BRIAN LAMB, C-SPAN: Tom Reid, author of The Healing of America: A Global Quest For Better, Cheaper, and Fairer Health Care. When was the first moment you can remember thinking about this issue?

T.R. REID, AUTHOR: I’ll tell you exactly. We - you know, I’ve lived around the world. And if you tell your kids you’re moving to another country, they say, ”Oh God, you’re wrecking my life. How could you do that?” We move to London in 1998, our kids said you’re wrecking my life. So Peggy and I said, OK, we’ll make the transition as easy as possible, we’ll loose them on London and they can do anything they want to make it easy. Sure enough, my 13-year-old goes over to Camden Town. This is the neighborhood where Bob Cratchit lived. Pretty dodgy neighborhood. And finds some store selling for ten pounds brass earrings. You have to have pierced ears. So the guy says, oh, no problem, mate. He pierces her ears. Two days later she wakes up and ear is swollen and oozing pus and very painful.

And we’d been in the country four days. We didn’t know where the doctor was, anything. What do you do? So we went out and get in a cab and the cab driver says no problem, mate. And he took us to St. Mary’s Hospital. This is on Parade Street, next to Paddington Station. This is so London. You walk in that hospital and there’s the gold plaque. It says on October 28, 1928, Sir Alexander Fleming discovered penicillin in this hospital, which I’m sure is true. And it looked like it hadn’t been painted since 1928. You know, these British hospitals, they’re grody , they have buckets catching the leaking rain. Not reassuring. But we got to the casualty ward - that’s the ER - a woman in a starched white uniform comes. She’s matron and that’s the head of a ward in a British hospital. Matron immediately spots which of us has a problem, she takes my daughter Willa into a room, maybe 10 minutes later a doctor comes along. After a while she comes out. They’ve drained the pus, they’ve cleaned it, they gave her a stern lecture on hygiene. And she was cured, she was fine.

And so you can imagine how I felt. I felt great. So I walked over to matron and pulled out my checkbook, and the matron says with great pride, ”Oh, no no no no, you may put away your checks. We do it differently here.” Free. Go home. No bill. No paperwork. No nothing. No co-pay, no deductible. They just give you health care. And I turned to my wife and said, you know, there are different ways to deliver health care. They’ve got it figured out.

So that’s when I started thinking. And you know we had lived in Japan, that’s a good health care system. And I think maybe I - originally the idea was planted for me - I covered Ted Kennedy’s race for president in 1980. And he went - everywhere he went he said all the other rich countries manage to cover everybody. Why can’t we? And I got intrigued with that question, how come they can all cover everybody with high quality care, spend half as much as we do. How do they do that? And I remembered our own experiences. So that’s where the book came from.

LAMB: But in your book there’s something called a bad shoulder.

REID: Yes. Yes.

LAMB: Which one is it?

REID: It’s my right shoulder. I bashed it in the U.S. Navy many years ago.

LAMB: How?

REID: Well, you know, the stairway in the Navy ship is called a ladder. It’s kind of a stairway. And their certain times when only an idiot would be climbing a ladder in a submarine. And I did and fell. I just dislocated my shoulder many times. And I was in there U.S. Navy and they took me to Bethesda Naval Hospital and basically - literally screwed my shoulder together. There’s a stainless steel screw in here. Worked fine. And over time - you know we’re getting old, Brian. And now my shoulder only goes this high. So I set off to see how other countries provide high quality health care, and I figured, hey, while I’m going to the doctor, why not get my shoulder fixed, too. So I took it to doctors all over the world.

LAMB: So what year did you have this …

REID: ’72.

LAMB: … shoulder …

REID: I had this procedure done. Yes.

LAMB: And how many different doctors in the world have diagnosed this - what to do about your shoulder?

REID: Oh, jeez. Ten, 12 countries. And many of these countries you have to go to the GP first, and then she refers you to the orthopedic surgeon. So, God, at least 20, maybe 25 docs, have palpated and examined and x-rayed my shoulder.

LAMB: All right, let’s start with the American doctor after you got out other the Navy that you’d gone to and said what can you do about this. Where was it?

REID: That was in Denver. Dr. Don Frillick, a great doctor. And he fixed this shoulder, which I busted skiing. Look at that movement. That’s great. But this one. So I went in to Don Frillick and said - you know, I really trust this doctor. He’s an orthopedic surgeon and very, you know, confident, aggressive people. And, look, that’s all I can do. I can’t swing a golf club anymore. You know? And you know he’s an orthopedic surgeon. Yes, we’ll fix that. What are you going to do? And he goes out of the room and he comes back with a little red box and he opens it up and said here’s your new shoulder. He’s going to cut out the shoulder that God gave me and put in something made out of titanium to replace it. That’s the American high-tech aggressive way.

What’ll it cost? No idea. You know the doctor in America doesn’t know what he’s going to be paid for his procedure. Turns out to be about a $47,000 procedure in America. And I like this doc. And I said to him, well, what can go wrong? And he said, well, you know, it’s major surgery, there are always some risks. Like what? Well, you know, disease, paralysis, death. And I thought, well, maybe I - get a second opinion. And actually I got about 20 other opinions.

So I took my shoulder around the world. I was trying to get a cure for this. But I was also looking for a cure for our health care system.

LAMB: Go back to Dr. Frillick . At the time - you’re not working for the Washington Post anymore.

REID: Oh, no no.

LAMB: So are you on Medicare?

REID: At that time I was working for the Washington Post and I had good insurance. I mean, they would have covered most of it. I think we figured out that operation would have cost me out of pocket at $1,650.

LAMB: And are you on Medicare yet?

REID: Yes, I am on now. Yes.

LAMB: So now what would have happened if you’re going to have this operation?

REID: Well, in America first you’d have to go to a second doctor to agree that it was necessary. And I think I’d get the operation - I don’t know what it would cost. I don’t - I don’t know - you can’t tell in America. You know?

LAMB: OK, give us another example of a doctor you visited about the shoulder. What about Japan?

