Looking outside our borders

LOOKING OUTSIDE OUR BORDERS…. About a month ago, Sen. Richard Shelby (R-Ala.) told Fox News that the health care status quo in the United States is “the best health care system the world has ever known.”

It was a strikingly foolish thing to say, but it was also a reminder that as far as conservatives are concerned, health care systems outside the United States aren’t just awful, they’re dystopian nightmares. While some Americans are able to enjoy “the best health care system the world has ever known,” the right tells us, non-Americans are forced to endure rationing, life-threatening wait times, soul-crushing bureaucracies, and sub-standard medical care. (That many of these problems already plague the U.S. system is an inconvenient detail, usually ignored.)

Jonathan Cohn sets the record straight. While most conservative complaints focus on England and Canada, which rely on socialized medicine and single payer, it’s not the comparable model for U.S. reform.

Last year, I had the opportunity to spend time researching two of these countries: France and the Netherlands. Neither country gets the attention that Canada and England do. That might be because English isn’t their language. Or it might be because they don’t fit the negative stereotypes of life in countries where government is more directly involved in medical care.

Over the course of a month, I spoke to just about everybody I could find who might know something about these healthcare systems: Elected officials, industry leaders, scholars — plus, of course, doctors and patients. And sure enough, I heard some complaints. Dutch doctors, for example, thought they had too much paperwork. French public health experts thought patients with chronic disease weren’t getting the kind of sustained, coordinated medical care that they needed.

But in the course of a few dozen lengthy interviews, not once did I encounter an interview subject who wanted to trade places with an American. And it was easy enough to see why. People in these countries were getting precisely what most Americans say they want: Timely, quality care. Physicians felt free to practice medicine the way they wanted; companies got to concentrate on their lines of business, rather than develop expertise in managing health benefits. But, in contrast with the US, everybody had insurance. The papers weren’t filled with stories of people going bankrupt or skipping medical care because they couldn’t afford to pay their bills. And they did all this while paying substantially less, overall, than we do.

The people in these countries have a system marked by “convenience, quality, and affordability.” How horrific.

Kevin Drum added, “Now, the fact that the French spend about half what we do doesn’t mean that we’d cut our costs in half if we adopted a French-style system. We wouldn’t… But what it does mean is that if we adopted something close to their system, we could certainly achieve high-quality 100% basic coverage — with the ability to purchase extra coverage for anyone who wants it — for no more than we spend now and possibly a bit less. We won’t, of course, because too many people are still convinced that healthcare in the United States is better than it is in France — or anywhere else. It’s not. It’s worse and more expensive.”

Democrats have the White House, a 60-seat majority in the Senate, a 255-seat majority in the House, and a popular mandate. If they really want “the best health care system the world has ever known,” they can start making it happen right now.