Fix Health Care By Learning From Other Countries

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By Larry Struck

Picture yourself with a serious health problem and no medical care. This is not difficult to imagine for anyone without health insurance or with substandard coverage.

Fortunately, my partner Debra, and I were in excellent health when we departed the U.S. aboard our sailboat for a multi-year sabbatical. We left corporate and government jobs, which had provided complete first-class health care and insurance for decades. Now we were self-insured and decided to see what a medical system in another country could offer.

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In the U.S. if you are unable to pay to see a doctor, then you reluctantly learn to live with that low-grade fever, strange pain, rash, persistent cough, or deep ache in the gut. Your shortness of breath probably just means you have to take it easy if you can and maybe lose a few pounds. You hate to do it but you’d better postpone checkups for the kids.

As a result, you or your family’s health, and maybe lives, are at risk. This could be avoided if the U.S. would summon the courage to truly change the health system for the better.

Currently more than 45 million U.S. citizens have no health insurance, not to mention the millions more with insufficient coverage. Waiting in the wings are those who are one major medical event away from loss of insurance or personal bankruptcy.

The deepening economic crisis and rise in unemployment ensure that these numbers will grow. Some may say that this is just a natural outcome of market dynamics, an unpleasant economic reality. You may think that the uninsured and sick will always be with us. But losing your job or watching a friend fall through the cracks might change your mind.

Recent research by the Kaiser Foundation and the Harvard School of Public Health found that more that 60 percent of Americans feel that in light of overwhelming economic problems facing the country, “it is more important than ever to take on health reform now.”

Total health care expenditures in the U.S. for one year amount to $2.4 trillion—more than the combined economies of all of Latin America. Of that amount, which is expected to double by 2017, it has been estimated that 30 percent is wasted or badly spent. Among 191 nations, the World Health Organization ranked the U.S. health care system as the highest in cost per capita, 37th in overall performance and 72nd by overall level of health.

The U.S. can learn from other countries to provide more cost-effective health care. We should not be afraid to borrow workable ideas wherever we see them. They can be found in unexpected places.

Venezuela, for example, values its citizens’ health. Their constitution gives all Venezuelans the right to health care. Alongside a traditional fee-for-service medical system, a network of 6,500 neighborhood clinics has been created so that anyone with a medical problem can see a doctor at no charge.

We underwent extensive health checkups in both systems. The quality was high, and when there was a fee, it was a fraction of what you would pay in the U.S. The free clinic system, known as “Barrio Adentro,” focuses on health education, early intervention and disease prevention, rather than expensive treatment. The clinics provide medications, dentistry, eye exams with new glasses and referrals for more specialized treatment, counseling or other community services.

Universal care, often made to sound threatening, can range from a single payer to various public/private arrangements of insurers, provider networks or employers. We don’t need to offer all free medical services or copy another nation’s system, but we can at least redefine “affordable” in a way that makes sense to out-of-work heads of families.

Let’s consider a joint venture with Venezuela. Health care experts from each country could exchange visits and begin to build on the limited community services already available. Foreign advisors working in our neighborhoods may seem strange, but how many times have we provided help to other countries expecting them to see the good sense that collaboration makes?

We can expect problems and obstacles as we try to expand health care coverage. But Americans have always been known as problem solvers, a quality we especially need now, whether in health care, jobs, public safety, education or international affairs. Finding solutions based on cooperation, rather than a “not invented here” mentality, can be just what the doctor ordered.

Struck is a Minnesota training consultant.


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