Despite the fact the US continues to rank poorly in worldwide health care standards, John McCain like many, maintains that the United States health care is the best in the world. The Real News Network spoke to Steven Lewis, health policy and research consultant from Canada, Dr. Don McCanne of Physicians for a National Health Program, and Dr. Steffie Woolhandler from the Harvard Medical School. Comparisons with other countries on costs and quality still leave the United States low in health care standards amongst rich industrialized nations.

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Health care in the USA Pt. 2
Producers: Carlo Basilone & Tina Whitham

CARLO BASILONE, TRNN: Despite the fact that the US continues to rank poorly in worldwide healthcare standards, many people, including John McCain, maintain that US health care is the best in the world.

SEN. JOHN MCCAIN (R-AZ), PRESIDENTIAL CANDIDATE: Senator Obama wants to set up healthcare bureaucracies, take oven the health care of America through—as he said, his object is a single-payer system. If you like that, you would love Canada and England.

STEVEN LEWIS, HEALTH POLICY AND RESEARCH CONSULTANT: I can see why John McCain would perhaps listen to the propaganda about the Canadian and the UK system. The reality is the UK system has gotten remarkably better in the last ten years: they’ve reduced wait times immensely; there are no waits for primary care, which is what most people need; they are improving quality all the time. And the American quality improvement guru Dr. Don Berwick says that the UK is the single most incredibly positive transformation of any large public sector in human history. So I think John McCain ought to go and visit, and with an open mind, and just see what you can get from those other systems.

BASILONE: In a PBS Frontline documentary called Sick Around the World, aired last April, Washington Post correspondent T. R. Reid did visit the UK and five other countries just to make those comparisons.


Courtesy: PBS Frontline

T. R. REID, PBS FRONTLINE CORRESPONDENT: Have you ever paid a medical bill?


REID: Will you ever pay a medical bill in your life?


DEMONSTRATOR: I hope not. This is what we’re doing here.

DEMONSTRATOR: We don’t want to, and even in ten year’s time, if we’re not around, we don’t want our kids to either.



PASCAL COUCHEPIN, PRESIDENT, SWISS CONFEDERATION: Everybody has the right to health care.

REID: Yeah, now, see, that’s striking for an American, ’cause we would certainly say everyone’s entitled to an education, everyone is entitled to legal protection if you get in trouble with the law, but we don’t say that everyone’s entitled to health care.

COUCHEPIN: Why? Because it is a profound need for people to be sure that if they are struck by destiny, by a stroke of destiny, they can have a good health system.


BASILONE: In July 2005, the Archives of Internal Medicine reported that a coronary bypass cost 82 percent more in the US than in Canada.

LEWIS: It’s generally the case that almost all surgical procedures and major operations cost a lot more in the States, easily up to double. So, yes, they have a very expensive health system. They have a huge amount of money that goes to administration. If you’ve ever seen a printout of a hospital stay in the United States, it runs to pages and pages. Well, somebody has to be inputting that data, and somebody has to do the accounting, and someone has to fight with the insurance companies about how much they’re going to reimburse, the insurance company has to advertise to make sure it has lots of clientèle, and so on, and it all adds up to a whole lot of money spent away from the bedside. People tend to get paid better in the United States. Physicians make more money than in Canada—the differences aren’t huge, but they’re significant. And they have a lot of hospital beds that aren’t used. So when they’re running at lower capacity than Canadian hospitals, someone has to pay for that overhead too.

BASILONE: If I was to have a heart attack in the US or in France, where would I be better off?

DR. DON MCCANNE, PHYSICIANS FOR A NATIONAL HEALTH POLICY: I think in general a heart attack is going to be cared for anywhere, as far as the emergency basis. In the United States, if you have a heart attack, you’re taken to an emergency room. They’re going to provide you good care. It’s when you get out that you won’t have follow-up. We have a law in the United States that it’s illegal to turn away a person who needs care, to turn them away from the emergency room; but it certainly is not illegal to turn them away from private offices, specialists’ offices, laboratories, imaging centers, and so forth. So people can’t get follow-up care when they’ve had a heart attack. So, overall, it’s worse in the United States for those 47 million with no insurance, and then the under-insured individuals, whereas everyone in France would have decent follow-up of their heart attack.