REID: Japan, that was the widest choice of care. I went to a famous orthopedic clinic at Kayo (ph) University Hospital. Very prestigious clinic. Called them up and said could I get an appointment, my shoulder hurts. Can you come in this afternoon? Because you don’t wait in Japan. They don’t have waiting lines. That afternoon I was in the office of Dr. Nakamitchi , very famous orthopedic surgeon, and he palpates and pushes. He did something that no other doctor in the world did. He called up my condition on his computer and read about it while he was treating me, which was kind of reassuring to me. He’s an expert but he just wanted to check.

In Japan their insurance would pay for the broadest range of treatment. He would have given me the operation, he would have given me you know months or years of physical therapy. He suggested monthly cortisone shots, which would have been free in Japan. But in Japan they’ll also do traditional Chinese medicine. They gave me acupuncture. They’ll give you herbal remedies. All that’s covered by Japanese insurance. And in Japan that operation would cost $10,000. but my co-pay would have been about 65 bucks.

LAMB: Explain that, though. What insurance would have covered that in Japan? Would it have been your Washington Post insurance?

REID: Yes or my - the - if I’d lived in Japan it would have been my corporate insurance or you can also get insurance municipally. In Japan they have private plants. And then they have what’s called the public option. You can get it from the municipal government, too.

LAMB: What’s it cost a year on the public option?

REID: The premiums are not cheap. They’re cheaper than in America. I think for a working person like you and me for a family of four it’s about $400 a month. And then the employer pays as well.

LAMB: All right. You have an example in here for an Indian doctor that treated you.

REID: Yes, I did a film for PBS Frontline about traditional Indian medicine called Ayurveda. It’s a 3,000-year-old medicine. And so we took my shoulder to southern India, to the Mayo Clinic of Ayurveda. And -

LAMB: It’s not really Mayo, right, it’s just -

REID: No, it’s the most famous Ayurveda clinic in the world, the Ayurveda Chicket Saliam (ph) is what it’s called. And they don’t cut. You know they’re - your body is going to heal yourself in Ayurveda. And basically it’s an ancient herbal and laying on of hands kind of medicine. So the - what you do is you lie on this dark wood, neem wood (ph) table, and six guys massage you with warm oil. I mean it was sweet. I did it every day for five weeks. It was just -

LAMB: You were in India for five weeks?

REID: Yes, I was making a movie for PBS Frontline, so they covered this whole thing. And at this Chicket Saliam (ph), at the clinic they gave me a suite. It had my own massage chamber in my hospital suite, all my meals, $42 a day, including all the treatment. And basically they take these oils and they put these herbs and medications in them and rub you. So it’s kind of like being a rotisserie chicken. You know? They’re rubbing oil on your skin. And it was great. And they did it for five weeks, and at the end - I didn’t believe in any of this. And they made me - every day they made me go over to the Hindu temple and walk three times around the statue of Don Juan Tadi (ph), the god of healing. I didn’t buy any of that stuff. Right? Guess what, it worked. I got more movement and less pain. And they told me if I’d just stay five more weeks I’d do even better. OK? It was -

LAMB: What year was this?

REID: That was 2007, 2007. And we made a movie. And most of this movie I’m lying there being massaged by these guys. And so now I walk down the street in America - and, you know, this is one of those films they show at 2: 30 in the morning, every insomniac in America has seen it. You know? And I walk down the street and people come up to me and they say one of two things. Either how’s your shoulder or I saw you naked. That’s what I get. Because that’s - a lot of nude scenes of me in that film. I was being massaged, you know.

LAMB: Completely nude.

REID: Yes. They fuzzed, you know. They did - they pixilated. But - yes, I didn’t realize what I was getting into when I agreed to this. But basically it was sweet. And I didn’t buy the religious background, I didn’t buy any of this stuff, but it worked. There’s no question I got improvement.

LAMB: But if you lived in India, what would it have cost you?

REID: Probably the same $42 a day, although that’s a significant amount of money for most people in India.

LAMB: How do Indians get their health care?

REID: India is basically a developing nation, a third world can we say. And in those countries they’re basically isn’t a health care system. The system in those countries is called the out of the pocket system, which means if you have the money to pay the doctor you get treated. If you don’t have any money, which most people in India don’t, you stay sick or you die. That’s the system in all third world countries. It’s brutal, it’s simple, and that’s the fact.

LAMB: By the way, which is the program you had the falling out with where they didn’t use you and then you walked out of the - you walked away from it?

REID: Yes, so I made two films for PBS Frontline in which I’m reporting this book. One was this Indian film, A Second Opinion, and the other was called Sick Around The World where I go to the doctor in five countries to see how health care works. And those were pretty successful films. So then we made Sick Around America and we took a look at American health care. And worked months on it, worked months on it. And you know I’m on the on air guy. They call you the talent. Did you know this? I’m the talent. I don’t have any, but. So did my bit, which was going around interviewing everybody. We spent months on it. And then the producers go to Boston where Frontline is and put all this together into a documentary film. And maybe after six or seven weeks of editing they sent me the movie and I looked at it and it was wrong. I just thought it was wrong as a matter of health policy. They suggested that the solution to our health care problem was to mandate everybody into private for profit American health insurance. And no other country would do that, no other country would allow the kind of things that our insurance companies do. So I said to them that’s wrong. That contradicts our film, it contradicts my book, and I don’t agree with this. And they didn’t want to change it. They were happy with their movie. That’s their right, you know, it’s their film. And I didn’t want to be in their movie. So we had an amicable parting of the ways and I dropped out.

LAMB: So you’re through dealing with them after this.

REID: Not only am I through dealing with them, I think I’m persona non grata at Frontline for all time. I don’t think they’re going to put T.R.Reid in another film.

LAMB: Did that surprise you that it was that severe at the end?

REID: Surprised me, yes. It stunned me. I think it’s perfectly reasonable for people to disagree on health policy. But they were pretty angry at me for withdrawing from their film.

LAMB: Are you going to do any more television?

REID: Yes. It turns out if you have a big public fight with Frontline, lots of other producers come and ask you to do a movie. So I’m going to make some more documentaries. And it’s fun work. You know, it’s - it’s like being as reporter. I think it’s easier. You have a producer to do a lot of the work for you, a lot of the stuff that a reporter would do himself if you worked for the Washington Post. So I like it. I think I will do more. But I will place you a bet it won’t appear on PBS Frontline, because I’m a bad guy there.

