"Sick Around the World" interview;
Frontline correspondent T.R. Reid was online Wednesday, April 16 at 11 a.m. ET to discuss his film "Sick Around the World," which examines how five other capitalist democracies -- United Kingdom, Japan, Germany, Taiwan and Switzerland -- deliver health care, and what the United States might learn from their successes and failures.
"Sick Around the World" aired Tuesday, April 15 at 9 p.m. on PBS.
The transcript follows.
Reid is a former chief of The Washington Post's London, Tokyo and Rocky Mountain bureaus, and also had stints covering Congress, national politics and four presidential elections for the paper. He is the author of eight books -- three in Japanese -- most recently "The United States of Europe: The New Superpower and the End of American Supremacy."
Philadelphia: Your excellent story has provoked many comments in my mind, but given our political contest, it seems appropriate to discuss what it takes to move the agenda in Washington. In Taiwan, you didn't mention that the opposition party -- the DPP back in the early '90s proposed national health insurance. It proved so popular that the KMT party also agreed, and so when the KMT won they were forced to enact what today has evolved into a true single-payer national health insurance program. Canada's NDP victory pushed for their health system in Saskatchewan back in the 1950s. So what political lesson can we learn from how countries obtain universal health care that could be relevant to the U.S.?
T.R. Reid: Hello, everybody. Thanks for watching our film. If you missed it (or fell asleep because I'm so boring), the documentary can be see at the Frontline.org web site.
In most countries that have revamped health care, the moral imperative was a driving political force. Switzerland decided it didn't want to be a society where 5% of the population was unable to see a doctor when sick. That feeling was strong enough to overcome the powerful political opposition of the drug and health insurance industries.
Taiwan was different. A poor country became rich almost overnight, and decided to build a rich country's system. But there, too, the choice -- for a single universal payment system, like Canada's -- was driven by concerns for equity.
In the U.S., I think two imperatives can lead us to change. First is the fiscal issue: Our system is too expensive for everybody. And second, is the same moral concern: Do we want to be a country where any of our neighbors has access to health care when they need it?
Minneapolis: What happens to the private insurance agencies and hospital systems when a country makes the change over to a national health care system?
T.R. Reid: In Switzerland, which switched to nonprofit in the '90's, the health insurance companies are still going strong. They can't make a profit on basic health insurance coverage, but they use the basic plans to draw in customers, to whom they can sell their supplemental (like Medi-gap) health insurance, plus life insurance, etc. The companies are all bigger today than they were when the switch was made.
Dover, Del.: I've heard that certain countries' health care systems have created "smart cards" for use as rapid health information identification when a citizen is admitted as a patient. Is there any tradeoff for the convenience of this service? How sophisticated is the information security in these programs?
T.R. Reid: I'm working on a book on health care systems in other advanced countries. I've seen the smart card in France (Le Carte Vitale), in Germany (gesundheitskarte), in Austria (E-Karte), and Taiwan.
You get two advantages from this system. First, paperwork is greatly reduced, and prices fall. Second, some medical errors can be avoided, because the doc can instantly see what other treatments and medication you've had.