BASILONE: And as shown in the PBS Frontline episode, medical bankruptcy is not a familiar term in the rest of the world.

Courtesy: PBS Frontline

REID: In Japan, how many people go bankrupt for medical costs?

SAITO HIDERO, MD, PRESIDENT, NAGOYA CENTRAL HOSPITAL: I don’t know. [inaudible] We’ve never heard of it here, almost never heard of it here.



REID: How many people in Taiwan every year go bankrupt because of medical bills?




REID: How many people in Switzerland go bankrupt because of medical bills?

COUCHEPIN: Nobody. It doesn’t happen. It would be a huge scandal if it happens.


MCCANNE: There is a brand new study out that is interesting because it’s very timely, and it’s a study that shows that medical bills are also a major contributor to home foreclosure. So, many of these people who were losing their homes, medical bills were the tipping point.

BASILONE: But how hard would it be to institute universal health care in the United States?

DR. STEFFIE WWOOLHANDLER, ASS. PROF., HARVARD MEDICAL SCHOOL: I do think it’s a really opportune moment. Obama himself does not advocate single-payer, though he has said things like, “Gee, if it was politically feasible, that might be the best thing to do.” So Obama is not ideologically opposed to the idea, but he’s not advocating it at this point. But I do think, given the economic difficulties, as I say, at the very least, a long and deep recession, and given the kind of political and social energy that the Obama campaign has unleashed, the kind of optimism and sense of possibility in the United States, it’s an extremely opportune time to be pushing for national health insurance. Economic arguments are very, very compelling at this point, because the single-payer plans tend to have administrative costs that are about half of the administrative costs in the US. US administrative costs account for nearly a third of total health spending, and the price of a single-payer is about one-sixth of health spending. The difference is a lot of money, about $400 billion a year in savings in administration, and it’s [potentially] money you could use to provide universal coverage without increasing spending. So the economic advantage of single-payer becomes a more prominent issue.


Please note that TRNN transcripts are typed from a recording of the program; The Real News Network cannot guarantee their complete accuracy.

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Steven Lewis is a health policy and research consultant in Saskatoon, and an adjunct professor of Health Policy at the University of Calgary and Simon
Fraser University. Previously, he headed a health research granting agency
and spent 7 years as CEO of the Health Services Utilization and Research
Commission in Saskatchewan .

Dr. Don McCanne served as president of Physicians for a National Health Program (PNHP) for two terms and is currently a Senior Health Policy Fellow.
PNHP is a widely recognized non-profit research and education organization
that represents over 15,000 doctors across the US who advocate for a
single-payer national health insurance plan. Dr. McCanne also writes a daily
health policy update online.

Dr. Steffie Woolhandler is an Associate Professor of Medicine at Harvard and co-director of the Harvard Medical School General Internal Medicine
Fellowship program. She worked in 1990-91 as a Robert Wood Johnson
Foundation health policy fellow at the Institute of Medicine and the
U.S. Congress. She is a co-founder of Physicians for a National Health Program (PNHP) and a current Board member. PNHP is a non-profit research and education
organization of 15,000 physicians, medical students and health professionals
who advocate for single-payer national health insurance. She has published
widely and is the co-author of: National Health Care Book: A Source Guide
for Advocates
and Bleeding the Patient Dry: The Consequences of Corporate

Dr. Don McCanne served as president of Physicians for a National Health
Program (PNHP) for two terms and is currently a Senior Health Policy Fellow.
PNHP is a widely recognized non-profit research and education organization
that represents over 15,000 doctors across the US who advocate for a
single-payer national health insurance plan. Dr. McCanne also writes a daily
health policy update online.