LAMB: Let’s get a T.R. Reid update. We’ve talked over the years a lot of times, and most of the time you’ve been with the Washington Post. Where do you live now?

REID: I live right in the heart of Denver, very near where you teach at the University of Denver, as you know.

LAMB: How many years did you work for the Washington Post?

REID: Gee, about 30. And my last - we worked around the world. But as you remember I married Peggy McMann , a Denver native, and she always said let’s go home. And the Post very kindly twice made me the Rocky Mountain Bureau Chief in Denver. They were good about that. And that was my last job. And now newspapers don’t have bureaus in Denver. You know? People just can’t afford that kind of thing. So they shut down their bureau and I was getting into making films and writing more books. So I’m - I’ve left the Washington Post.

LAMB: I picked up something on a blog out there - or either that or an online magazine - 5280 I think it’s called - where they said a couple things I didn’t know. One, that you’re a Democrat and, two, that you were interested in being appointed to the legislature in Colorado.

REID: Yes.

LAMB: One, the Democrat is right?

REID: Now, yes. I registered as a Democrat. Yes.

LAMB: OK And, two, did you get the seat?

REID: No. The - my state rep from our district in Denver was the leader in the Colorado legislature on health care policy. And she quit the job and took something else. And a bunch of people came to me and - because I’m doing health policy - and said why don’t you try for that. And I did apply for the job, but I didn’t get it. And I - you know what? I have to say the guy they picked is great, better than I would have been. So I can’t complain about it.

LAMB: Can they appoint legislators?

REID: Well, yes, they don’t have a special election for legislators. And here’s my argument. I think I a legislator quits in mid term they should make her pay for the special election to replace her. But as a matter of fact, they don’t. And lots of people and many state legislators get the job that way. And then once you’re incumbent you tend to win.

LAMB: Would you run for an office out there?

REID: I might do that. If people come to me - I - I think we may - I think the goal for American health policy is universal coverage at reasonable cost. That’s where we have to get. That’s where all the other rich countries are. I’m not sure our national government is going to get there. I mean this is summer is not promising. I think it might happen on a state by state basis. You read my chapter about Canada. What happened in Canada is one province in Canada, Sasquatchian, it’s a lot like Colorado, you know. It’s half plains and half mountains. There are no rivers out there, so the borders are straight lines. It’s Colorado. You know? They elected a very lefty governor. It’s called a premiere in Canada. And he said everybody in our province should have health care, everybody should have health care. So he set up a state run single payer system. This was in 1944. Tommy Douglas was this man’s name. He called it Medicare. And it worked. All of a sudden everybody in Sasquatchian had medical care. Lots of doctors came there because they knew they’d get paid. And the other provinces saw it and gradually one by one, two by two they copied it. They saw that it was working. And by 1961 it was so popular that the people of Canada demanded that the federal government establish it coast to coast.

But it started in one state. Tommy Douglas did this. And then in 2004 the Canadian Broadcasting Company did a poll to pick the greatest Canadian in history. Millions of voters. And the candidates included Wayne Gretzky, Alexander Graham Bell - they claim him, Pierre Trudeau, who was their JFK, all that.

LAMB: Lauren Green , Anne Murray .

REID: Yes, all that. Yes, yes, yes. And the winner was Tommy Douglas . The winner was Tommy Douglas (ph). And I have talked about this topic to several state legislators and I always say, you know, if you would institute a health care system in your state that worked, you’d be elected the best American in history. Because that’s what happened in Canada. So now I think what’s going to happen is we will get the universal coverage on a state by state experimentation, and some state will get it right and the others will copy. And one reason that can happen is in whatever bill comes out of Congress this year there’s going to be a state waiver clause -I think that’s going to be in there - that gives them waivers against national laws like the ARISA , leaves a lot more room for experimentation. I’ll bet you that next January 25 states at least will have bills in the state legislature to try to get to universal coverage on a state level. If some state makes it work, everybody will copy it.

LAMB: What’s ARISA ?

REID: ARISA is the national pension and insurance regulating law. And it has many desirable features. It forces - it requires that employers treat all their employees the same for health care. They can’t charge Betty more than they charge George kind of thing. And that makes it hard. And it’s a national - so it makes it hard for a state to change the rules of health insurance or health payment. So they’re going to give waivers on that law. That’s in the statute that’s probably going to pass Congress.

LAMB: Kaiser Family Foundation , health foundation and all, how does that play into - you mentioned that in here. Did they underwrite for this?

REID: They did. It’s a wonderful organization. And they fund and finance and do a lot of health policy research. They’re very good at this. And I went to them and said, hey, I’ve got this very expensive project - this is before I was making the movie - can you help me? And they helped me. And not only did they give me money, they gave me the kind of cachet you need to go overseas and health minister. People in Germany have heard of Kaiser. So they helped me a great deal. And then the best thing that happened was when - you know, when PBS Frontline signed me up to make this movie - so here’s the deal. In all these European countries and most Asian countries, the public broadcasting service is the big broadcaster. You know? That’s the powerful guy. NHK, BBC. And so if you guy to, say, Switzerland and say I’m from American PBS, they think you’re really important. You know, you’re a big shot, bigger than NBC or something. You know, they’re just private.

So I went to Switzerland and said to them I’m from American PBS and I’d like to interview your health minister. And they said, PBS? To our president. Which I did. I talked to two presidents in Switzerland, last time and the current one. So that helped a lot. But to see doctors, to see health care economists, it was quite useful to say I’m here under the imprimatur of the Kaiser Family Foundation . People know it and that helped me a great deal.

LAMB: There’s some names involved with the foundation. I want you to tell us how much they got involved in this. On the board, Bill Frist.

REID: I know Bill Frist , but he didn’t have anything to do with it.

LAMB: Cokie Roberts is on the board?

REID: Yes. Nothing.

LAMB: Donna Shalala?

REID: Nothing.

LAMB: David Satcher , the former Surgeon General.

REID: No, no. Drew Altman , who’s the boss of Kaiser , he was very helpful to me. He’s smart as a whip and he knows health policy. He helped me a lot.

