Italy Falls Lower in Rankings of Many Global Performance Measures

As a concerned Italian-American I simply could not pass up posting this chart and commentary, “Grading Italy: Berlusconi Blues” from The Economist (Daily Chart 10/22/2009) which shows how unfortunately “Italy is slipping down many global rankings” according to rankings by various organizations.

From Economist.com Daily Chart (10/22/2009)

From Economist.com Daily Chart (10/22/2009)

ON WEDNESDAY October 21st the European Parliament narrowly voted to throw out a resolution expressing concern over media rights in Italy. Silvio Berlusconi, the country’s prime minister, is also owner of Mediaset, one of Europe’s largest media companies. But Italy’s press freedom is a cause for concern according to Reporters Without Borders, an industry lobby group. Italy dropped five places to 49th in its annual world press freedom index, published this week, with only Bulgaria and Romania worst placed among EU countries. Out of the six annual rankings we consider, including corruption perceptions and economic freedom, in only one, the gender gap, has Italy improved.

Poll Shows That Most Virginians Want a Tighter Gun Sales Law

The New York Times 10/21/2009 editorial, “Virginia and Gun Control” tipped me off to the results of a recent political survey conducted in Virginia by the Christopher Newport University (CNU) Judy Ford Wason Center for Public Policy for The Virginian-Pilot, WVEC-TV, and CNU. Results form the survey were reported by Bill Bartel in the article, “Tighten Gun Rules, Most Virginians Say in Poll” (published in The Virginian-Pilot, 10/18/2009). Bartel reports that,

Most Virginians say they want to close the so-called gun show loophole that permits some gun sales without criminal background checks, and they dislike the notion of someone carrying a concealed firearm into a restaurant that serves alcohol, according to a new poll. The survey, conducted by Christopher Newport University’s Judy Ford Wason Center for Public Policy, found that eight of every 10 likely voters interviewed wanted to change a state law that allows someone to buy a firearm from an unlicensed seller at a gun show without first undergoing a criminal background check. If the same sale is between a buyer and a licensed dealer at a show, a background check is required.

Support for closing the loophole was shared by people of all ages and political and ethnic backgrounds – and in all regions of the state, the poll found. Almost 17 percent of those polled said they favor keeping the law as it is. A strong majority of those polled – 68.4 percent – also do not want Virginia to allow people with concealed-weapons permits to bring their firearms into eateries that sell alcohol. More than a quarter of those surveyed – 26.3 percent – disagreed, saying the ban should be lifted.

Earlier this year, the General Assembly passed legislation to legalize the practice but failed to muster the votes to override Gov. Timothy M. Kaine’s veto. In his veto message in March, Kaine noted the objection of law enforcement officials to the bill, saying it “puts the public, the employees and our public safety officers at risk.” [...]

As The New York Times editorial concluded, “[...] Those latest newspaper poll results show the people are speaking. Too bad politicians are not listening.”

A Cost-Saving Measure for States: Replace Capital Punishment With Life in Prison Without Parole

Source: Deathpenaltyinfor.org "Smart on Crime: Reconsidering the Death Penanlty in a Time of Economic Crisis

Source: Deathpenaltyinfor.org "Smart on Crime: Reconsidering the Death Penanlty in a Time of Economic Crisis

The Death Penalty Information Center (DPIC) report, “Smart on Crime: Reconsidering the Death Penalty in a Time of Economic Crisis” provides an economic rationale for a change in criminal law in States with the death penalty and budget woes. As explained in Warren Richely’s report  “Death Penalty Is too Expensive for States, Study Finds” (The Christian Science Monitor, 10/20/209), the main message from the DPIC reports is that “State and local government facing budget crunches can realize big savings by eliminating the death penalty…”

While Richely’s article reminds readers that in polls more than 50% of American support the death penalty (after all the sense of an eye for an eye justice prevails in our culture), the views of our law enforcement officials are different. In addition to examining the cost of the death penalty process, the DPIC report also summarizes results of a national poll of police chiefs that “…puts capital punishment at bottom of law enforcement priorities.” This chart from the DPIC report summarizes the views of police chiefs on various issues related to the death penalty. According to the DPIC report,

Of various statements about the death penalty, the one with which the police chiefs most identified was: “Philosophically, I support the death penalty, but I don’t think it is an effective law enforcement tool in practice.”

