With the U.S. Supreme Court hearing oral arguments in the health care reform case this week, the debate over access to affordable insurance is hotter than ever.
A new PBS documentary airing on Alaska One television tomorrow (Tuesday) examines low cost, quality health care in the United States. U.S. Health Care: The Good News finds that communities with the most affordable care have a system in place to cover the most people.
It’s the third film on health care made for public television by journalist T.R. Reid, who was in Alaska last week speaking to the Juneau and Anchorage World Affairs Councils. Casey Kelly has this report.
T.R. Reid’s interest in health care came about when he was working as a Washington Post foreign correspondent in Tokyo and London in the 1980s and ‘90s. He and his wife were initially concerned about the quality of health care abroad. Their concerns quickly disappeared.
In Japan, for example, Reid says you can tell just how important patient care is by the way the nurse calls your name in the waiting room.
“The receptionist or the nurse comes out and says, ‘[Speaks in Japanese].’ And that means: ‘Has the highly honorable Thomas Reid honored us with his presence today.’ Right away you feel better,” Reid says.
Kidding aside, Reid’s interest led to two PBS Frontline documentaries, and a book about health care in the U.S. The first film – Sick Around the World – examined how other countries provide low cost, quality care for every citizen. The second – Sick Around America – looked at people in the U.S. struggling to get and keep insurance.
Around the time he completed the second film and book, Reid began to hear from viewers who wanted him to look at areas in the U.S. where good, affordable care is readily available.
“Then PBS came to me and asked me if I would make that movie – good, reasonable cost health care in the United States. And I said, ‘Yeah. Sounds like a very good topic. But how do you find it?'” says Reid.
It turns out researchers at Dartmouth College have been comparing Medicare billing records in communities across the United States for more than 20 years. In his new film, U.S. Health Care: The Good News, Reid visits parts of the country where the “Dartmouth Atlas of Health Care” says costs are the lowest.
“And guess what?” he says. “The low cost counties have just as good results as the guys charging three times as much.”
Reid says specific services – like a doctor’s visit or surgery – cost pretty much the same no matter where you live. He says the biggest difference from one community to another has to do with efficiencies. For instance, a doctor in Miami – where health care costs are nearly twice the national average – will see a patient with high blood pressure once a month. In Seattle, where costs are below average, the same patient is seen once a year.
“So you’re paying twelve times in Miami for the treatment you would have gotten once in Seattle,” says Reid. “And the system, our system, pays those bills.”
Whether in the U.S. or abroad, Reid says he’s never found a perfect health care system. But he says anything would be better than the patchwork system the U.S. has now. One thing he did find is that parts of the country with the best quality, lowest cost health care, have doctors and hospital administrators willing to lead the way.
“We met doctors all over the country in this film, who said to us, ‘I have an obligation to preserve the physical health of my patients. But I also have an obligation to preserve the fiscal health of my community.'” he says.
Reid met with the board of directors for Juneau’s city-owned Bartlett Regional Hospital last week. He also met with the board during a previous trip to the Capital City, and Chairman Bob Storer says members are big fans of Reid’s work.
In recent years, Storer says the board has become more conscientious of rising health care costs.
“There is a growing sensitivity that some of the procedures that we do offer at the hospital are well above alternatives in Seattle,” Storer says. “We talk about that, we hope to be able to reduce those kinds of costs. It’s not going to happen overnight.”
But Storer says Juneau’s population size and isolation mean there will always be challenges to providing affordable care.
“One of the issues we have is pharmaceuticals,” says Storer. “We have to keep a greater supply on hand, as an example, because it has to be available immediately, and it’s not a drive down the street.”
Reid says the only sure way to get lower health care costs is to make sure everyone is covered. He says it’s done in other first-world countries, and on average they spend about half of what the United States’ spends per capita on health care. And he says it doesn’t have to be done with a government takeover.
“You can definitely do this in a private system,” says Reid. “Many countries do – Germany, Switzerland, Belgium, Netherlands, Japan. They do it, arguably, with less government involvement than we have.”
Reid’s film, U.S. Health Care: The Good News airs Tuesday at 8 p.m., and re-airs Wednesday morning at 2 a.m. on Alaska One.