By Fareed Zakaria, CNN
America's health care system is broken. Our healthy life expectancy, the standard measurement, ranks only 29th in the world - behind Slovenia. Our infant mortality rate ranks 30th - more than twice that of Sweden and Japan. And for this sub-par care, we pay more than any other nation in the world. Almost one out of every five dollars spent in America is spent on health care.
Can it be fixed? How?
This Sunday at 8pm and 11pm ET/PT I'll explore these questions with a GPS Special: Global Lessons - The GPS Road Map for Saving Heath Care. This is the the first in a series of four GPS “Global Lessons” specials. The special will run again Saturday, March 24th, at 8pm and 11pm ET/PT. It will air on CNN International on Saturday, March 24 at 9:00pm ET.
The health care special will take you around the world to show you how other nations manage their health care. We'll learn lessons from Britain, Switzerland and Taiwan. I'll show you just how expensive U.S. health care can be - for comparatively low-quality returns. And finally, I'll share my own thoughts on what we need to do to fix our system. Be sure to tune in. You can also join a live discussion on twitter during the special using the hashtag #SavingHealthCare.
I was so happy to a honest look at health systems in different countries and they have worked. Obviously, there is no perfect solution. But, we should know if we have the highest cost, we clearly don't have the best solution and ought to looking at what others do. The ACA is a step in the right direction but more can be done. Unfortunately, too many only talk about repealing what has been done before it has even had a chance to work. And those naysayers never have any real answers for alternatives. And usually have no real knowledge about the systems in other countries that they condemn.
I believe a single payer approach for high cost medical expenses with personal responsibility for routine expenses (with assistance for those who need it) is a good combination.
I hope this show will repeat many times.
A great program presenting honest facts and possible solutions. The program looked at some great health care models that are working in other countries with better outcomes and for less money.
I lookk forward to a national health care system similar to what Taiwan utilizes.
It is worthy to note the glaring omission of any mention of the effects of medical malpractice suits on health care delivery in the U.S. This demonstrates the bias of this program and the obvious support for a single-payer, gov't-controlled system. This is further apparent in the way that the moderator 'glossed over' such significant issues of rationing and the liklihood of lengthy waiting periods for necessary care. While the Camden example was interesting, it was unclear whether the investigatory team was paid, or if they were a group of volunteers. Certainly, such disclosures would impact the feasibility of expanding similar programs. When will we see fair and honest programming that actually educates the public?
Medical malpractice payments are what percentage of the 2 trillion dollars of HC spending in this country? One percent, two percent, ten percent? Ten percent is 200M dollars, do you or anyone think that medical malpractice awards in this country even approaches 200M? Very unlikely. You are more likely attempting to throw out "facts" to divert attention from much needed reform, reform that will cost HC companies billions but save thousands of American lives.
An enlightening and informative commentary however, I am somewhat surprised Canada’s Health Care model was not really discussed in the comparison evaluations. Great Britain’s system appears quite efficient with the exception of their “high taxes”. However, is it reasonable as to what they will and not pay for?
Perhaps we ought to be looking at Taiwan’s model after all.
Britain simply has decided....and got used to....spending a relatively modest proportion of GDP on the health service.
May be some waiting for non urgent procedures but certainly not for vital treatment. It's a trade-off which needs to be made when the US is being bankrupted. As it can be measured as better than the US there's a lesson there.
BTW all Brits that I know seem happy with things there. The fact is that unlike Americans they really don't think much about healthcare......it's always been there for them, so they can concentrate on more important things like enjoying themselves instead of working themselves to death to pay for the myth of the world's best healthcare.
Cheeryble (John Wickenden)
ps mention should be made of truly inventive new practices that I know of like Britain's telephonic and online self diagnosis....they seem to work. Not to mention the fantastic new ambulance practices in France whereby ambulance crews are matched to the call, spend much more time on site when necessary and then with extra knowledge about the patient sending the patient to the very best hospital for their particular treatment meaning a great saving in messing around and later changes....all good for the patient.
The program failed to address the significant cost of the litigious society we practice medicine in – which adds to the cost of medicine via defensive medicine, and malpractice premiums.
Additionally, the description of the NJ "model"medical system experiment was quite misleading. Many of the patients who over utilize the Emergency Department are no pay patients (patients' whose cost of health care is not paid for, and is eaten by the hospital and physicians involved in their care, since no one is turned away), so implying the idea that NJ hospitals were making 12 million dollars from the patients in the subsidized housing building is misleading.
The program also omitted the HUGE concepts of cost shifting in the American medical system as well has the faults of an EMPLOYER payed insurance system. But this is well covered by NPR in a This American Life episode. Google it
Hgh health care costs are squeezing America's corporations and its workers. High HC costs leaves less for other forms of employee compensation and our corporations less able to compete against foreign companies who do not have this burden.
