The prospect of universal health care in the United States, particularly compared to international equivalents, was explored in depth at a panel discussion at the Alpert Medical School entitled “American Health Care Reform: Lessons Learned from International Systems” Thursday evening.
Former President of Chile and Professor-at-Large Ricardo Lagos spoke extensively about his experience enacting a universal health care system in Chile. Lagos emphasized the importance of access to preventative health care and the ethical implications of denying universal health care.
“If you don’t have the money, then you are not entitled to have that pathology solved. Is that the kind of society you want to be living in?” Lagos asked the audience.
Lagos also spoke about the necessity of looking beyond political lobbies when considering health care policies. “The only ones who have no lobby are those future patients that are going to die of cancer,” Lagos said.
The success of Chile’s health care reform was evident in the “famous” 56 pathologies program, Lagos said. When establishing the system, the Chilean government selected 56 medical conditions that it would cover for all citizens. Currently about 70 conditions are covered, and another 10 will be added within a couple of years, Lagos said.
The most important part of health care is “to go from the concept that you have the right to be attended to a guarantee,” Lagos said. “Human beings in this world are entitled to good health,” he added.
The panel also discussed how public and private sectors could work together to benefit the U.S. health care system and how to best implement universal health care in the United States.
James Morone, professor of political science and urban studies, argued that the United States needs to follow its own path for universal health care. “There is no nirvana, no Chile for us to perfectly emulate,” Morone said, adding that health care systems tend to reflect the individual values of a country.
Monroe also addressed the politics of the federal government shutdown partially caused by partisan disputes on health care reform. The shutdown is “the last gas of a party that feels itself losing its grip, a white man’s 55-and-older party losing its grip and now frantically overstepping and painting itself into a corner,” Monroe said.
Elizabeth Roberts, lieutenant governor of Rhode Island, focused on the role state governments can play in implementing health care.
“Significant delivery reforms will be on a state-by-state level,” Roberts said, adding that she did not view an entirely new health care system stemming from the national government as realistic.
“I am a believer in incremental change. We have a country that believes in incremental change, not revolutionary change,” she said.
Monroe disagreed with this view, saying that health care is a national problem and the federal government must be involved in its solution. Until the United States meets international standards, health care will remain a “national problem,” Monroe said.
Monroe also added that state governments have a role to play in creating a system that serves people equally and said the federal government has held a “remarkable” silence on this issue.
Vincent Mor, professor of health services, policy and practice, spoke on the ability of universal health care to equalize access to health insurance. “This is the first time people will be able to buy health care without being skewered,” Mor said. “If you’re buying your private health insurance and your neighbor gets a subsidy, it’s the same plan that’s actually delivering it,” he added.
Richard Locke, director of the Watson Institute for International Studies, addressed the economic gains that could result from universal health care. “Access to good quality health care is important to economic prosperity,” Locke said. Businesses should support health care reform because “we know that when workers are healthy, they pay more attention, productivity is higher, they’re not focused on some other problem and can be focused on the job. It’s good for their profits if there’s actually good health care,” Locke said.
The discussion was moderated by Terrie Fox Wetle, dean of the public school of health.
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