Watching Americans debate health care reform throughout 2009 called to mind the old Irish joke.
Lost in rural Ireland, the tourist asks a local, “How do I get to Ballygambema?” “Well,” replies the local, “I wouldn't start from here.”
“Here” is a system that leaves about 45 million people without insurance, millions more underinsured, insurance and pharmaceutical companies making huge profits – a system that costs the country 16 per cent of its annual national income for aggregate health outcomes no better than in countries such as Canada, whose systems cost much less.
Put another way, there are a bunch of good reasons why no other country in the world copies the U.S. health-care system, or would want to reform its system by using the “here” of U.S. health care. It's too costly and ineffective, although the system works just fine for those with first-rate insurance. (And critiquing the U.S. system can be dangerous for Canadians, since it can lead to a hear-no-evil, speak-no-evil attitude toward our own system.)
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