LAMB: But there is another name that you mention several times - and I’m not sure I’m pronouncing it right - Uva Reinhardt (ph).

REID: Yes, Uva - the great Uva Reinhardt .

LAMB: Princeton.

REID: Health care economist at Princeton. He’s marvelous. Here’s what happened. I signed up to do this book. I started in 2006. Well, that’s a pretty nice idea. I’d just go to other rich countries and see how they do health care. Signed a contract, got a pretty decent advance, and then I realized how big it was. It’s a huge, huge - it’s so complicated. In the fall of 2006 I taught a course at Princeton. And was kind of leafing through the catalogue the day I got there and here’s a course called The Woodrow Wilson School - WWS 597. It’s a graduate seminar, and the title is The Political Economy of Health Care Systems. That’s my book. You know? So I walked over and it was a pretty formidable topic and the syllabus looked very difficult and charts and economics, you know. And I walked in and within two minutes I knew it was going to be a great course, because this Uva Reinhardt (ph) is just a marvelous teacher and he knows everything. And he became my guru. And I can say to Uva, how do they keep cost down for major surgery in Germany? And he’ll say, well, they had the commission four years ago, you know. And he knows everything. He’s really good. And then he knows the health care economists in every country. So I - you know, I’m going to take a look at the British system. Well, you need to talk to Dr. Allen Maynard (ph), at University of Birmingham. He knows him. You know?

So if you’re a journalist you need that. And I’ll tell you something. You’ll really like this. I could have Uva Reinhardt . At one point I actually - this is so hard. I said to Uva , you know, you really ought to - why don’t we write this book together? And he said, no, no, no. Look, I’m an economist, nobody can understand us. You guys, you journalists, you can explain it to people. I could have kissed him, because that’s what we all think. You know? Academics are deep and smart, but we can say things in English in a way people can understand it.

LAMB: He was born in Germany?

REID: He was born in Germany and he grew up in Canada. So he knows those systems. And as I say in my book at one point, Uva has been advocating for universal coverage in America for a long, long time. And at one point he wrote a letter to the Journal of the American Medical Association, you know, their journal, and said I just want to pose a simple question. In America if the child of a rich family and the child of a poor family both contract the same disease, should they both have access to the same care to treat it?

Now, his answer would be yes. In every other country - rich country in the world the answer would be yes. Of course rich people and poor people get the same care. All these doctors wrote in and said tell Uva Reinhardt to take his socialist views elsewhere. I mean, doctors wrote in and said the answer is no. No, we shouldn’t do that. Now, you wouldn’t get that answer in any other country. All the other countries have made what I think is a moral decision, an ethical decision, everybody who needs health care should have access to care.

LAMB: We’ll go back to that, but I want to take your shoulder to Germany.

REID: Yes, OK.

LAMB: What happened there?

REID: Germany is good high-tech medicine. And she, the doctor in Germany - you have to go to the GP first, and then she would send me to the orthopedic surgeon. And he, you know, palpated and examined and all that. And he could have done the operations recommended in America. He didn’t think it was my kind of - my need. My big problem is really the movement. The operation is better for people with a lot of pain. So in Germany they proposed a regular regime of physical therapy, which of course would be free in Germany. And -

LAMB: Why free?

REID: In Germany health care is paid for - you have to pay an insurance premium, but it’s paid for by health insurance. And traditionally in Germany nobody ever paid a co-pay. There wasn’t any. You paid your insurance, but then you never - in Germany you don’t even get a bill. And then in 2006 all countries are having problems with the cost of health care. Every - like we are. So Germany came up with this shocking, shocking change. And that is once a quarter, every three months, you have to pay a co-pay to go to the doctor. Ten euros, 14 bucks. And once you pay that in January, all health care is covered for the next three months. And if you have to come back on April 2, they make you pay another 10 euros.

This doctor I went to in Germany told me that - she thought this was so funny - there was an American expat living in her town. And he came in, you know, with a hangnail or something in early January and she said, oh, I’m so sorry, Bruce , you now have to pay 10 euros. Well, he’s American, you know. OK, here. Right? And then he came back in late February with some other problem and she says he tried to pay me again. He’d already paid for that quarter. She says to me I don’t get this. Do Americans pay every time they go to the doctor? Is that what happens in your country? How could that - like that.

So in Germany I would have paid the 10 euro co-pay and everything else would have been free.

LAMB: So in Germany - if I worked in Germany and I didn’t have insurance, didn’t pay for insurance, what would happen to me?

REID: Well, it’s taken out of your pay. You don’t have the choice not to have insurance.

LAMB: What I didn’t have a job?

REID: If you don’t have a job, well, then the government takes the role of your employer and the government pays the employer’s part of the premium. And if you don’t have enough money to pay your half of the premium, the government does that, too. Most people in Germany get health insurance through the employer and they split the cost between the employee and the employer. This is called the Bismarck model. It was invented by the chancellor - first chancellor of Germany, Otto von Bismarck. A hundred fifty million Americans are on that plan. The difference is in Germany - the big difference is if you lose your job, you keep your insurance. The government takes over and pays your employer’s part of the premium. And many people in Europe - they’re all mystified by our health care system, believe me. They can’t figure it out. Why would a rich country leave so many people uninsured. But as I say in the book, the health minister of Sweden to me once - I was pretty friendly with her, I spent a lot of time with her - she said, Mr. Reid, could you explain something to me? There’s something I don’t quite understand about your country. What? And she says, well, you know, in Sweden we feel when you lose your job that’s when you really need health insurance. But in your country when you lose your job they take away your health insurance. Why would you do that?

Do have an answer for that one, Brian? I’ve never figured that out myself. That’s arguably the cruelest of all the cruel twists of American health care policy. When you need insurance most is when you lose it. That can’t happen in any other country.

LAMB: Your shoulder is now in France.

