A Concerned Doctor Wants You to Know the Truth About Health Reform
I wrote this short book advocating a single-payer health care system (now known as “Medicare for All”) in 1993, after publishing Medicine at the Crossroads. Working on that book and the PBS/BBC television series tied to it exposed me to the health care systems of many countries, and convinced me that the U.S. was as much of an outlier in health care as South Africa had been in race relations. We still are. We were and are the only industrial country without universal health care coverage. This book argues in favor of a system in the range of all those countries. There are two ends of the continuum that I would not favor–the one in the United Kingdom, where health care itself has been nationalized, and the one in Germany, where private insurance companies have been preserved along with all their inefficiencies and waste. Most of the others have nationalized health insurance (with some private supplements) and independent doctors and hospitals. Pick almost any one you like–France, Sweden, Japan, Australia, New Zealand, Canada, or one of many others–and you will have a system far better and fairer than ours, and one that delivers lower mortality and greater longevity than ours does. This was true in 1993 and it remains true today. The coronavirus pandemic (2019-?) has made this American national shame more apparent than ever, but it was gratifying to me to see the Affordable Care Act (“Obamacare”) address it in part in 2009, and also to see single-payer (“Medicare for All”) enter the national conversation (thanks mainly to Bernie Sanders) in the 2019-2020 primary season.
Incidentally, I did not choose the title of this book, the publisher did, and I have never liked it. My preferred title was Real Health Reform: The Single-Payer Solution to America’s Health Care Crisis.