Sick Around the World

Last night PBS Frontline replayed "Sick Around the World: Can the U.S. learn anything from the rest of the world about how to run a health care system?" I've seen it twice now and have been struck each time by a number of points: (1) there seems to be general agreement that ending the fee-for-service system (essentially, paying physicians a fixed yearly salary) will control prices for physicians services, (2) mandating health insurance, eliminating underwriting and, here's the tough one, making insurance companies nonprofit organizations, solves the coverage problem, (3) fixing drug prices (in Switzerland) did not reduce innovation (although Swiss drug firms still had the lucrative US market), and (4) setting limits on prices for medical technology (e.g., CAT scanners) led to the development of lower-cost technology (Japan). These four steps, if they could be implemented in the US (a big "if"), would effectively control health care costs.

However, I was also struck by the cultural differences between the other capitalist democracies (United Kingdom, Japan, Germany, Taiwan, and Switzerland) compared to the US. There is a clear agreement in these countries (even among conservatives, it seems) that health care is a basic right, something that every citizen should have regardless of income. In the US brand of capitalist democracy, health care is still a commodity. Without a change of philosophy in the US, there can't really be a change in policy.