REID: In France - yes. So the doctor puts my x-ray up on the light machine, you know, the orthopedic surgeon. And as I said, they put a stainless steel screw in my shoulder at Bethesda Naval Hospital. This guy sees that. Big smile on his face. You know why? That’s a French procedure. The French invented the operation - it’s called the La Torget procedure - that I had Bethesda Naval Hospital. So here comes this American shoulder with a French screw in it. He was so pleased, you know, like seeing an old friend on the street. You know? And he, too, told me, he said you could have this procedure done in France. It would cost 5,000 euros, about $6,000, of which I would have paid 60 bucks out of pocket. That’s all. And - but he also said I don’t think it’s indicated for you. He suggested physical therapy or maybe pain pills or something if it were hurting. He would have done it. He said you can definitely find an orthopod in France that will do it, because he’s going to get 5,000 euros for doing it. But he didn’t recommend it.

LAMB: Who says that France is the number one medical health care system in the world?

REID: The World Health Organization did a big four-year study of all the health systems in the world, 191 countries. They hired a professor at Harvard, Dr. Christopher Murray , to do this. And he was afraid that this was going to be just one more four-year study that comes out in a big study and somebody puts it on the shelf and nobody ever reads it. How could he get attention for his study? So they came up with a scheme. We’ll rate each of the health care systems in the world on grounds of quality and fairness. They rated them from one through 191. And France came in first. So they rated it as number one. And I - is it best in the world? I don’t know what - I think it’s a very good health care system. Their results are great, they live longer and healthier than Americans do, and spend maybe 60 percent of what we do on health care per capita.

LAMB: Let me offer some kickback on some of the things you’re saying just to see what your reaction is. The World Health Organization is basically the UN.

REID: Yes, yes.

LAMB: Most of the organizations that belong to the UN and have control of this would be - this universal health care - they would not be disposed to like anything America does.

REID: Yes, that’s wrong. In the first place, there are 191 countries in the World Health Organization and only about 40 of the world’s richest countries have any health care system at all. All the others are on this out of pocket system we describe where if you can pay the doctor you get treated. So most of them would be developing countries. And, yes, I’ve heard this before. It’s in Geneva, it’s a bunch of Swiss-French people. Of course they don’t like America. No. They hired Chris Murray , at Harvard, and Julio Frank (ph), who was the Health Minister of Mexico, did the study for them. It was not done by Europeans.

LAMB: Conservatives are going to say, Harvard, a bunch of liberals, they want universal health care.

REID: Yes, you can make that argument I guess. The big problem with America - as you know, we were notoriously rated 37th in that ranking. And the major reason was fairness. And they’re right on fairness. Some Americans get absolutely world-class care, as good as anybody, better than the French. The problem is we leave tens of millions of people outside the door. They don’t get treated. According to the National Academy of Sciences about 20,000 Americans die every year of treatable diseases because they can’t afford a doctor. We meet one on the first page of my book. You know how many people in France die of treatable diseases? Zero. Germany, zero. France - Britain, zero. No other country lets it happen. According to the Harvard School of Public Health about 700,000 Americans go bankrupt every year from medical bills. Medical bankruptcies around the world. Japan, zero. Canada, zero. Britain, zero. Germany - other countries don’t let that happen. So in terms of the fairness of our system, that’s where we get rated down.

LAMB: A GP, a general practitioner, a family doctor, makes, I don’t know, $140,000 a year on average, something like that?

REID: Yes, a little higher than that in America. Yes. Yes.

LAMB: What does as GP make in France?

REID: Sixty thousand. The fellow I spend a week with makes 60,000, and that’s about average.

LAMB: Japan.

REID: He probably makes $80,000 a year.

LAMB: Germany.

REID: She makes closer to 100,000, maybe 90,000 a year.

LAMB: You point out often that their education’s paid for by the government.

REID: Yes, most of them - in most countries medical school is free or if there is a tuition your local government pays. There are malpractice premiums. I asked this doctor - the doctor I spent time with in Japan has a clinic with nine beds in it. He’s running a hospital. And I said to him what’s your malpractice premium? You know, any doctor in America knows that off the - gosh, what is my malpractice - I have no idea. He calls the office manager. She says, well, that’s included in the dues for the Japan Medical Association - $30 a month. That’s his malpractice premium. And he’ll never be sued. So they make less, but you know their cost burden - they don’t have a big loan to pay off when they start. I think the fundamental difference is their expectations are lower. Doctors in France and Germany and Japan don’t expect to make 500,000 a year and drive a Lexus to the country club. It’s not their - they want to help people. They’re people who like biology, they like science. You know, all doctors everywhere I’ve met, in our country, in other countries, complain that they’re not paid enough. Everybody says that. But they’re comfortable middle class people and they’re comfortable with that and they’re helping people - you know, they’re curing illness. That feels pretty good.

LAMB: If you set out to write a book that would show the American medical system in the best of lights, what would you do? How would you tell that story? I mean, basically what you’ve done in your book is say that we’re - we - we’re - our numbers stink in every poll you show here.

REID: Yes. No, that’s true. Certainly coverage we’re bad at. Cost, we’re the worst in the world. It’s kind of striking that even on quality, on results we rate lower than most of the other rich countries. That kind of surprised me.

LAMB: Even on life’s longevity. I mean, you show us 50 something or whatever.

REID: Yes, yes. Well, we’re at 77, but the other rich countries are at 79 or 82 or something like that. So. Neonatal death, the death in the first year of life, we’re two or three times worse than all the other rich countries. That seems outrageous to me. A rich country can’t keep its babies alive? I can’t stomach that one. But I could tell you a million great things. We should have the best health care system in the world. We definitely have the best medical schools, nursing schools, and pharmaceutical schools. We have certainly world-class and maybe world-leading medical research. I’m absolutely convinced that our hospitals are the best in the world. I mean they’re the finest facilities, they care for you, they - you know, they have all sorts of people treating you. All that stuff, facilities, training, skill, nobody can match us.

The problem is the system people have to work in, the payment system is just really badly screwed up. It’s very expensive and it’s extremely unfair and we just haven’t allocated these resources equally. All the other countries started by saying we want everyone in our country who needs a doctor to have access. And for some reason - and as you know, I struggle with this question in the book - we never have. The richest country in the world has never made that commitment. We - I’ve talked to a - you know, I’m pretty tough on Canada in my book because I said they keep you waiting so long. Long waiting lines. And I was talking to a minister in Canada and I said, you know, you keep - you keep people waiting. How can you call this good health care? You have to wait months to see a doc, the specialist. And his answer was, look, Canadians don’t mind waiting so much as long as the rich Canadian and the poor Canadian have to wait about the same amount of time. And, you know, that is their national culture. They’re very egalitarian. And we don’t have that. It’s a standard in America that rich people are going to get better health care than poor people. No other country let’s that happen.

