Editor's note: "Global Lessons: The GPS Road Map for Saving Health Care" re-airs on CNN TV on Sunday at 8 p.m., 11 p.m. and 2 a.m. ET; on CNN International on Saturday at 9 p.m. ET and Sunday at 6 a.m. ET. We'll take you around the world to show you how other nations manage their health care and what lessons the U.S. can learn.
As the U.S. Supreme Court released its rulings on the constitutionality of Obamacare, check out a round-up of ideas for how to save health care from a previous "Global Lessons" report and Fareed Zakaria's takes from the past few months in the lead-up to this court decision.
Zakaria: How to fix U.S. health care
From Fareed Zakaria:
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? Read more
Zakaria: A lesson from Switzerland
From Fareed Zakaria in TIME:
The centerpiece of the case against Obamacare is the requirement that everyone buy some kind of health insurance or face stiff penalties – the so-called individual mandate. It is a way of moving toward universal coverage without a government-run or single-payer system. It might surprise Americans to learn that another advanced industrial country, one with a totally private health care system, made precisely the same choice nearly 20 years ago: Switzerland. The lessons from Switzerland and other countries can’t resolve the constitutional issues, but they suggest the inevitability of some version of Obamacare.
Switzerland is not your typical European welfare-state society. It is extremely business-friendly and has always gone its own way, shunning the euro and charting its own course on health care. The country ranks higher than the U.S. on the Heritage Foundation’s Index of Economic Freedom.
Twenty years ago, Switzerland had a system very similar to America’s – private insurers, private providers – with very similar problems. People didn’t buy insurance but ended up in emergency rooms, insurers screened out people with pre-existing conditions, and costs were rising fast. The country came to the conclusion that to make health care work, everyone had to buy insurance. So the Swiss passed an individual mandate and reformed their system along lines very similar to Obamacare. The reform law passed by referendum, narrowly.
The result two decades later: quality of care remains very high, everyone has access, and costs have moderated. Switzerland spends 11% of its GDP on health care, compared with 17% in the U.S. Its 8 million people have health care that is not tied to their employers, they can choose among many plans, and they can switch plans every year. Overall satisfaction with the system is high.
Zakaria: Private health insurance is not efficient
From Fareed Zakaria:
Under Britain's National Health Service (NHS), the patient doesn't pay a thing. ... Compare that to the U.S., where an estimated 137,000 people died over seven years because they were uninsured. Of course, the Brits do pay for their health care in another way – with taxes. their sales tax is a whopping 20% and income taxes are as high as 50%.
All of that money feeds a health care behemoth. The NHS is Europe's largest employer, with well over 1 million people on the payroll. So you'd think it would be inefficient.
T.R. Reid, a former overseas bureau chief with The Washington Post toured the world's health care systems for his recent book, The Healing of America. Reid says:
"That seems sensible, right? The private sector can do things more efficiently? It doesn't work in health care. The least efficient payers in the world are the American private insurance companies. They have administrative costs of 20 to 30%. That's a 30% tax on every dollar you spend on health care. Britain is totally socialized medicine [and its] administrative costs [are] 5%. Canada is private doctors and public payers – 6% administrative costs. So it turns out, for some reason in health care, governments are doing this more efficiently than our private sector."
A crucial statistic
New Jersey’s Camden Coalition of Healthcare Providers founder and family medicine practitioner, Jeffrey Brenner, used medical billing records to find that just 1% of patients accounted for 30% of health care costs in Camden. And that's not all he discovered in the city's three hospitals. He says: "We learned that someone went 113 times in one year. Someone went 324 times in five years. In similar workup in Trenton, they found someone who went 450 times in one year." These were people with complicated medical histories and chronic illnesses. One patient alone racked up $3.5 million in medical bills over a five year period. As Brenner says, :"They're the difficult patients to treat, and no one is being paid and incentivized to pay attention to them."
What's more, Camden's problem is America's problem. Just 5% of Americans accounted for half of our nation's health care costs in 2009. This is perhaps the crucial statistic to understand about America's health care problem.
MORE FROM GPS
In opposing Obamacare, we were serious the whole time
What states can do even without the mandate
A brief history of Taiwan's individual mandate
The costs of overturning Obama's health care reforms
Over the past few months, hundreds of readers have weighed in on the debate.
