Health care reform a global constant

Historically, health care expansion has a record of winning public support.

In England, conservative Prime Minister Margaret Thatcher dismantled several nationalized sectors of the economy, returning them to private enterprise. But she did not try to tear apart England’s nationalized health care system – it was too popular. Then and now. Last summer, when London hosted the Olympic Games, the opening ceremony included a prominent celebration of the National Health Service.

In Germany, in 1883, Chancellor Otto von Bismarck created the first national health care system in the world. It helped make him popular and provided healthy workers for Germany’s industrial revolution. Today, it remains in place and has been a model for other countries. Under the system, health insurance is mandatory and is provided by private insurance companies.

In Taiwan, conservatives secured political power by stealing one of the liberals’ favorite issues – creation of a national health care system.

In the United States, the federal Medicare program poses a political hazard to those who threaten it. One prominent example was U.S. Rep. Paul Ryan, Mitt Romney’s running mate in last year’s presidential election. Ryan favors replacing Medicare with a system that would hand Americans money to help them purchase private insurance. Voters, however, re-elected President Barack Obama, who had made his opposition to Ryan’s proposals a centerpiece of the presidential campaign.

T.R. Reid, a Washington Post reporter, wrote a best-selling book investigating health care systems in other countries such as England, Germany and Taiwan. It’s titled “The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care.”

Reid’s premise: The United States could learn from other countries. It spends more per capita on health care than other industrialized democracies, yet unlike them it does not cover all its people. In spite of this high rate of spending, the U.S. system ranks worst among industrialized democracies, according to public-health yardsticks such as mortality rates.

Reid has criticized the Affordable Care Act. It will leave the United States with a health-care financing system that’s way too complicated, he writes. The U.S. system’s complexity, he contends, is a primary reason for its high cost.

The world’s other industrialized democracies work frequently to reform their health systems, Reid writes, popular though those systems tend to be. Which raises the question: What reforms will Americans be pushing several years from now if “Obamacare” becomes established, as Medicare is today?