LAMB: You know, if you talk to people that run Mayo or run Cleveland Clinic and all these places, they’ll tell you that the big 737 fly in from Saudi Arabia and all over the world to get their people treated there. You talk about the Canadians all the time. If you’re listening to conservatives talk about it, they say the Canadians are coming over the border to get treated.

REID: Yes.

LAMB: What did you find there?

REID: No, there are good studies on these Canadian snowbirds. There aren’t many of them. There are a few of them. The Canadians claim that more Americans go north across the border to get treated or to get drugs than Canadians come here. It’s a pretty small number either way. It’s certainly true that Arab oil sheiks fly to Johns Hopkins or the Mayo Clinic for treatment, because, as I say, at the top nobody can match America. We have the best care in the world and the best medical schools, the best research. We just haven’t made it available to all Americans. And that’s the fundamental difference between our country and all the others.

LAMB: You did France and Japan and Canada and Britain.

REID: Germany.

LAMB: Germany. Did you do Italy? Italy’s up there pretty high in -

REID: Yes, Italy and Spain rate high. Those are both British style systems, which I think Americans would call socialized medicine, in that it’s called the beverage model. In the British model, health care is the government’s job. I think that’s social - the government owns the hospitals and employees most of the doctors and pays all the bills. You don’t get a bill in those countries.

LAMB: But you pay it in taxes.

REID: You pay it in taxes. Yes, they definitely pay for health care. They pay less than we do, you know, because their per capita rate is about half of what we get, we pay. But, yes, they definitely pay for health care. But you don’t get a bill. That’s the so called beverage model. And I’d call that socialized medicine, wouldn’t you? The striking thing is - and many other rich countries, Germany, France, Belgium, Japan, they’re private. In fact, in some cases more private, less socialized than America. In Germany, the doctors are private, the hospitals are private, the labs are private, drug companies are private, and the insurance plans are private. And everybody stays with private insurance cradle to grave. They don’t have a Medicare for old people. They just - I argue that that’s less socialized than the U.S.

LAMB: So how much of all this in this country is the profit? Whether it’s the drug companies or the hospitals - I know Kaiser is non-profit.

REID: Yes, non-profit. Yes, yes.

LAMB: But the Hospital Corporation of America, the biggest of all -

REID: That’s the for profit. You know, here’s the - when you’re talking about the costs and profits. In my book I divide health care into the providers - docs, hospitals, drug companies - and the players, the insurance system. Most countries have decided that it’s OK for the providers to be for profit. There’s some competition there. But all the other countries have decided that the payment system, whether it’s government or private, has to be non-profit. That’s a fundamental distinction with the United States. So how much does that contribute? The American health insurance companies are the least efficient payers in the world. They have administrative costs - they report this to the SEC every quarter - the administrative costs 18 or 20 percent of the premium dollar. So they add 20 percent to every doctor they pay. In France, which is private - basically private insurance - their administrative costs are four percent. Germany five percent. Japan about five to five and a half percent. Canada’s payment system, as I said, is government, it’s a bunch of lazy over-fed government bureaucrats. Right? They’re administrative costs, 5. 5 percent, one quarter of what our insurance companies pay (INAUDIBLE).

LAMB: Did you say that Medicare was three percent?

REID: Yes, Medicare says three percent. That’s right. Well, you know, there’s no marketing in Medicare, no marketing costs. They don’t deny claims and they don’t make a profit. And that all keeps administrative costs down.

LAMB: So what about the doctors? I mean, shouldn’t they be allowed to make - I mean, some of them make a lot of money, but a lot of them just make that - I mean, they make - I mean, a lot of money in this system compared to others, but very few of them make the several million dollars a year.

REID: That’s right, not many do. But docs are - doctors do very well in America. They’re the best paid doctors in the world, there’s no question about it. And -

LAMB: Are they the best doctors in the world?

REID: They’re certainly the best educated. But, you know, our results, as I say - let’s see, in terms of recovery rates from major disease, we’re kind of mediocre. Neonatal death, I told you we’re the worst of all the rich countries. Yes, so we have very good doctors, very well trained doctors, a lot of high-tech medicine. But we’re about equal with the other countries. I don’t think we’re remarkably better.

LAMB: How much of this is the 11 million illegals that come into the country, and don’t pay anything and they’re not registered and they’re given health care and they’re figured in these averages?

REID: Yes, there’s some of that. The big problem in America - the reason the averages are low is all the people who can’t get care. So you take recovery rates from Lupus, which is a chronic disease that strikes young women, and it’s a series disease. But modern medicine knows how to manage it. If you get the right care, you’ll live to be 75 if you have Lupus. And in other rich countries where everybody gets care they do. But in America somebody without insurance who gets Lupus is in very serious trouble and they die young, much younger in America. Same with asthmatics, die much younger in America than in other countries. Not because - the rich ones do fine. They get care. But a lot of poor people get asthma who can’t get the medical care they need and they die much younger in our country.

LAMB: Talk about this book. When did you complete your research?

REID: It took me - oh, gosh - three - more than three years to do this book. It was much harder than I thought. I was - I missed the deadline by 18 months. My editor beat up on me for a year, let’s go, let’s go, where’s this book. And of course my claim now is that I always knew that in the summer 2009 our country would be obsessed with health policy and would want to know how other countries do it. And so it’s - it’s not true, it’s sheer luck that I brought out the book at the right time. But, no, I’m claiming that I saw this coming, that’s my story and I’m sticking with it.

LAMB: How many different days were you on the road?

REID: Months, months. I was -

LAMB: Thank your wife with you?

REID: A couple of trips. Yes, a couple of trips.

LAMB: Your kids? Are they - how old are your kids now?

REID: I tried to get my kids to go. I don’t think any of the kids went. But they lived with me - you know, they lived with us in Japan and Britain. So they were kind of the guinea pigs for this book. I took to the NHS hospitals and -

LAMB: How old are they now?