Furthermore, the DPIC report said that “The Police chiefs rejected any suggestion that insufficient use of the death penalty interfered with their work” and “A significant reason why police chiefs do not favor use of the death penalty is that they do not believe it deters murder.”

Here are some excerpts form Richely’s The Christian Science Monitor article,

[...] State and local governments facing dire budget crunches can realize substantial savings by replacing capital punishment with a regime that sentences the worst offenders to life in prison without parole, according to a report released Tuesday by the Death Penalty Information Center (DPIC). The number of death sentences handed down in the United States has dropped from roughly 300 a year in the 1990s to 115 a year more recently. Executions are falling off at the same rate, the report says. In the meantime, some 3,300 inmates remain on death row.

“[T]he death penalty is turning into a very expensive form of life without parole,” said Richard Dieter, DPIC executive director, in a statement. “At a time of budget shortfalls, the death penalty cannot be exempt from reevaluation alongside other wasteful government programs that no longer make sense.” [...]

A 2008 study in California found that the state was spending $137 million a year on capital cases. A comparable system that instead sentenced the same offenders to life without parole would cost $11.5 million, says the DPIC report [...]. New York spent $170 million over nine years on capital cases before repealing the death penalty. No executions were carried out there. New Jersey spent $253 million over 25 years with no executions. That state also repealed capital punishment.

Some officials may be tempted to try to cut capital-punishment costs, notes the DPIC report, but many of those costs reflect Supreme Court-mandated protections at the trial and appeals-court levels. “The choice today is between a very expensive death penalty and one that risks falling below constitutional standards,” the report says.

Nationwide, the report estimates, at least $2 billion has been spent since 1976 for costs that wouldn’t have been incurred if the severest penalty were life in prison. The figure is based on an estimate in a 1993 North Carolina study that found the average extra cost of a death sentence in this state was $300,000. The average extra cost of capital punishment is significantly higher in several other states like California, Florida, and Maryland, the report says. [...]

The DPIC report includes the results of a recent poll of 500 police chiefs nationwide. Fifty-seven percent of the chiefs polled said they agreed with the statement that the death penalty does little to prevent violent crimes because perpetrators rarely consider the consequences when engaged in violence. Thirty-nine percent of police chiefs disagreed with this statement.

The DPIC study concludes that capital punishment is a wasteful, expensive program that no longer makes sense. “The promised benefits from the death penalty have not materialized,” the report says. “If more states choose to end the death penalty, it will hardly be missed, and the economic savings will be significant.”

Wake-Up: Goverment-Subsidized Safety Nets for the Rich Do Nothing for the Rest of Us

I think that a lot of my fellow US citizens walk around with selective blinders and ear mufflers, not seeing and hearing about the things that really affect their lives (for example, issues related to the economy, health care, and education), while suddenly becoming enthralled about inconsequential things like balloon boy or some juicy star-studded sex scandal. You got to wake-up at least once in while friends—nothing will improve if we let ourselves be so easily distracted while the rich get richer and the rest of us pay the bill.

Scaremongering messages are being propagated to make people ridiculously afraid of things like flu-shots, so that somehow they will make a leap that government is bad and thus we can’t have it in charge of health care reform. No—the insidious message implies—we should put our trust in the free-market insurance industry whose job is to make money for investors. Of course, those big businesses will protect the interests and pocketbooks of us ordinary citizens who are not their shareholders? I love fairy tales too, but I have to live in reality. So while the government should not be allowed to restrain greedy businesses, it’s somehow perfectly fine for it to spend billions of our tax payer money to save other big businesses that screwed things up for everybody? The rich get richer and the rest of us don’t, with many falling deeper into the abyss. How is this supposed to help the rest of us?

