reid is a reporter, documentary film correspondent and author. He is also a frequent guest on NPR's Morning Edition. Through his reporting for The Washington Post, his syndicated weekly column, and his light-hearted commentary from around the world for National Public Radio, he has become one of America’s best-known foreign correspondents.

Reid, a Classics major at Princeton Univer...more

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Books by T.R. Reid

The United States of Europe: The New Superpower and the End of American Supremacy

Confucius Lives Next Door: What Living in the East Teaches Us About Living in the West

The Chip : How Two Americans Invented the Microchip and Launched a Revolution

Congressional Odyssey: The Saga of a Senate Bill

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