REID: Thirty-four, 27, and 25. One of my kids was - she’s a runner and she was running in - an America - a female runner has to get a blood test to test your mercury level. This matters, you know. Iron level. I’m sorry, iron level.

LAMB: Where do they have to do that, here?

REID: Yes, anywhere. Anywhere, females runners need to do this. And so my daughter was a competitive runner in Britain. And she finishes high school and comes to college in America and calls me up and - and she’s on the team, you know, on the team - the coach said everybody go over to Princeton hospital and get a blood test. Right? So she calls me from the Princeton hospital in America - I’m in London - and says, dad, dad, they want 120 bucks for this blood test. I don’t know what a blood tests costs. And I said to her, well, that’s sounds OK. What do you pay in Britain? She said, dad, I go to the Royal Free Hospital. I’ve never paid a penny for medical care. You know, that was her idea of what medical care should be like. So that’s kind of addictive if you think about it, free health care. And then you come home and they want to actually give you a bill.

LAMB: And this time that you did your research, did you have camera crews with you all the time?

REID: Did I have what?

LAMB: Camera crews with you.

REID: When we did the PBS Frontline show, yes, I did. For - so I did two movies and had camera crews. But by then I had met - I had been to all these countries at least once. I’d met most of the doctors. And had to kind of convince these docs - I had spent a week with each of these docs, and then I had to convince them to go on camera. And some of them said, oh, yes, I’m ready, you know, put me on. Some of them were a little shy about it and didn’t want to do it. But in the end they all did. And then we got Uva Reinhardt to help out, and then this marvelous guy, Bill - Professor Bill Hsaio at Harvard. Wonderful man. He teaches at Harvard School of Public Health. He’s designed about 25 countries’ health care systems. He did Egypt, he did Cameroon, he did Taiwan. He’s now designing a new health care system for China. A fantastic resource for a guy like me who wants to know how other countries do health care. And he went to Taiwan with us. And we had a wonderful moment there. He designed the Taiwanese health care system which covers everybody. They basically adopted the Canadian model. And they did this in 1994. And we went to a hospital at a little fishing village on the coast and there was a woman in the lobby of the hospital and she was taking people’s blood pressure. And I said to her, you know, Mrs. (Lee), do you work here? No, I just do this as a volunteer, I’m just trying to help out. Well, why do you volunteer?

Here’s why. In 1980 - this is before Taiwan had a health care system - her mother got breast cancer and died. There was no hospital in the town, there was nobody to treat her. She died at age about 46. In 2005 Mrs. (Lee), the daughter, gets breast cancer, but by now there’s a health care system that covers everybody in there’s a hospital in her town and she went in there. And of course they treated her cancer and saved her life for free.

And I said to her right over there is Professor Bill Hsaio, from Harvard, and he designed the system that saved your life. You know? He put this hospital in your town. This Taiwanese woman, and she walks over to him in the quietest, most deferential way. She has to say to this man thank you for saving my life. How would you say that? So she’s Chinese. She walks over to him and just gives him the most imperceptible bow, a one-inch bow, and walks away. And I thought, God, that was a perfect way in Asia to say thank you for saving my life. A great moment.

LAMB: So as you watch - and we’ve had many, many hours on this network in last few weeks of these town hall meetings, and you see very sincere people standing up and saying, you know …

REID: Yes, yes.

LAMB: … all the things they say about we’re - don’t mess with my health care.

REID: Yes, yes. Yes.

LAMB: What do you say to them? And if you were up there - first of all, do you think that the members of Congress understand this?

REID: Yes. I think they get health care. Yes.

LAMB: But you think they understand all the ins and outs of what’s going on -

REID: Well, the guys who are saying it’s all socialized nanny state overseas, they definitely don’t get it. They need to read my book, to be frank, because it’s not. A lot of countries, as I say, are less socialized than we are. Here’s what I see is the difference between - you know, I set out to figure out how other countries manage to cover everybody at half the cost. I think I got that in the book. But I figured along the way there was a more important question. And that is why do other countries cover everybody, what makes the country make the moral commitment to cover everybody? I worked hard on that one, too. And if you think about that for a while, it leads to this question. Why doesn’t the world’s richest country commit to cover everybody? Why have we never done this?

And as you saw, I struggle with that in the book. I spent a lot of time worrying about that. Why is it? And I think - to me we’re just going at it from a different direction. All the other countries that I went to first decided the moral issue, everybody in our society who needs health care can have it, and we’ll find a mechanism to get there. My sense is our argument is all about the mechanism and we’ve lost - we’ve lost sight of the basic moral goal. I think if we could focus on that goal, then rather than saying, well, my insurance is OK, so the heck with you, we might say, yes, I want to find a way for my neighbors to get health care when they need it.

LAMB: But if you’re - if you sit back and look at these debates going on, it appears to some people that you have one side that’s for universal health care saying this is the greatest way in the world to get votes. I’m going to promise we’re going to have universal health care and it’s not going to cost you a thing. When it’s all said and done it’s not going to cost you a thing.

REID: Yes.

LAMB: And then you have the other side saying I worked hard all my life, I’ve paid my health insurance, now I’m going to enjoy good health care. What do you say to them about the cynicism they have about people saying I’m going to take care of you.

REID: Yes. So it’s not going to cost you anything, that’s baloney. It’s going to cost. In all the other countries - I think a woman in France said this to me and it’s true in all the other countries - the fundamental rule is - the formula is simple. Health care for everybody paid for by everybody. That’s the system. We’re all going to have to pay to make sure that all our neighbors have health care. It’s not going to be free. I think the argument could be that the people - the organizations that have been the big winners in our current unfair system, the big hospital corporations, the insurance corporations, and many specialist docs, should perhaps pay more, because they’re sitting on more of our health care money than perhaps they should get. But the crucial point is we want everyone in our country to have health care when they want it. If we believe that, we could get there. And I know we could, because all the other rich countries have done it.

LAMB: We’ve been focusing on the Virginia Hospital Center and they have something called a Cyber Knife. It’s a $6 million radiation machine.

REID: Yes.

LAMB: It’s the best of the best.

REID: Yes.