Reader "U.S.M.D." had this to say: "I think two issues predominate in why America spends so much of its GDP (18% or so) on healthcare, but has terrible outcomes compared to other developed contries. One, we have poor national healthcare coverage to lower socioeconomic groups, and two primary care physicians face poor patient compliance with lifestyle changes and treatment compliance. In short, even after extensive counseling, many Americans would rather be obese or would rather smoke cigarettes now, and face the consequences later. We all need to step up to the plate on this one by improving our personal health, in order to significantly lower healthcare costs and increase the average health of our country."
Ted left this comment: "The USCare ship is sinking and there are not enought life-boats (physicians, facilites, etc). So some are saying – let's get everyone on boats. If the boats overturn, we go down together. The others are saying, let's limit the numbers to a safe limit. They are being accused of being previliged. What would the captain of a real ship decide?"
A Canadian reader weighed in with her perspective: "I am Canadian... . I could also add that the admin costs are kept lower because paperwork is much less. Necessary surgeries are paid for ie heart surgery. My mother had a heart attack about 2.5 years ago, and the surgery and recovery did not cost us or cause her to lose her home or her savings. However things like elective surgery ie cosmetic etc are paid for by those who wish it. Our system isn't perfect, however we don't fear dying and or losing our homes to pay healthcare bills. This was resolved about 70+ years ago, and in the UK this was done right after WWII and they still had food rationing. I find it unbelievable that this is something the US is still arguing about."
What do you think? Is there another model in the world the U.S. should use? What has been your experience of other countries' health care systems?
I kissed my way up to VP at a health insurance company. Now I take over $500,000 of your health care dollars for NO VALUE ADDED to your health care. And that’s just me. Now think about how many other VPs, Directors, Managers, etc. are at my company alone. Now multiply that by thousands of others at hundreds of other health insurance companies. From 10 to 25% of your health care dollars go towards administration that adds NO VALUE to your health care. But my company’s PAC dollars will continue to fool you little people into thinking that a single payer system will be bad. Little people like you are so easy to fool. Little people also don’t realize that a single payer system is the ONLY system that would allow little people (as an entire country) to negotiate better health care prices. Little people don’t realize that the Medical Cartels already know that. And that is the reason why the Medical Cartels spend so much PAC money from the hospitals and doctors lobbying against a single payer system. Some little people say that a single payer system would cost you little people more. But if that were true, then wouldn’t the hospitals and doctors WANT that extra money? Yes they would. So why do the Medical Cartels lobby against a single payer system? It’s because the Medical Cartels know it would allow little people to negotiate better health care prices. And that’s what the Medical Cartels are afraid of. Period.
But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easy to be fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $106,800 level. Now I only pay 1.3% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.
Then replace Timmy Suckle with any VP at any Insurance Company and then it's all true!!!!!!!!! Hahahahahahahahahaha
Ian.. He is not. As part of my studies, I did a course on health care and a single payer system is considered as themost efficient and the most successful formof health care. Moreover, what Zakkaria says is also true. Government for some reasons is always great at providing services that do not returna profit like Health care. When you turn health care into a business, then supply and demand forces kick in and what we have is the poor who do not have purchasing power is left behind with people who have that power getting in to the game with an unfair advantage. what every country has shown , is that private businesses cannot run health care efficienty as a democratically elected government can. At least in health care, socialism is the way to go.
Which part is a lie Mr. Clueless American fool. Your comment is exactly what sells the American as stupid and they vote against their best interest. If Mitt wins in Nov, the whole world is going to laugh their asses off. Do the research and you will find out what the world thinks of Mitt, the man that sold out his own country men to make a profit!
Totally bogus lie
I would like to know if Americans are going to have to pay for illegal immigrants to have health care in the United States. If they are not legal, how are they going to get their health care?
Free ticket back to their country of origin.
Cindy, we pay for it now. They go to emergency, get treated and we pay.
OLD news we all ready do just ask any hospital in NYC or New Jersey.... NEXT QUESTION
I believe many people are missing a more ominious looming problem.This forced to pay mandate has larger problems .The court clearly stated that all of us will participate in health care so all should pay .All of us consume food,water, energy, land and a myriade of other basic needs,so where will paying for something on top of paying taxes stop .Where will the next forced picking of our pockets come from when the govt system cant manage corporations or funds.The court has branded the many uninsured tax payers an automatic non contributor label.IThis is a court that is obviously pro corp ,pro gov ,and poor on protecting the majorities privacy ,or liberty.There is a clear lack of looking down the road to the gigantic abuses it keeps clearing the path for. Complicating the balance in campaighns by allowing more gross amounts of special intrest money in any already tipped system,the orwellian gaul of giving corps a individual liberty like status,and now multiplte layers of tax,by simply rebrandig as not a tax ,but the irs fines if yiou dont particape.
