Why is it so hard to change the American health care system? And so much easier to change other countries’ systems?
I pondered this question recently while attending the Commonwealth Fund’s International Symposium on Health in Washington where our latest survey comparing primary care in eleven countries was discussed. I heard presentations describing changes that have been, or are being, implemented in England, France, Germany, Norway, Sweden, Switzerland, the Netherlands, Canada, Australia and New Zealand. In some cases, these are fundamental reforms in how medical care is delivered and how providers are reimbursed. Many of these countries can demonstrate real improvements in the quality of care and efficiency in their systems.
Evidence of how much more difficult it to improve this country’s system is provided by the OECD data from nineteen countries on the number of “deaths amenable to medical care,” that is deaths that could have been prevented by appropriate medical care. It is bad enough that the United States has dropped to last place – with the highest proportion of preventable deaths – of all nineteen countries measured. The data also show that all the other eighteen countries had lowered the number of preventable deaths over five years by much more than this country’s modest 4% improvement.
I would suggest that all of the following are reasons why it is easier, in some countries much easier, to reform their systems than it is to change ours:
- Their systems are so much simpler. Ours is much more complicated with our “thousand points of payment,” Medicare, Medicaid, Kaiser, the VA, the Mayo Clinic, HMOs, PPOs, and millions of employers and their different health plans.
- They already have universal coverage, so they can focus on improving quality, efficiency and cost containment without a huge ideological debate about the roles of government and the private sector.
- They have parliamentary systems, where their governments can usually win the votes of a majority of legislators and only a simple majority is needed. It is much, much harder for an American president to win enough votes in both houses of Congress, including a filibuster-proof sixty votes in the Senate, for controversial new legislation.
- Lobbies, representing special interests, are much more influential in this county.
- The power of money; elected officials in most other countries do not have to raise larger sums of money for their campaigns, and are therefore much less beholden to industries or professional groups.
- They only need a bare majority of votes in their legislatures. None of them have anything like the US Senate’s ability to filibuster.
Another factor that may also make a different is the influence of partisan news networks, especially Fox News, and of talk radio, that spread emotional and often misleading arguments, fuel populist feelings and dumb down the debate.
I should note here that the ease with which parliamentary systems can enact major reforms is not always a good thing. After World War II, Britain’s Labour government nationalized its substantial steel industry. It was then privatized (i.e. denationalized) by the next Conservative government, nationalized again in the 1960s and then denationalized in the 1970s – by which time it had been almost wiped out.
However, when we look at the difficulties our presidents since Theodore Roosevelt have had when trying to pass major health care reforms, one wonders if the uniquely American barriers to change and reform are really desirable.
Losing weight has become a favorite pastime in the West, and more and more of a preoccupation in the East also. The effects of the western diet and lifestyle have been devastating for the weight management and healthy living of almost all people touched by it. The ever increasing availability of instant, often over processed and nutrient deficient food, to the daily commutes we make from one location of idleness to another, all while sitting down in the comfort of a car have had huge impact on obesity and general lowered the amount of physical activity that a person is faced with.
Western society has a never-ending obsession with weight, while at the same time producing the most obese populations on the face of the planet with no side of subsiding the trend.
One of the most common mistake that people make that leads to weight loss failure is to chase fast weight loss solutions.
Often the loss of hair can be controlled, or even stopped in its tracks and reversed, if it is caught early enough. With recent technological advances in hair care, especially in the area of male pattern baldness, the ability to slow down the rate of hair loss, stop it, and even re-grow hair is a medical fact. Feeling that your only options are hair pieces, spray products or surgery are a thing of the past. Hormonal and medicated creams and lotions, as well as ingested medication are now available on the market that can bring back a healthy head of hair with early detection.
Women aren’t the only ones that want to look their best; men are becoming more and more conscious of their looks as far as their skin, hair, and other cosmetic issues.
In the push to get Americans vaccinated against both the seasonal flu and the swine flu, infectious disease experts and public health officials are also sounding the alarm about continuing low rates of adult vaccination for a host of other preventable diseases, as I write in my latest column.

We live in a fast paced world where food is often consumed while driving down the highway over the speed limit and watching for police vehicles. Fast food restaurants have figured this out and are stepping up to the challenge of providing healthier food to all of the patrons that go whizzing by their drive up service windows.
Many of us believe that eating salad at a restaurant is good for us. Sometimes we may be right but in most cases it is far from the truth. Most coffee shops serve a salad made from iceberg lettuce. This lettuce has no nutritional value, it is very basically fiber held together by water. In the digestive system iceberg lettuce has the nasty habit of turning into a slime that your body then has to break down.
Most of us have suffered from some sort of anxiety during our lifetime; many of us suffer from it much more often. Anxiety produces a large number of different symptoms. Some people become obsessive compulsive, washing their hands over and over again, even though they know they are already clean. Maybe they feel uneasy about something, don’t know why, and see that other people are not affected. Maybe the anxiety is about a certain thing like riding an elevator or crossing a bridge or even going to a social event.
Many people suffering from OCD will not seek help even if they have known for a long period of time that they have a problem. Since therapy is a crucial part of treating OCD, this is detrimental to the person’s healthy life. 
Hospitals have pledged accept more than $150 billion in pay cuts over the next decade.
The state of Wisconsin is planning to require a open bidding process for private health insurance companies which seek to manage the BadgerCare Plus Health Insurance Program
State Farm Health Insurance is giving America a highly needed challenge. They are challenging Americans to collectively lose 50 million pounds across the nation, according to the article “Insurance agency challenges Americans to lose weight” on wqow.com.