Book Review: The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care
Friday, May 29, 2020
I first read The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, by T.R. Reid, when I was applying to medical school in anticipation of the health policy questions I might be asked during interviews. Now, over three years later, we find ourselves amidst a global pandemic that has not only tested the capacity of the U.S. healthcare system but also brought many of the inequalities inherent within it into the public eye. Even under normal circumstances, the idea that our healthcare system is expensive, inefficient, and plagued with inequity is far from novel. Healthcare reform has dominated political discussions for nearly a decade and promises to remain at the center of the upcoming presidential election. It seemed like a timely opportunity to revisit this book which takes readers on a tour of the systems in five industrialized countries and poses the question, is access to healthcare a privilege or a human right?
One of the most appealing aspects of this book is that Reid is neither a physician, an economist nor even a health policy expert. He is a journalist for the Washington Post who quite literally traveled the world as a patient seeking treatment for an ailing shoulder. This journey led him to examine the four main models of health care delivery and insurance: The Bismark Model (exemplified by Germany, France, Switzerland and Japan), the Beveridge Model (used in the United Kingdom, Italy and Cuba), the National Health Insurance Model (represented by Canada and Taiwan), and, lastly, the out-of-pocket model used by the millions of uninsured Americans.
As one might expect, Reid found that no single system is perfect and, rather than give an inflated view of these other models, he thoughtfully points out the flaws he encounters. However, what all of these countries do have in common is a commitment to providing necessary health services to their citizens. He ends the book by tackling the criticism that the U.S. system is too large and too established to significantly change. To this end, he provides the examples of Switzerland and Taiwan who both re-built their healthcare systems in recent history, suggesting that, while it is a daunting task, it is never too late to change.
This book is not an empirical analysis of which healthcare delivery model is “best,” and Reid refrains from divulging his opinion as to which he thinks the U.S. should adopt. Rather, it provides an overview of the different options and the problems with our current status-quo through a combination of background research and anecdotal experiences from his travels. It is as engaging and easy to read as it is informative, and I would highly recommend it to both my peers in medicine as well as my friends and family so that we might all form an educated opinion about the future of the U.S. healthcare system.
Annalise Manley is a rising fourth year medical student at Oregon Health & Science University (OHSU). Originally from Wyoming, she took an indirect path to medicine after first pursuing a career as a professional skier. After an injury forced her to hang up her skis, she attended college at the University of Wyoming where she earned a B.S. in Physiology and discovered her dream of becoming a physician. Her passion for surgery was immediate when she completed a summer clinical research internship in vascular surgery as an undergrad. She now looks forward to a career as a rural General Surgeon where she hopes to bring access to modern surgical care to under-served communities. She had the privilege of serving first as Treasurer and then President of OHSU’s AWS chapter and is currently the West Regional Representative for the AWS National Medical Student Committee. Outside of medicine, Annalise loves discovering new hikes with her fiancé, trying new recipes, and cuddling up with her dog, Buddy.