Your pocket is already being picked by freeloaders who show up at the ER uninsured. Not just those not poor enough to be on Medicaid but I'm talking about the Young Invincibles who get into unforeseen auto, skiing, snowboard or skateboard accidents, or who come down with a cancer that they didn't foresee.
Can you imagine these people having the audacity to get cancer!
Why I never. Some people.
To an American their is no world, just their country, surrounded by commies, socialists, terrorists and all kinds more of mies and ists
Hello everyone, you are all welcome to visit – thestarofkaduri.com
I think chief justice believed that politicians played enough games with health care. He gave very specific guidance on how health care law could be implemented.
I have lived in the UK and France and now the US. The little people of America are held hostage to their notion of freedom. Oh the irony! Yesterday was a moral victory for the country but a lot of work still lies ahead.
One should work and earn money in Switzerland but not to live there. The premiums are horrendously expensive and rise every year. For the same quality of healthcare you pay less in Germany. Many doctors – especially dentists – rip patients off, just to earn a quick buck to finance their lifestyle.
One thing else you and Zakaria forgot to mention, Switzerland has only 6 million people to manage. How are you going to manage 300 million? They also have low unemployment and a strong middle and upper class. They make sure they enforce their borders against illegal immigration and have stiff penalties for breaking just about any law.
G.Snyder....these were the exact thoughts I had while watching the program...population difference, not as many slackers, and fairly secure borders. Why people continue to whine that every other industrialized nation have a universal health care system, so we should too, seem to never take into account our size and population compared to other nations. Simply, we are NOT other nations (though I fear we are heading down the rabbit hole.).
You haven't explained how population size makes a difference. What difference? How? Do you know? Or is this the old straw man argument?
If we're going to fix something that obviously needs fixing, we need to start with facts, not politically-driven beliefs, obfuscations, and distortions. Serious issues demand serious participants seeking serious solutions.
Your point is an important one...if it's valid.
"Everybody wins when everybody wins." – W.F. Hightower, a Texan
There should be no fault health insurance where patients can buy a policy such that if they have an untoward result from health care they get compensated appropriate to their needs..they do not need to sue anyone..Statistically not every operation will work even in the best hands..Lawyers picking out the most profitable cases damage the system.They need to get out of health care– ooops sorry I forgot that they pay for the democratic party's campaigning..physician quality review can be improved without waiting for disasters and perhaps the lawyers–like John Edwards-would like to volunteer to participate in this process that they find so important, unless of course the case would not get them into 30,000 square foot houses...
Whether we should provide health care to everyone is the wrong debate. The question should be: Why has the cost doubled and tripled in the past 10 years?
Dear Fareed and staff,
I'm impressed by your report about healthcare.
Living in the Netherlands, we have seen the result of commercialisation of our healthcare in the recent years.
Insurance prices went up, incomes of the insurance compagnies went thru the ceiling.
And the heathcare itself ?! it is under a constant scruteny of downsizing.
The money goes to the insurance-compagnies and not, as it used to be, to our healthcare.
Our goverment is more and more rethinking it's turn towards commercialisation of healthcare.
No healthcare system is perfect, but we have to realize that no right to healthcare at all is like
I'm studying here in the Netherlands for a year. Here in Europe, I bought a student health plan for €560 for the entire year (the whole year, In the U.S. COBRA would have been $500 per month).
I was not charged to see the doctor, nor the neurologist. Here, my Copaxone cost €900 per month, which is reimbursed by the insurance company. In the U.S, it cost over $3,000 per month, which is up from $800 per month ten years ago. I don't know who is making all the money. I have seen no cures or improved treatments.
What eveyyone appears to skip in their questioning the GOP reps on the news shows is this," If the Republicans dont like Obamacare and want to replace it, why dont they have a plan ready to show that will replace Obamacare and how it is more advantageous."?!
I enjoyed the debate this morning except for the Republican that seemed he had the right to talk over the other panelists by raising his voice and speaking faster. I know the importance of a variety of opinions and I appreciate that but I dislike the panelists that are not polite enough to allow the other panelists to have an equal say.
I'm in complete agreement. Peter Schiff was a bad guest, and not only because of his impolite and agressive behavior, but also because he brought so little of substance to the conversation. If I want to listen to politicians spewing propaganda with no regard for an intelligent exchange of views, I'll watch Meet The Press. GPS can do better.
