Health Care Reform Around the World

When Taiwan sought to reform their healthcare system a few years ago, they commissioned a study of six major countries which were achieving superior public health results, at relatively low cost. Experts from each of these countries conducted independent rigorous studies of their systems, analyzing the strengths and weaknesses of their systems, as well as potential opportunities and threats. Then these experts came together in a major symposium, where the various systems were discussed, debated, weighed against one another and evaluated. From the results of this symposium, the leaders of Taiwan designed a modern integrated system, which was a hybrid of the best ideas from around the World, with elements chosen to fit the particular needs of the Taiwanese culture, economy and existing infrastructure. Theirs is now respected as among the most modern, efficient healthcare delivery and financing systems anywhere. 

The United States took a somewhat different approach to reform. Those companies and industry consortia which profit most from the status quo accumulated a war chest to resist and/or shape any possible changes in order to protect their power position and profit margins. They coordinated with right-wing radio commentators and Fox News, launching a disinformation campaign of fear, distortion, slander, and character assassination, which drowned out any meaningful substantive discussion. Their most dim-witted followers—once adequately roused to anger and fear—were unleashed upon elected representatives at town hall meetings around the country. Many of them dressed up in Indian garb, like colonial ‘tea party’ participants; many brought weapons; none brought any meaningful insight. In the end, the law that passed was a very expensive face-saving program for the Democrats, which would have the appearance of reform, without risking profits to the corporate players. 

I’m not saying that either the Taiwanese or the US approach is necessarily better than the other in terms of developing and implementing effective public policy … just contrasting the different approaches.