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The Eleventh Hour and Sick Around the World: Studies on the U.S. Healthcare system

What did I learn from the novel and the PBS videos?

Both the novel and the documentary film has been full of relevant information for me.  I learnt different things from the two different media.  The novel The Eleventh Hour is a unique mélange of fact and fiction.  That it presents details pertaining to the American healthcare system in the form of an engaging story made it easy for me to focus and keep track.  As the drama of the story unfolded I was able to pick up facts about the healthcare system that were erstwhile unknown to me.

Sick Around the World, on the other hand, offered me a comparative perspective on several leading healthcare systems. I was astounded that countries which are less economically powerful than the United States offer a better healthcare deal to their citizens.  The five countries studied by the PBS documentary crew – Germany, United Kingdom, Japan, Taiwan and Switzerland – all have cheaper average per capita healthcare costs.  More impressively they also produce better health outcomes and near universal coverage of health services.  In all these countries, the connecting theme seems to be ‘socialized medicine’, where, profit motive is largely removed from the health industry.  It is a noble stance indeed to accord such dignity to healthcare. These health systems expose all that is wrong with the American health delivery model.

Why does it matter to me?

The content of both the sources of information matter a great deal to me.  As an aspiring healthcare professional there is plenty of knowledge and insight that I could gather from them.  The novel offers an in-depth understanding of the various cogs that operate the US healthcare machinery.  These include the politicians, hospital owners, doctors, insurance companies, pharmaceutical companies, the citizens, etc.  Of all these stakeholders in the US healthcare system, it bothers me to think that the majority of citizens/patients are the most disadvantaged in terms of economic and health outcomes. The two sources thus provide me with the motivation to play my part in changing the system for the better.

What does this book and the videos have to do with better understanding of the U.S. health care system?

The book and the video help the audience to better comprehend the U.S. healthcare system. One of the main reasons why the U.S. healthcare system is expensive is due to profit-motive of insurance companies and higher administrative costs inherent in private healthcare.  Through Sick Around the World we understand that the government managed single-payer system greatly alleviates administrative costs and minimizes patient co-pay. The government also negotiates with healthcare providers so that the costs are not unreasonable.  This centralized government management of the healthcare system is conspicuously absent in the United States.  The United States is the only advanced society in the world to not have a nationalized healthcare dispensing model. Authors Richard McDermott and Kevin Stocks lay out the commercial inter-dependencies of various private institutions in the American model. The insurance companies give preferential coverage to the young and well-to-do.  This goes against commonsense as it is the elderly and the economically disadvantaged that are more prone to illness. Though the authors do not take sides, it is clear that they think of the present system as deeply flawed.

In what way does the book corroborate or refute knowledge you have gleaned from previous experiences or study?

To me the book and the video are real eye-openers. Prior to this I had a vague idea of the inefficiencies inherent in the American healthcare system.  But I was not privy to the extent, scale and implications of the situation. I now understand that close to 20% of the American population has no health insurance coverage whatsoever.  I believe this is quite a shame for the most prosperous and powerful country in the world.  My exposure to alternative healthcare models in the form of Germany, Switzerland, Japan, etc, has offered me new perspectives for thinking about healthcare dispensation. Through reading the novel I was disabused of my misconceptions about private health insurance.  I believed that the free-market competition among various insurers would pull down the premiums to the least possible. But the fact that healthcare providers negotiate how much they charge for various standardized procedures undermines the free-market effect.

If you were to tell a colleague about these resources, what would you communicate, and why?

I would tell my colleagues to peruse the two works for gaining an in-depth understanding of the American healthcare system.  By viewing the video, especially, they would get a comparative perspective on leading healthcare systems across the globe.  The alternative healthcare models that they would be exposed to would make them think about their own professions and the commercial arrangements within them in new light. The other major reason why I would encourage my colleagues to peruse these resources is one of social responsibility. As healthcare professionals we all take the Hippocratic oath to serve the patients in a fair and expedient manner. As healthcare professionals it is a breach of that oath to turn a blind eye to the millions of Americans who are uninsured (and thereby denied healthcare).  Our duty does not begin and end within the premises of the hospital but extends to the larger community.  It is for broadening the scope and responsibility of our profession that I would urge my fellow practitioners to read and watch the two works in question.

Conclusion

In conclusion, both the novel and the documentary video have helped me in widening my horizons. It has made me see healthcare from the point of view of the weaker sections of the population.  Previously I was focused on developing my career and bothered only about gathering certifications and work experience.  But now my goals have become more inclusive.  I have come to think of my practice in an integrated communitarian way.  I am also motivated to set up interactive platforms where patients and healthcare providers can negotiate and agree upon mutually beneficial commercial arrangements.  I am quite impressed with the success of nationalized healthcare management in other capitalist economies. It is my hope that through active public organization and dialogue with the political class this goal can be realized in the United States one day.

References:

Sick Around the World: Can the U.S. learn anything from the rest of the world about how to run a health care system? PBS Documentary, video accessed from <http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/> on 1st October, 2013.

Richard E. McDermott & Kevin D. Stocks, The Eleventh Hour: A Tale of Compassion, Service, Power, and Politics. Published in 2005 by Traemus Books. U.S.A.

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