Please do not seat loudmouths like Peter Schiff on your program.This man ruined part of my listening pleasure today.
But Taiwan is no U.S.A. Taiwan does not have the problem of illegal immigrants getting the tax payers pay for their child birth child support as well as their healthcare etc. Taiwan does not have illegal immigration problem.
Yes, Taiwan does have illegal immigrants from China. A big headache to Taiwan goverment.
I am a loyal listener who appreciates your balanced and thorough analysis of issues. Thank you very much for this important element that unfortunately is vanishing from the public press.
However, on today’s show you had Mr. Peter Schiff as a guest. He obviously was at one end of the political spectrum. I accept and honor his views, but what I do not honor was his consistent attempt to interrupt and bully the other guests on the panel. This is the norm on Fox News… I would hope that you would leave him on Fox… and not burden the rest of us who are much more interested in a meaningful and civil debate about issues.
Are we no linger able to view the live show online?I have not been on the site in a while, but I have an assignment to complete and i do not have CNN, and I can't find any other way to view the video. Does anyone know where or when I can see it online?
Worst show ever today Fareed. Start with an unbalanced argument over Obamacare, with three proponents (consisting two people planning to cash in big on the program and a left-wing journalist) against a single right-wing ideologue whose father is in prison for tax evasion. This was an obvious setup meant to make the anti-Obamacare position look extreme.
Follow that with an anemic presentation on how the housing market is beginning to recover (it isn't even close yet) that seems to be timed before a major election to influence voter sentiment.
You've produced a really remarkable show, why would you now want to destroy your credibility with this type of propoganda? Analyze and report, leave the spin to somebody else. There are plenty of people in that space already. Could you recommend a news outlet that still practices honest journalism? I can't find one.
My opoin is to help the Econmis why don't they let the RV of the currency than place then in could a lot of prob.
I am utterly disgusted by so-called 'experts' who igonorantly make grandiose pronouncements that the outcome of government run health care systms in europe is better than ours in the US. It is like insisting that 2 plus two equals 5, completely ignoring facts, information, and common sense.
Anyone interested in FACTS, not moronic, ignorant, pretentious, and poltically motivated pronouncements by people with such big egos that they are 'beyond' facts can do little research. Try googling "5 year cancer survival rate by country" and "5 year heart attack survival rate by country". Look at the result and keep doing more research.
Can you guess which country comes out number one? In case you can't take the trouble to look for yourself, the number one country is the US. The UK, whose medical system Obama and his cohorts admire, is WAY down the list. They also have hospital beds in their hallways due to overcrowding. Canada has published 'wait lists' for various medical tests and procedures, which can be weeks or months. Is it any wonder that rich Canadians come to the US for medical treatment?
Something is fundamentally wrong when so much of the news and so many supposed experts exist in a vacuum that is ignorant of basic facts. The next time you see these puffed up ignorant media experts making their mealy mouthed pronouncements, give them the credibility they deserve - absolutely none. Do your own research, and let your respect turn into contempt for their arrogant ignorance.
To a thirsty man h2o is a needed commodity!
Would that same thirsty man drink offered to him with cyanide? Are there uninsured sick people throughout America... indeed! Many are sick as a result of sinful, irresponsible choices. Now Obama with his cunning tax promises to reward rebellion. What he's offering is h2o with cyanide. It doesn't matter how many ways he trys to justify it...he's wrong! The cure for Americas I'll isn't Obama's Marxist quack policies...what's needed is for sinners to repent!Jesus didn't mandate miracles or that Cesar extort money from the rich. As true healing is a gift of God!
Fareed, You missed one thing major issue that makes American health care so expensive, malpractice suits. Other countries don't allow suing their doctors who
work hard to care for their patients. Your show was a terrible misrepresentation of the problem and solutions. Sad.
He's nothing but a mouthpiece for ObamBoozler. Thinking he can fool people with all his skewed stats and projecting Obama scam as the ultimate fix. Straight up Marxist godless punks!
This country use to be of the people, by the people and for the people. If we go back to that the health can be made affordable. To day the people have no voice in how the health care dollar is spent. People need to wake up and know that democrats or Republicans are interested in taking care of the people.
Don't compare USA with Swizerland. How many illegal immigratants in Switzerland? How many people live on welfair in Switzerland? What is the education level and citizens' self-awareness in Switzerland? The same thing works for Switzerland does not work for USA.
