Books - One Injury, 10 Countries - A Journey in Health Care - Review - NYTimes.com
Similarly, what Americans often consider a single unique system of health care is an illusion: we exist in a sea of not-so-unique alternatives. Like the citizens of Germany and Japan, workers in the United States share insurance premiums with an employer. Like Canadians, our older, destitute and disabled citizens see private providers with the government paying. Like the British, military veterans and Native Americans receive care in government facilities with the government paying the tab. And like the poor around the world, our uninsured pay cash, finagle charity care, or stay home.
Our archipelago of plans means that those safe on a good island with good insurance can be delighted with the system, even as millions of invisible fellow citizens tread water or drown offshore. It means that those on a mediocre island are stuck there. It also means that not one single piece of the infrastructure — like record keeping, drug pricing and administrative costs — can be streamlined across islands in any meaningful way. Hence the expense, the inequity and the tragedy.