There are a few points about your special that I would like to address. 1. The increase in cost of healthcare apparently rose in the past several years- In reality, the value of money has decreased. The cost of health insurance for a family has gone down in terms of Gold, Gasoline, and Food. 2. I agree with you that there is not a free market in healthcare. Largely prices are fixed by A. The Government and B. The Insurance Industry (In back room negotiations with healthcare organizations and providers). Unlike Lasik, which you mentioned, this does not create a market for healthcare, but a monopoly in-a-sense. If every provider had to publish their price publicly and charge everyone the same, and not interact in back-room deals with insurance companies- there would be a true market. The Insurance-consumer relationship should be strictly that, relationships between your insurance company and the consumer should not have anything to do with the physician and the price. Same with drugs- drug companies should have nothing to do with insurance companies- they should sell their products direct to the consumer- also would eliminate the high prices and the conflict of interest between the doctor and the drug company. 3. Not everyone should have healthcare- People die. People make choices, and people suffer the consequences of these choices. There is a great market for charity that would and should take care of people who cannot afford healthcare. People make this argument that things are too important for the free market- just look at two areas- the hamburger and the rhinoceros horn. The government does not regulate the hamburger and it is plentiful and inexpensive. The government does regulate the rhinoceros horn- illegal in fact to traffic- very expensive and hardly available. If the rhinoceros horn is so valuable, there should be no problem 'saving' the rhinoceros, except for the government. (It is just a big cow, albeit feistier).
Mr. Zakaria. I am the author of the World Atlas of Experience. As a imaginary cartographer I draw maps of ideas, to illustrate complex situations. Healthcare is such a domain. I can chart it. Check my site and google my book. If you're interested, please get in touch. Regards, Jean Klare
Great program, Fareed. Objective, rational, & nicely articulated presentation of the massive inefficiencies in our healthcare system & the huge economic (& opportunity) costs that have resulted. I previously read Dr. Atul Gawande's pieces in The New Yorker (which you nicely summarized), & believe that Dr. Gawande's approach – identification of and outreach to the small percentage of patients accounting for hugely disproportionate share of healthcare spending – is one critical piece, & hope (& believe) this approach will be adopted, embraced & fine-tuned by payers and providers over the next few years. But we must somehow find a catalyst for motivation to move toward a single payer system, and to correct perverse incentives in our healthcare delivery system (such as a fee-for-service approach) which encourage overdiagnosis & excessive tests & procedures. The healthcare debate (surrounding the Affordable Care Act) has made one thing crystal clear: There will be too much political opposition (from entrenched vested interests) for substantive nationwide structural change in the healthcare delivery system of this sort, regardless of the projected savings. So, it seems to me that significant, meaningful reforms must be planned & implemented in a few key states (or geographical areas) which are more progressive (politically, & with respect to healthcare delivery), & less likely to encounter political resistance. Oregon, Washington State, & Vermont are a few possibilities. These changes could then be implemented nationally.
Excellent reporting. I also found the Time Magazine article (March 26) excellent. Thank you so much for sharing your expertise with us. I sincerely hope this special will be replayed every 3 days so so between now and when the Supreme Court rules. Our citizens need to know the facts, not what they hear from those who have a political agenda.
I am 47 years old and have a pre existing condition and had to go on Medicare because my husbands insurance denied me coverage. I have a 21 year old son in college and my 57 year old husband just lost his job and health benefits for himself and my son. The Cobra payment would have been $16,400 a year for the two of them and obviously, this was not an option. I ended up getting my husband on a high deductible plan through Healthy NY and put my son on his college insurance. What will happen when my husband no longer meets the qualifications for Healthy NY and when my son is out of college?
With that said, I would like to know why the Republicans (and some Democrats) are so against health care reform? It is so blatantly obvious that our system is broken and is bankrupting many Americans. My assumption is that there are many corporations and special interests groups that are funding these politicians campaigns that will have a lot to lose if we switch over to universal type health care. Can anyone explain this to me?
I also wanted to mention that being that no one is hiring in my husbands field, he is going to have to work as a subcontractor and become self employed. This is going to make affording health benefits almost impossible. If we went to universal type health in America and it was funded through our taxes, wouldn't that relieve employers of the huge expense of having to provide health benefits to their employees?
Every American deserve to see this report. Thank you for your excellent, well researched report!
Great special very informative. I found it quite interesting the Swiss model which has has a great outcome is very similar to Obama's health care law. I also found it interesting that Taiwan who reformed their system went with the single payer system. Though I am not sure it would work in the US. the fact the doctors are getting paid low and work 11 hours a day may not work here. Though I think a single payer as an option would help to reduce the waste in the private insurer. The fact that Private insurers spend 30% on non medical related cost is also a problem and should be controlled. Finally 5% of patients account for 50% of the costs sound slike we need death panels (only kidding but these numbers need to be fixed.
