The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care

But no other country relies on for-profit insurance companies to pay for basic health care.

The most distinctive lesson we could take, though, from Canada’s health care system is the key point of the Tommy Douglas saga: Universal health care coverage doesn’t have to start at the national level. Once Douglas established free hospital care in a poor rural province and made it work, the demonstration effect drove other provinces to do the sa

But some Americans have been pressing their countrymen to deal with that “first question” as a foundation for building a new national health care system. Professor Uwe Reinhardt, the economist at Princeton University and global leader in the field of health care economics, argues that U.S. policy makers have deliberately avoided the moral question.

Since the premium is a percentage of pay, the premium stays the same, no matter which fund a worker chooses. And yet there is heated competition among these nonprofit insurance plans. Some compete by promising to pay all claims within five days; some offer benefits beyond the basic package, like exotic Asian therapies or free neonatal nursing care

other countries do allow health insurance companies to make a profit on some supplemental policies—but not on the basic coverage plan available to everybody.

Professor William Hsiao, the Harvard economist, has helped design health care systems for more than a dozen nations. He says the creation of a national health care system involves political, economic, and medical decisions, but the primary decision to be made is a moral one.

The ethical issue of universal coverage—Professor Hsiao’s “first question”—was not part of the conversation.

the French for-profit hospitals tend to specialize in certain illnesses and procedures.

“But our Krankenkassen compete because the executives earn more money, and higher prestige, if they have a larger pool of insured members.