Reid went and visited a bunch of countries and looked at how they fund health care.
- Not every modern country uses a socialist scheme: private health care works in other rich democracies.
- Not every modern country is single-payer; e.g. Japan has 3000 payers, Germany 220, Switzerland has 70.
- Not all developed countries do the same things.
- The Beverage model (UK): taxes are high, but they pay half of the what the U.S. does; government owns hospitals, pays doctors, and pays bills. This is real socialized medicine.
- The Bismarck model (Germany): premiums are split between employers and employees; private insurance purchased through employer. Private doctors/hospitals/insurance.
- National Health Insurance model (Canada): private providers; government pays. Premiums are paid to provincial governments (Reid did not deal with the question of whether people opt out). Model for Johnson/Medicare plan. Popular in newly-rich countries. Reid singled this approach out for criticism because Canada has limited numbers of specialists and advanced equipment; "lots of waiting" for non-emergency care. A gatekeeper system.
- Out of pocket model (much of the world). Patient pays at point of service; for some reason Reid spent a lot of time talking about people paying with potatoes.
Why do most countries have one model? Reid chose to examine Switzerland:
- It's simpler and cheaper to administer; Reid says in the U.S. we spend 18-25% of our health care dollars on administrative costs.
- They have a strong incentive for preventive health care; cited many anecdotes from the UK.
- It is "fairer" to have everyone have the same access to the same health care at the same cost. Reid ended his remarks here by admitting this is a subjective assessment of a moral question and fundamentally reflects a moral value.