I am bipolar. I live on SSDI. Because I get insurance and not welfare, I can't get Medicaid. Medicaid in the state of Texas is the only way I can afford Abilify and see a psychiatrist. I had to pay blood cash that took the food out of my mouth for a psychiatrist to give me a perscription over the border in Nuevo Laredo - I live in Laredo. Know what the home base of NL is? The Zeta drug cartel. I had to go into their territory to get an American pharmaceutical drug that I couldn't afford here. And people will ask, "Oh, was it the right drug no matter what it said on the label?" And my answer is think for a second. I'm in cartel territory. You think the products there are inaccurate? Yeah, it's the right medicine.
But this is what I have to do because I've been in two minor car accidents in a year, and I need a dopamine modulator to help me concentrate because I won't get in the car without it. Bipolar disorder does a lot of things to your brain, but it doesn't take away your morality.
Dear Mr. Zakaria:
As the author of two major works on this subject, and as a consultant and speaker deeply involved for 22 years with these issues, I can say with substantial authority that your piece was excellent and dead on. You were very wise to include T.R. Reid, whose work (The Healing of America) should be read by every American who is still able to form an independent opinion based on fact instead of political sloganism. I speak also for my coauthor Kathleen Bartholomew in applauding your work. We would also advise those who attack your conclusions to have the intellectual honesty to reexamine the basis of any such demurrer. For instance, one columnist/blogger who has already weighed in in the negative had the temerity to assert that he had "blown away" the factual assertions that we are providing less than half the quality of care of the rest of the industrialized world, and that our longevity and infant mortality rates are abysmal compared with other nations. You may rail against those facts as must as you desire, but they are still facts. John Boehner discredited himself with me en toto two years ago when he made the absurd statement that "We still have the best healthcare in the world." Sorry, John...not on this planet. We can't scare away the reality of the disaster this great non-system has become. It's time to blow away the counterproductive party demagoguery (and both sides are guilty) and join minds as American on the real issues in order to produce something we have never had: A true healthcare system that is affordable, efficient, and stable. We have nothing even remotely resembling that today.
John J. Nance
Kathleen M. Bartholomew
WHERE IS THE VIDEO OF THIS? I'd like to show it to some colleagues. (I work in politics in Germany.)
Magnificent points altogether, you simply won a new reader. What may you suggest about your post that you made a few days ago? Any certain?
Remarkable issues here. I am very satisfied to look your post. Thanks a lot and I'm having a look ahead to touch you. Will you kindly drop me a mail?
This is really a remarkable thing that we must take our future with the gps system taht takes part in the safety in our driving.
Please tell me when this will be on again. My whole family is interested in seeing this! Can we watch it online?
I grew up and worked in the NHS. In the UK, we find it unconscionable that a developed nation such as the US wouldn't provide healthcare for it's citizens. It's not a political issue of conservative versus liberal, it's a human rights issue. There was no such thing as 'death panels'. If you needed treatment right away, you got it, if you could wait, you did. There was no fear that if you lost your job, you lost your healthcare. You didn't have to worry that if you got sick, you potentially could go bankrupt in order to pay for treatment. Yes, we paid more in taxes, and that's where the real battle is in the US. Those who make more money don't want to pay higher taxes. It all comes down to money, forget about looking out for the interests of others.
Link disabled. I need to see this doc again, and to pass the link to other interested parties. The item will not play
Dear Mr. Zakaria, I watched your well researched piece this past Sunday (July 1, 2012). I am a practising pediatrician based in Los Angeles, having grown up in India. I graduated from medical college in India, 22 years ago. I liked the intellectual honesty in your show. It is appalling to note that the economic fate of a catastrophic illness for an individual is no different in the U.S., the lone superpower on this planet, compared to an emerging economy like India. It appears that the vested interests in the healthcare industry would like to keep the American public in the dark about the intellectual aspects of the argument for universal healthcare and play to the emotions of the opponents to perpetuate the misguided notion that people's freedom about healthcare choices are being taken away by the government. Strategies to forge meaningful public-private partnerships in the quest for universal healthcare coverage and affordability, would be a good start, as envisaged in the Affordable Care Act.
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There is no country in the world that currently provides universal healthcare which has legal costs associated with malpractice or the cost of education to become a physician comparable to the United States. American public is not ready to pay a 50% income tax (although those making over 250$/yr are being forced into it), but they expect the government to somehow provide them with high quality healthcare. Physicians are under growing costs of regulations, but no private insurance companies or legal systems that allow frivolous medical law suits are being regulated to any reasonable extent. When did a clerk for an iansurance company gain the clinical understanding of what medication or procedure to approve for a patient they have never laid their eyes on? The system is a mess and needs reform, and public deserves access to healthcare without a doubt, but aren't we approaching this from the wrong end?
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The Global Public Square is where you can make sense of the world every day with insights and explanations from CNN's Fareed Zakaria, leading journalists at CNN, and other international thinkers. Join GPS editor Jason Miks and get informed about global issues, exposed to unique stories, and engaged with diverse and original perspectives.
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