LAMB: Do you see any Cyber Knives as you went around the world?

REID: Oh, yes. Yes.

LAMB: Everywhere?

REID: The notion that other countries are backward or something is just not right. No, there’s a lot of good - fantastic medical innovation in America, no question about that.

LAMB: Does it start here?

REID: Yes, a lot of it starts here. Although a lot of it comes out of Universities and government, it’s not all industry. Some comes from industry. But other countries with much lower cost structures have good innovation. Anybody out there who has an artificial hip or an artificial knee or an artificial shoulder, hey, that’s French technology. They invented that. This deep brain stimulation which is the first thing they’ve come up with that deals with Alzheimer’s, that’s Canadian. Insulin is Canadian. X-rays are German.

LAMB: What about the drugs? I mean -

REID: A lot of the drugs that we see advertised on American TV come from Swiss labs or British labs or German labs, including viva Viagra. That’s a British invention.

LAMB: Why is it that the drugs that are sold here can be bought for so much less money in Canada or in Europe or in Africa and places like that?

REID: That’s sheer market power. That’s economic clout. In Britain, the national health service buys every pill, and then you get your - you get your prescription through that. And they negotiate a very good price, because the drug company can’t charge twice as much to anybody else. They’re the only buyer. And they do that in Germany, they do that in France. And therefore those countries have negotiated lower prices. As I say in my book, the same pill made in the same factory costs 20 cents in Britain and $1. 20 a pill in America. Same thing. And the reason is they have negotiated a price. In America all - we have so many different buyers that we don’t have that kind of economic clout. And of course as you know, in Medicare Part D the government agreed not to negotiate for a good price. They won’t use their economic clout.

You get pretty good drug prices in the VA, the VA gets good prices, because they do use their bargaining power to get lower prices. If we did that - so here’s what the drug companies say. They say, well, if you cut your prices in America we couldn’t do innovation. I’m not sure I buy that. They spend three times as much on marketing as they do on research. So maybe they could cut that. But why - Brian, you know, people in Japan have a higher per capita income than Americans do. Why should I subsidize them to get cheaper pills because I’m paying more? That doesn’t seem right to me. Let’s let the drug companies charge everybody a fair price and then ours would go down.

LAMB: Go back, though, to the - looking at it from the outside and you see politicians saying I’m going to take care of you. And then you have the other side saying, no, you’re not, you’re going to end up costing me more money, I like my health care system now. How do you get past that? Because it seems to me that we’re 50 years late in trying to sell the idea that you’re talking about, because you’re not going to get away from this idea that one side is going to say you’re just buying my vote.

REID: I think it’s fundamentally a moral issue. And I think that’s where the argument has to be. Does a rich country have an obligation to see to it that everybody can have health care.

LAMB: And the answer?

REID: Well, in every other developed country the answer is yes, we have an obligation and we’ll do it. And the United States has never made that commitment. You know, as I say in the book, Democratic candidate for president in the election, the guy who won the campaign said that - he said providing health care for all our men and women is not some illusionary wish. It’s a moral demand on our country. And the Democratic president who said that was Woodrow Wilson in 1912. And we’ve never gotten there. But - and I argue in the book it’s because we always lose the moral argument in the kind of noise about nanny state and socialist government and insurance companies will lose or the hospital companies won’t make as much. The other countries first made the moral commitment, we’ll cover everybody, and then found a way to do it.

LAMB: The book’s done, it’s selling.

REID: Yes.

LAMB: It’s high on the charts and all that already.

REID: Yes, yes. Reviews are good for once.

LAMB: You get sick today.

REID: Yes.

LAMB: Or that shoulder is still bothering you.

REID: Yes, yes.

LAMB: Where in the world are you going to go?

REID: Well, I happen to be on the board of the University of Colorado Medical School, so I’m going to go to CU Hospital I think and get treated. You mean of the whole world?

LAMB: Yes.

REID: I have access to the great care in America, so I can get it. If I didn’t, I wouldn’t have any trouble going to the doctor in Britain. I - they treated my family great when we were in the NHS. Japanese care is excellent. But -

LAMB: How about French?

REID: French care, terrific. It was (INAUDIBLE).

LAMB: Anyplace that you went you’re a little skittish about and you’d just as soon put them lower on the list than the others?

REID: None of the rich countries. I think they’re all fine. India, I don’t think I’d want to be treated in India if I could avoid it. There’s nothing wrong with it, but I’m not sure their sanitary standards are as high. I don’t want to demean India because I got good care in India myself. I’d do it in - I’m American. I’d go to an American doctor and I’d get great care, and I have decent insurance that would pay for it. The problem is tens of millions of our fellow citizens don’t have that kind of access.

LAMB: Are you buying insurance other than the Medicare now?

REID: Yes, I am. And you know what I’m doing? Ladies and gentlemen of America, you’re subsidizing me, because I bought one of these Medicare Advantage plans. And this is - you know the history of Medicare Advantage. It was set up to prove that the private insurance companies could provide the same coverage as Medicare more efficiently. And as it turns out, they haven’t been able to and they get a subsidy from Congress. They now get about $1,400 per person per year to pay to subsidize them so that they can provide me insurance. And it turns out it’s very cheap insurance, because I’m getting subsidized by the taxpayers. Now, President Obama and the Democrats in Congress have said they’re going to end that. So I’m probably going to lose my sweet deal. But at the moment I don’t think it’s right. But I have a very good policy that’s subsidized by the taxpayers.

LAMB: We’re out of time. One year from now.

REID: Yes.

LAMB: Will there be a health care bill that has been passed in the Congress?

REID: A bill will pass and the Democrats will declare victory, but I don’t think we’re going to get to universal coverage, which is the goal. I think that’s a ways away. And as I say, it might happen state by state. So five years from now maybe we’ll have a everybody in America covered.

LAMB: Last question. Will you run for office as the way you feel about it now? And when?

REID: Yes, if I thought that we were going to do something in Colorado on a state level, I’d like to be there and work for it. Because I definitely want to see us cover everybody.

LAMB: T.R. Reid. The name of the book is The Healing of America. We thank you for joining us.

REID: I’m delighted, Brian, to be here. Thanks.