I have been watching the reruns of your Global Health Care show. I wonder why you went to Thailand and Switzerland to study their programs. There is a country closer to the United States that has had universal healthcare for over 35 years and has only 6-7% uninsured. Hawaii. In the 90’s, the Clintons came here to Hawaii and Hillary spent the whole week learning about our health care plan. They went back and tried to sell it to the Republican congress.
We LOVE our healthcare program. The employers love our health care program because it is all tax deductible. Further, they are allowed to charge the employee up to 50% of the premium. The employee is happy because he gets great coverage for only 50%. The employer is happy because he only has to pay half the premium but can deduct the whole amount.
If you are not employed, there is Cobra and if you cannot afford that, there is state subsidized Quest. I had a mastectomy on Quest and it cost me nothing.
When the United States started fighting Obamacare, the Hawaii government introduced a bill that our health care program would stay the same no matter what the clueless people of the US did. When our current governor (who spent toooo much time in the United States government) threatened to veto it, it got the biggest response (phone calls, emails, and letters) ever!
I am a health care policy analyst and I have never seen a better written and more informative piece. None of the information about the American and the British health care systems was new to me, so I was extremely impressed not only with the specific elements Fareed chose to highlight and that are key to understanding what the problems are and what fixes might work, but also how succinctly it was presented. Anyone who comes in with an open mind could learn so much from this show.
When I was a student in England five decades ago, I lived on a shoestring budget in the poor East End section of London, rubbing shoulders with dockhands and leather-jacketed, motorcycle riding hoodlums called Teddy Boys and surviving on a diet of fish and chips but I never had to worry about what would happen to me if I fell sick. In fact, one of my classmates did fall ill and I had an occasion to see their entire system first-hand. It was a no-frills system but I would take it any day than our crazy-quilt health scare system designed to squeeze money out of people and then denying care when it is needed the most.
However, you left out one important group on socialized medicine right here in this country, namely the members of our Congress who eagerly give themselves government-run, taxpayer-paid medical care (http://oneutah.org/conservatives/conservative-sell-outs/asshat-teabagger-congressman-wants-his-socialized-healthcare-now-not-in-28-days/) and then steadfastly deny it to the rest of us and I hope you will see fit to make an episode on the quality and economics of Congressional health care for the benefit of your viewers.
Alzheimers is the #1 Health expenditure followed by Vision Loss the #2, with Women 60% more prone to AMD Vision Loss than Men. Why? According to A.Gore,A.Wegener & Dr.A.Fletcher/UK these statistics stem from (1) dark UV Sunglasses "dilate" the pupils allowing in more UV/UVB radiation into the Eye (2) $39.95 Sunglasses as well as a $399.00 Sunglass, the UV filter wears off soon. Today's PHOTOCHROMIC Sunglasses do not have these problems. Obama can start Vision Loss reductions himself by losing HIS old dark UV Sunglasses and choosing the new UVB PHOTOCHROMICS. Sen Romney, can he DO BETTER??
Its a step right over the tyrannical cliff! I'm an uninsured Latino, lower income Latino. Obama scam tax rewards laziness and irresponsible behaviour. Obama tax is a crafty way for the godless leadership to decay the moral of a people. Over 2k pages and you believe it's filled with things that all benefit you? You have way to much trust in man, especially a man that won on false pretenses! JESUS is light , Obama is anti Christian opaque Marxist.
truthisfreedom you need to stop using Jesus" Judge ye not "Read the word..... God does not need your help .... You can read a man's heart now... What you are doing is wrong... GOD tells us not to do this .... STOP IT better yet Read the bible and learn something..." Your views I have no problem with its yours" But keep the son of man out of it
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.
Every week we bring you in-depth interviews with world leaders, newsmakers and analysts who break down the world's toughest problems.
CNN U.S.: Sundays 10 a.m. & 1 p.m ET | CNN International: Find local times
Buy the GPS mug | Books| Transcripts | Audio
Connect on Facebook | Twitter | GPS@cnn.com
Buy past episodes on iTunes! | Download the audio podcast
Check out all of Fareed's Washington Post columns here:
Obama as a foreign policy president?
Why Snowden should stand trial in U.S.
Hillary Clinton's truly hard choice
China's trapped transition
Obama should rethink Syria strategy
Enter your email address to follow this blog and receive notifications of new posts by email.
RSS - Posts
Get every new post delivered to your Inbox.
Join 4,862 other followers