Cutting Edge: Sick Around the World

6 June 2008 | 14:48 - By SBS

Screening on SBS Television Tuesday, 10 June at 8.30pm in the Cutting Edge timeslot is Sick Around The World. Veteran Washington Post foreign correspondent T.R. Reid finds out how five other capitalist democracies (the United Kingdom, Japan, Germany, Taiwan and Switzerland) deliver health care and what the US might learn from their successes and failures.

Tuesday, 10 June 8.30pm

Reid's first stop is the UK, where the government-run National Health Service (NHS) is funded through taxes. "Every single person who's born in the UK will use the NHS," says Whittington Hospital CEO David Sloman, "and none of them will be presented a bill at any point during that time." Often dismissed in America as "socialised medicine," the NHS is now trying some free-market tactics like "pay-for-performance," where doctors are paid more if they get good results controlling chronic diseases like diabetes. And now patients can choose where they go for medical procedures, forcing hospitals to go head to head.

While such initiatives have helped reduce waiting times for elective surgeries, Times of London health editor Nigel Hawkes thinks the NHS hasn't made enough progress. "We're now in a world in which people are much more demanding, and I think that the NHS is not very effective at delivering in that modern, market-orientated world."

Reid reports next from Japan, which boasts the second largest economy and the best health statistics in the world. The Japanese are three times more likely to go the doctor as Americans, have more than twice as many MRI scans, use more drugs and spend more days in hospital. Yet Japan spends about half as much on health care per capita as the United States.

One secret to Japan's success? By law, everyone must buy health insurance - either through an employer or a community plan - and, unlike in the US, insurers cannot turn down a patient for a pre-existing illness, nor are they allowed to make a profit.

Reid's journey then takes him to Germany, the country that invented the concept of a national health care system. For its 80 million people, Germany offers universal health care including medical, dental, mental health, homeopathy and spa treatment. Professor Karl Lauterbach, a member of the German parliament, describes it as "a system where the rich pay for the poor and where the ill are covered by the healthy." As they do in Japan, medical providers must charge standard prices. This keeps costs down, but it also means physicians in Germany earn far less than their US counterparts.

In the 1990s, Taiwan researched many health care systems before settling on one where the government collects the money and pays providers. But the delivery of health care is left to the market. Every person in Taiwan has a "smart card" containing all of his or her relevant health information, and bills are paid automatically. But the Taiwanese are spending too little to sustain their health care system, according to Princeton's Tsung-mei Cheng, who advised the Taiwanese government. "As we speak, the government is borrowing from banks to pay what there isn't enough to pay the providers," she says.

Reid's last stop is Switzerland, a country which, like Taiwan, set out to reform a system that did not cover all its citizens. In 1994, a national referendum approved a law called LAMal ("the sickness"), which set up a universal health care system that, among other things, restricted insurance companies from making a profit on basic medical care. The Swiss example shows health care reform is possible, even in a highly capitalist country with powerful insurance and pharmaceutical companies.

Today, Swiss politicians from the right and left enthusiastically support universal health care. "Everybody has a right to health care," says Pascal Couchepin, the current president of Switzerland. "It is a profound need for people to be sure that if they are struck by destiny...they can have a good health system."

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Comments (2)

25 Jun 2008 12:37 AEST

itisjoe

From: safety beach austraia 3936

Australia could learn from it

Australia could learn a lot from this presentation but that would be too much to expect from our politicians!

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13 Jun 2008 9:00 AEST

Slask

From: Stafford Heights

Interesting

Very interesting program and equally entertaining when compared to Michael Moore's Sicko. It's not just the US that has a lot to learn from these 5 countries. We should take note ourselves. The free market system is not in everyone's best interest when it comes to health care.

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