With  these morose thoughts in my mind I found it refreshing to read Bob Herbert’s,  “Safety Nets for the Rich” (The New York Times Op-Ed, 10/19/2009). Here are some excerpts form Herbet’s Op-Ed (with some bold I added for emphasis),

[...] We’ve spent the last few decades shoveling money at the rich like there was no tomorrow. We abandoned the poor, put an economic stranglehold on the middle class and all but bankrupted the federal government — while giving the banks and megacorporations and the rest of the swells at the top of the economic pyramid just about everything they’ve wanted. And we still don’t seem to have learned the proper lessons. We’ve allowed so many people to fall into the terrible abyss of unemployment that no one [...]  has a clue about how to put them back to work.

Meanwhile, Wall Street is living it up. I’m amazed at how passive the population has remained in the face of this sustained outrage. Even as tens of millions of working Americans are struggling to hang onto their jobs and keep a roof over their families’ heads, the wise guys of Wall Street are licking their fat-cat chops over yet another round of obscene multibillion-dollar bonuses — this time thanks to the bailout billions that were sent their way by Uncle Sam, with very little in the way of strings attached. Nevermind that the economy remains deeply troubled. As The Times pointed out on Saturday, much of Wall Street “is minting money.” [...] Whether P.T. Barnum actually said it or not, there is a sucker born every minute. American taxpayers might want to take a look in the mirror. If the epithet fits…

We need to make some fundamental changes in the way we do things in this country. The gamblers and con artists of the financial sector, the very same clowns who did so much to bring the economy down in the first place, are howling self-righteously over the prospect of regulations aimed at curbing the worst aspects of their excessively risky behavior and preventing them from causing yet another economic meltdown. We should be going even further. We’ve institutionalized the idea that there are firms that are too big to fail and, therefore, “we, the people” are obliged to see that they don’t — even if that means bankrupting the national treasury and undermining the living standards of ordinary people. What sense does that make?

If some company is too big to fail, then it’s too big to exist. Break it up. Why should the general public have to constantly worry that a misstep by the high-wire artists at Goldman Sachs (to take the most obvious example) would put the entire economy in peril? These financial acrobats get the extraordinary benefits of their outlandish risk-taking — multimillion-dollar paychecks, homes the size of castles — but the public has to be there to absorb the worst of the pain when they take a terrible fall.

Enough! Goldman Sachs is thriving while the combined rates of unemployment and underemployment are creeping toward a mind-boggling 20 percent. Two-thirds of all the income gains from the years 2002 to 2007 — two-thirds! — went to the top 1 percent of Americans.

We cannot continue transferring the nation’s wealth to those at the apex of the economic pyramid — which is what we have been doing for the past three decades or so — while hoping that someday, maybe, the benefits of that transfer will trickle down in the form of steady employment and improved living standards for the many millions of families struggling to make it from day to day. That money is never going to trickle down. It’s a fairy tale. We’re crazy to continue believing it.

A Public Option Must Be Included to Make a Workable HealthCare Reform Bill

A recent journal article and a recent editorial provide good arguments for including a public option in the health care reform. The logic is clear but will Congress and the administration support it or succumb to the lobbying of the health insurance industry and its invested (and well rewarded) defenders? The New York Times editorial “The Public Plan, Continued” (10/17,/2009) states that,

[...] we strongly support inclusion of a public option — the bigger and stronger the better. That is the best way to give consumers more choices, inject more competition into insurance markets, hold down the cost of insurance policies, and save money for the federal budget. Here are some of the basic issues to consider, and the current legislative state of play:

WHO COULD ENROLL? While critics rail against a government takeover of health care, the reality is that the vast majority of Americans — those who have access to health insurance offered by large employers — would not be eligible to enroll in a public plan. [...]

