One approach to solving problems is to pick and choose from the
solutions of others (since nobody's solution is without problems and
since even the best solution for another country will not be "the
best" for our country).
I know a lot of Canadians who have spent years here in the US (moving
back and forth for professional reasons). Not one of them would trade
their system for ours, even though they have serious gripes about
their system. What's good and what's bad about their system? What can
we learn from them?
I work with dozens of people from France. Some of them HATE their
overall governmental system (I've never been able to get my head
around it, either), but not one of them would trade their healthcare
system for ours. They think it's better, and some numbers seem to
bear this out. Parts of Their healthcare system may be something we
need to look at closely since, in many ways, they face challenges
similar to ours (relatively large geographically, diverse population,
immigrant issues, etc.).
Same for Germans (though I know fewer of them), even after they
started paying for East Germans to join.
I only know three Dutch. They _know_ their healthcare system is
better (though they do some advanced training over here, which is why
I know them). And it is better. But, their country is much different
from ours; different challenges and different populaces.
The UK citizens are a mixed bag. Some people my age (mid-40s) and
older that I know prefer our system. Younger people I know prefer the
UK system. Apparently the original NHS plan was never implemented (as
I understand it, it was somewhat like the more successful Canadian
plan). What was good about the original plan? What caused it to
semi-fail? Was failure inherent? I thought their system was abysmal
in the early 90s, when my family had direct experience with it.
However, many of the docs said it was wrecked by Thatcher and
corporatists intentionally. Not having been there at the time, nor
studied the history, I don't know.
We can whine all day about "the way things should be", or we can
learn from others' mistakes and successes, learn from our mistakes
and successes, and go from there. Right now, I don't think we're
willing to even pull our heads out of the sand and admit that we no
longer have the best system (for _some_ parts of healthcare) and
that, indeed, what we have is getting worse (for a subsection of
those problems). We already spend more on healthcare than any other
country per capita. In fact, our government already spends more than
any other government in this respect. Think about that. No matter how
"socialistic" we do or do not become, the government itself is
already spending more per person than governments that we consider
more socialistic (which, at this point, is Canada, all of Europe, and
lots of Asia). So, if others can get better healthcare at less cost,
I'd say we need to look closely at what they're doing right and avoid
what they're doing wrong.
I know, it's like saying "don't take any wooden nickels". But, we
need to at least admit that our system may have "evolved" in the
wrong direction and make corrections.
Jeffrey H. Boatright, Ph.D.
Department of Ophthalmology
Emory University School of Medicine
Atlanta, GA 30322