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What the U.S. Can Learn From Health Care Abroad

Gwen Ifill speaks with health experts about what the United States can learn from health care systems throughout the world.

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  • JIM LEHRER:

    And now, Gwen Ifill looks at how the U.S. health care system compares to the Netherlands and those of other countries.

  • GWEN IFILL:

    And for that, we talk to two people with different points of view: Cathy Schoen, the senior vice president of the Commonwealth Fund, which does research on health policy; and Scott Atlas, a senior fellow at the Hoover Institution at Stanford University. He's also the chief of neuroradiology at Stanford University.

    Welcome to you both.

  • SCOTT ATLAS, Hoover Institution:

    Thank you.

  • CATHY SCHOEN, The Commonwealth Fund:

    Hi.

  • GWEN IFILL:

    Cathy Schoen, based on what we just saw Ray Suarez tell us about just one country, the Netherlands, what about what we just saw there — and he also did this last night, as well, telling us how it works — what's transferable to the way we do things here and the way we can reform our health care system here?

  • CATHY SCHOEN:

    Gwen, thank you for having me on the show. I think, as you look at the Netherlands and other countries, every country has developed systems that come out of their own history, their own culture, and they're building on them.

    But the kind of ideas that are shared in common is, first, everybody is insured, everyone's in continuously in the Netherlands, and they've made that a top priority. And what we've just seen with some of the examples is they've also really worried about primary care, getting in quickly to see the doctor, having a long-term relationship with the doctor. People have very long-term relationships in the Netherlands.

    And when we've done surveys, we are struck by how quickly they get in when they need same-day treatment, much more quickly than in the United States. And as we just heard, there's no trouble getting care after hours. So this emphasis on primary care as well as integrated care is critical.

    And it's not just the Netherlands. We see multiple countries that have strong insurance systems with good primary care spending far less. We're spending about twice as much as every other country. And our outcomes are often not better (inaudible) and in some times worse.

    So we really can look at that insurance system as being a foundation for the way the physicians are paid to push on prevention, primary care, rapid access when people need it, and a more integrated care approach.

  • GWEN IFILL:

    Scott Atlas, is what we see in these countries transferable to our system here?

  • SCOTT ATLAS:

    Well, I think that you have to be careful what you want to glean from other countries' systems. Obviously, the Netherlands or places like Switzerland, they're very different from the United States, both culturally as well as the homogeneity of the population, for instance.

    But I think we can learn some good lessons from even the piece you just showed, where emphasis on preventive care is a priority. I think access to things like the clinics for minor illnesses as opposed to going into a high-powered emergency room, these sorts of things can be extracted and prioritized in our system.

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