DOES IT MAKE INSURANCE MORE AFFORDABLE? Most experts agree that a public plan should be able to provide insurance at a lower cost because it would have no need to earn a profit and could either demand or bargain for lower prices from health care providers. That should spur private insurers, eager to attract millions of new customers on the exchanges, to find ways to hold down their premiums as well, at least on the exchanges. [...]

WHAT’S THE STRONGEST PUBLIC PLAN? That is apt to emerge from the House, where the Democrats need only a majority to pass legislation and are constrained only by the need to satisfy conservatives in their own party. [...]

A PUBLIC PLAN FOR EVERYBODY? Too often insurance markets are dominated by one or two big companies. We believe that, after a break-in period, the insurance exchanges, with a public option, should be opened to virtually everyone covered by large employer-based plans. That would give the vast majority of Americans a bigger choice of insurance options than they now have at most workplaces — and a greater stake in pushing Congress to approve a strong public plan.

In his piece “Poor Substitutes — Why Cooperatives and Triggers Can’t Achieve the Goals of a Public Option” (The New England Journal of Medicine, 09/23/2009), Jacob S. Hacker writes that,

According to a recent survey, a majority of U.S. physicians support health care reform that includes a new national public health insurance plan, which would compete with private plans. Polls have shown that a substantial majority of Americans support the public option as well.

[...] Senate Finance Committee chairman Max Baucus (D-MT) recently unveiled his draft bill [...], which contains no competing public plan. Instead, it substitutes the largely untested idea of providing federal loans and start-up funds to encourage the creation of decentralized, member-run health care “cooperatives.” Another prominent senator on the Finance Committee, Olympia Snowe (R-ME), has indicated that she would support a public plan only in the event that private health plans failed to offer affordable coverage in a particular region, “triggering” the creation of a public option. President Barack Obama — while reiterating his support for a public plan — has said that he could support both these alternatives if they could create accountability and competition for private insurance.

Could they? Both proposals lack adequate specificity to make the answer clear [...]. But analysis of existing outlines of both ideas and similar initiatives in prior legislation suggest that they could not.

The “public option” is meant to bring greater competition, choice, accountability, and cost restraint to U.S. health insurance. It would do so by offering the choice of a new national, public, nonprofit insurance plan modeled after Medicare to those who lack employer-sponsored coverage or work for very small firms that decide to buy coverage through a proposed national insurance “exchange.” This plan would be subject to the same rules as private health plans and would be wholly self-financing, with revenues derived entirely from premiums, employer contributions, and the same government subsidy payments for lower-income Americans that would be available to private plans. [...]

As envisioned, cooperatives almost certainly could not achieve the key aims of the public plan. Although they might offer a backup option in some regions, they would have little chance of offering the broad choice of providers and portable, standardized, nation-spanning coverage that a national public plan offers. Moreover, as is the case with any private health plan entering a local market, decentralized cooperatives would find it difficult to get off the ground and expand, much less attain the reach or authority required to drive widespread delivery and payment reforms or compete strongly with private insurers. The history of consumer health cooperatives supports this pessimism.[...]

Any new federally authorized health plan must be able to counterbalance the leverage of dominant insurers and providers, in part by constructing its own competitive provider networks. Otherwise, it will have neither the market share nor the bargaining power necessary to become established and serve as a check on those entities. Alas, cooperatives have no real prospect of garnering the requisite market power. The Congressional Budget Office, which has said that the competing public plan could achieve substantial savings if it paid rates linked to Medicare’s payment schedule, has concluded that cooperatives would have “very little effect” on health care spending.[...]

In short, neither the cooperative nor the trigger represents an acceptable substitute for the immediate creation of a national public plan. Rather than developing fig leaves to provide political cover, congressional leaders and the President should push for a national public plan that competes on a level playing field with private insurance to provide coverage to people who are uninsured and workers in the smallest firms. Such competition is the key to creating greater choice and accountability in increasingly consolidated insurance markets.

