Pick up a good book…

One of the benefits of living in these times is that information flows so freely. As a nation, we really cannot be hoodwinked unless we choose to.

Those who want to expand their fact-based understanding of the need for health care reform can find a number of reliable, unbiased news sites to visit online, such as the Washington, D.C.,-based independent Kaiser Health News and California Healthline, an aggregate site produced by the California HealthCare Foundation.

And then, there’s the bookshelf as well. I recently picked up a copy of longtime Washington Post reporter T.R. Reid’s “The Healing of America: a Global Quest for Better, Cheaper, and Fairer Health Care.” (I know, I know…it’s not exactly the blogosphere, but it is bound in an old-fashioned way with 277 pages — and oh so portable!)

Published in 2009 by The Penguin Press, the book offers a refreshing bird’s-eye view of what the world has to offer in terms of health care delivery systems. Reid’s travels and reportage pivot around his search for treatment of a bum shoulder; he’d badly injured his right shoulder decades ago, and the effectiveness of the initial fix — surgery and steel screws –has long since worn off, leaving him with pain and stiffness (albiet not disability) and in search of quality, affordable care.

From India to Japan, from France to Taipei, from Britain to Canada and beyond, Reid roams the continents, checking out his options.

That’s after starting in the United States, where his visit to “a brilliant American orthopedist” results in a proposed surgical intervention that Reid says reflects the (flawed) “high-tech ethos of American contemporary medicine.”

In other words, a solution that involves what seems like the most complicated, space-aged, super-techno, state-of-the-art, expensive, over-the-top procedure possible. The author writes:

“This operation — it is known as total shoulder arthroplasty, Procedure No. 080.81 on the National Center for Health Statistics’ roster of ‘clinical modifications’ — would require the orthopedist to take a surgical saw, cut off the shoulder joint that God gave me, and replace it with a man-made contraption of silicon and titanium. This new arthroplastic joint would be hammered into my upper arm and then cemented to my clavicle…. I had serious reservations about Procedure No. 080.81. The saws and hammers and glue made the procedure sound rather drastic. It would cost tens of thousands of dollars (like most major medical procedures in the United States, the exact price was veiled in mystery). The best prognosis I could get was that the operation might or might not give me more shoulder movement…A certain skepticism crept into my soul about this high-tech medical intervention. I departed my American surgeon’s office and took my aching shoulder to other doctors, doctors all over the globe. Over the next year or so, I had my blood pressure and temperature taken in ten different languages….”

Reid admits the shoulder wasn’t really all that bad, but his condition did provide a way in the door to medical offices worldwide. His thesis? “We can bring about fundamental change by borrowing ideas from foreign models of health care.”

He pooh-poohs the notion that anybody who dares say that other countries could offer lessons to America is unpatriotic or anti-American…. “The real patriot, the person who genuinely loves his country, or college, or company, is the person who recognizes its problems and tries to fix them. Often, the best way to solve a problem is to study what other colleges, companies, or countries have done.”

And why not? Take Japan, for one. Japan has the oldest population in the world, and the Japanese go to the doctor on average 14 times per year, compared to an average of 5 times for an American. The U.S. average expenditure per capita is $7,000 on health care; Japan spends about $3,000.

Surely, we can still learn a lot from other nations older and more experienced than ours. Reid’s book provides plenty of mind-expanding experiences and ideas in a fairly breezy voice, neither leaden with policy nor politics.

A New York Times online book review concludes with the line: “Evidently, when it comes to health care, America is exceptional only in that it’s a rich country with a poor country’s approach to taking care of people.”

Health Access California promotes quality, affordable health care for all Californians.
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