Restrictive Abortion Laws Kill Women

A recently released global survey by the Guttmacher Institute reported that while increased use of contraceptives has decreased abortions worldwide, 70,000 women die each year because of unsafe abortions. More than half of the deaths were in Africa, which has the lowest rate of contraceptive use (reported in an AP article, The Philadephia Inquirer, 10/14/2009).

According to the Economist.com Daily Chart (10/14/2009) on the Gutthmacher Institute report, “Abortion: A Woman’s right“, restrictive abortion laws do not prevent abortion, au contraire,

AROUND 40% of women live in countries where abortion is severely restricted by law, a figure that has changed little in a decade. Such laws do not prevent abortion, but they do mean that the procedures are more often unsafe (for example carried out by an unskilled practitioner in unhygienic conditions), according to a report by the Guttmacher Institute, a research group. Some of the highest abortion rates are in Latin America, where abortion is all but outlawed. Nearly all abortions in Africa are unsafe, despite the liberalisation of laws in South Africa in 1997. The most recent data available, for 2003, show that a woman is as likely to have an abortion in regions where it is broadly legal as in regions where it is highly restricted. Globally the abortion rate has fallen since 1995 mainly through a reduction in safe abortions. Unintended pregnancies have also fallen, from 69 per 1,000 women in 1995 to 55 per 1,000 in 2008, as contraception use has increased.

Senate Finance Committee Healthcare Reform Bill Leaves Millions of Americans With No Healthy Future

I read about today’s Senate Finance Committee 14 to 9 vote to pass their version of a so-called healthcare reform bill, grandly called “America’s Healthy Future Act,” in a Medscape Medical News report and an AP report “Health Bill Clears Hurdle With Support from Snowe.” I am disgusted and dismayed about how proud the committee chairman, Senator Max Baucus, seems to be about this bill despite the fact that it has no public option to force  insurance companies into true competition and it would still leave over 25 million nonelderly adults without health insurance. Much of what is wrong with this bill is outlined in John Nichols’ blog,  “Baucus Committee OKs a Health Bill, but not Reform” (The Nation, 10/13/2009). Nichols pointedly wrote,

[...] the Finance Committee bill falls far short of real health care reform. It steers billions of taxpayer dollars into the accounts of insurance companies while failing to provide a realistic, humane or fiscally-responsible alternative to their profiteering.

Of course, that embarrassing omission did not prevent the committee’s chairman, Max Baucus, a Montana Democrat whose campaign accounts are overflowing with insurance-industry contributions, from hailing his “accomplishment.” Baucus has always fancied himself as the man who would define the parameters of reform. On the committee, he set up an elaborate process for achieving bipartisan “buy-in.” He assured everyone that he would get all the warring camps of the Senate Democratic Caucus behind one bill. And he promised that it would be a good bill. Baucus failed on all three counts:

1. He blew deadline after deadline, delaying action for so long that the entire reform initiative was put in jeopardy.[...] Instead of making it possible for the Congress to craft comprehensive legislation before the August break – and giving Americans something real to consider – Baucus delayed for so long and created so much confusion that extremists were able to take advantage of the recess to spin fantasies about “death panels,” “massive tax increases” and “creeping socialism.”

2. He never achieved meaningful consensus – between Democrats and Republicans and even on some issues among Democrats. Comically, the chairman bragged on Tuesday that, “Six Members of the Committee – three Republicans and three Democrats — held 31 meetings to try to come to consensus. We held exhaustive meetings. We met for more than 61 hours. We went the extra mile.” What Baucus did not mention was that the Democrats and Republicans who went through the “exhaustive” and time-consuming exercise did not come to any kind of consensus. (Only Snowe, a regular renegade from the Republican camp, sided with the Democrats on the committee.) In other words, it was a waste of time.

3. He produced a bill that satisfies no one and should infuriate everyone. [...] neither side – Republicans who oppose real reform and Democrats who favor it – look kindly on the Baucus bill. There’s been every bit as much criticism of it from the Congressional Progressive Caucus members as from Grassley’s “party of no” colleagues. [...]

The problems with the Finance Committee’s proposal extend far beyond the fact that it fails to establish a government-run alternative to compete with the private insurers that will be ridiculously enriched by it. But the lack of a “public option” should make the Baucus bill a nonstarter. As insurance-industry insider turned whistleblower Wendell Potter explained in an advertisement produced by MoveOn.org, the Baucus bill would, if enacted effectively, “kill health reform.”

“Take it from me,” argues Potter [a former health insurance executive], “the Senate Finance bill is a dream come true of the health insurance industry. If there is no public option insurance companies aren’t going to change. The choice of a public health insurance option is the only way to keep insurance companies honest.” [...]

Are the United States of America Addicted to War?

There is much food for thought in Tom Engelhardt’s “Is America Hooked on War?” (The Nation 9/17/2009). Here are some of my favorite quotes from Engelhardt’s article,

[...] Because the United States does not look like a militarized country, it’s hard for Americans to grasp that Washington is a war capital, that the United States is a war state, that it garrisons much of the planet, and that the norm for us is to be at war somewhere at any moment. Similarly, we’ve become used to the idea that, when various forms of force (or threats of force) don’t work, our response, as in Afghanistan, is to recalibrate and apply some alternate version of the same under a new or rebranded name–the hot one now being “counterinsurgency” or COIN–in a marginally different manner. When it comes to war, as well as preparations for war, more is now generally the order of the day.

This wasn’t always the case. The early Republic that the most hawkish conservatives love to cite was a land whose leaders looked with suspicion on the very idea of a standing army. They would have viewed our hundreds of global garrisons, our vast network of spies, agents, Special Forces teams, surveillance operatives, interrogators, rent-a-guns and mercenary corporations, as well as our staggering Pentagon budget and the constant future-war gaming and planning that accompanies it, with genuine horror. [...]

What does it mean when the most military-obsessed administration in our history, which, year after year, submitted ever more bloated Pentagon budgets to Congress, is succeeded by one headed by a president who ran, at least partially, on an antiwar platform, and who has now submitted an even larger Pentagon budget? What does this tell you about Washington and about the viability of non-militarized alternatives to the path George W. Bush took? What does it mean when the new administration, surveying nearly eight years and two wars’ worth of disasters, decides to expand the US Armed Forces rather than shrink the US global mission? [...]

And do you ever wonder about this: If such weaponry is being endlessly developed for our safety and security, and that of our children and grandchildren, why is it that one of our most successful businesses involves the sale of the same weaponry to other countries? [...] Recently, the Times Pentagon correspondent Thom Shanker, for instance, wrote a piece on the subject which appeared inside the paper on a quiet Labor Day. “Despite Slump, US Role as Top Arms Supplier Grows” was the headline. Perhaps Shanker, too, felt uncomfortable with his subject, because he included the following generic description: “In the highly competitive global arms market, nations vie for both profit and political influence through weapons sales, in particular to developing nations…” The figures he cited from a new congressional study of that “highly competitive” market told a different story: The United States, with $37.8 billion in arms sales (up $12.4 billion from 2007), controlled 68.4 percent of the global arms market in 2008. Highly competitively speaking, Italy came “a distant second” with $3.7 billion. In sales to “developing nations,” the US inked $29.6 billion in weapons agreements or 70.1 percent of the market. Russia was a vanishingly distant second at $3.3 billion or 7.8 percent of the market. In other words, with 70 percent of the market, the US actually has what, in any other field, would qualify as a monopoly position–in this case, in things that go boom in the night. With the American car industry in a ditch, it seems that this (along with Hollywood films that go boom in the night) is what we now do best, as befits a war, if not warrior, state. Is that an American accomplishment you’re comfortable with? [...]

As for “peace,” war’s companion and theoretical opposite, though still used in official speeches, it, too, has been emptied of meaning and all but discredited. Appropriately enough, diplomacy, that part of government which classically would have been associated with peace, or at least with the pursuit of the goals of war by other means, has been dwarfed by, subordinated to, or even subsumed by the Pentagon. In recent years, the US military with its vast funds has taken over, or encroached upon, a range of activities that once would have been left to an underfunded State Department, especially humanitarian aid operations, foreign aid, and what’s now called nation-building.[...]

And peace itself? Simply put, there’s no money in it. Of the nearly trillion dollars the US invests in war and war-related activities, nothing goes to peace. No money, no effort, no thought. [...]

What a world might be like in which we began not just to withdraw our troops from one war to fight another, but to seriously scale down the American global mission, close those hundreds of bases–recently, there were almost 300 of them, macro to micro, in Iraq alone–and bring our military home is beyond imagining. To discuss such obviously absurd possibilities makes you an apostate to America’s true religion and addiction, which is force. However much it might seem that most of us are peaceably watching our TV sets or computer screens or iPhones, we Americans are also–always–marching as to war. [...]

Actors Make a Video Plea to Protect Health Insurance Companies’ Profits

In the “Protect Insurance Companies PSA” video (funded by MoveOn.org and posted at FunnyorDie.com) several well-known actors make a heart-felt  plea to help insurance companies keep their high profits. Who needs health care reform when these needy companies are making such healthy profits? Aren’t they so much more deserving than the rest of us? Very inspirational! And just like the actors in the video, I am also not being sarcastic.

Protect Insurance Companies PSA

Food for Thought About Health Care Reform in a Book and a Song

Here are a couple of suggestions for those of you who might want to hear or read more about health care reform and related matters. A good friend of mine led me to check out Paul Hipp’s sarcastic song, “We’re number 37″ inspired by the World Health Organization (WHO)’s ranking of nations around the world. If you want to fact-check the song go to this article on PolitiFact.com truth-o-meter “The US ranks 37th in the world for health care.”

Abigail Zuger’s review (“One Injury, 10 Countries: A Journey in Health Care,” The New York Times, 9/14/2009) of T. R. Reid’s new book, The Healing of America, convinced me to buy it (my local library’s waiting list for this book seemed too long). I haven’t read it yet but according to Zuger and others (see the San Francisco Chronicle 09/23/2009 review “A Global Quest for Better, Cheaper, and Fairer Health Care“), it seems like a “must read.” Here are some excerpts from Zuger’s review.

[...] a chronic shoulder problem offered the opportunity for an unusually well-controlled experiment: Mr. Reid decided to present his stiff shoulder for treatment around the world. One shoulder, 10 countries. Admittedly it’s a gimmick, but what saves the book from slumping into a sack of anecdotes like Michael Moore’s 2007 documentary “Sicko” is a steel backbone of health policy analysis that manages to trap immensely complicated concepts in crystalline prose.“The Healing of America” blends subjective and objective into a seamless indictment of our own disastrous system, an eloquent rebuttal against the arguments used to defend it, and appealing alternatives for fixing it.

Mr. Reid starts with a methodical clarification of terms. First: universal health care. Far from a single socialized system, the various plans other countries use to cover all their residents are quite distinct. Some are as private as our own, and most offer considerably more in the way of choice.

In Japan, and many European countries, private health insurers — all of them nonprofit — finance visits to private doctors and private hospitals through a system of payroll deductions. In Canada, South Korea and Taiwan, the insurer is government-run and financed by universal premiums, but doctors and hospitals are private. In Britain, Italy, Spain and most of Scandinavia, most hospitals are government-owned, and a tax-financed government agency pays doctors’ bills. In poor countries around the world, private commerce rules: residents pay cash for all health care, which generally means no health care at all.

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.

But the comparative merits of different orthopedic philosophies are secondary here: Mr. Reid’s attention is focused on a meticulous deconstruction of the history and philosophy of the policy decisions behind them. Among health policy narratives, this book’s clarity, comprehensiveness and readability are exceptional, and its bottom line is a little different from most. Instead of rationalization and hand-wringing, Mr. Reid offers an array of possible solutions for our crisis.[ ...]