This is a very informative look at the approach toward Afghanistan that is being taken by General McChrystal. He is a very disciplined man and is taking great personal sacrifice to serve our country.

I am a very big fan of the PBS program FRONTLINE which usually airs each Tuesday evening at 8 PM.  As I was researching for this past presidential election and the issues we are all facing as a country, I found FRONTLINE to be an invaluable resource.  In April 2008, they did a wonderful piece on the leading “national” health care programs in 5 wealthy and modern countries: UK, Germany, Switzerland, Japan, & Taiwan.  As the House and Senate are now focusing their efforts on putting bills forward in this direction, I thought it was appropriate to dust this piece off to revisit and educate us in how the rest of the world advanced ahead of the US in successful health programs.  Below are the necessary links, and the whole episode can be viewed for free online.

Here is the site: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Here is the transcript: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/script.html

Here is the introduction:

In Sick Around the World, FRONTLINE teams up with veteran Washington Post foreign correspondent T.R. Reid to find out how five other capitalist democracies — the United Kingdom, Japan, Germany, Taiwan and Switzerland — deliver health care, and what the United States might learn from their successes and their failures.

Reid’s first stop is the U.K., where the government-run National Health Service (NHS) is funded through taxes. “Every single person who’s born in the U.K. will use the NHS,” says Whittington Hospital CEO David Sloman, “and none of them will be presented a bill at any point during that time.” Often dismissed in America as “socialized medicine,” the NHS is now trying some free-market tactics like “pay-for-performance,” where doctors are paid more if they get good results controlling chronic diseases like diabetes. And now patients can choose where they go for medical procedures, forcing hospitals to compete head to head.

While such initiatives have helped reduce waiting times for elective surgeries, Times of London health editor Nigel Hawkes thinks the NHS hasn’t made enough progress. “We’re now in a world in which people are much more demanding, and I think that the NHS is not very effective at delivering in that modern, market-orientated world.”

Reid reports next from Japan, which boasts the second largest economy and the best health statistics in the world. The Japanese go to the doctor three times as often as Americans, have more than twice as many MRI scans, use more drugs, and spend more days in the hospital. Yet Japan spends about half as much on health care per capita as the United States.

One secret to Japan’s success? By law, everyone must buy health insurance — either through an employer or a community plan — and, unlike in the U.S., insurers cannot turn down a patient for a pre-existing illness, nor are they allowed to make a profit.

Reid’s journey then takes him to Germany, the country that invented the concept of a national health care system. For its 80 million people, Germany offers universal health care, including medical, dental, mental health, homeopathy and spa treatment. Professor Karl Lauterbach, a member of the German parliament, describes it as “a system where the rich pay for the poor and where the ill are covered by the healthy.” As they do in Japan, medical providers must charge standard prices. This keeps costs down, but it also means physicians in Germany earn between half and two-thirds as much as their U.S. counterparts.

In the 1990s, Taiwan researched many health care systems before settling on one where the government collects the money and pays providers. But the delivery of health care is left to the market. Every person in Taiwan has a “smart card” containing all of his or her relevant health information, and bills are paid automatically. But the Taiwanese are spending too little to sustain their health care system, according to Princeton’s Tsung-mei Cheng, who advised the Taiwanese government. “As we speak, the government is borrowing from banks to pay what there isn’t enough to pay the providers,” she told FRONTLINE.

Reid’s last stop is Switzerland, a country which, like Taiwan, set out to reform a system that did not cover all its citizens. In 1994, a national referendum approved a law called LAMal (”the sickness”), which set up a universal health care system that, among other things, restricted insurance companies from making a profit on basic medical care. The Swiss example shows health care reform is possible, even in a highly capitalist country with powerful insurance and pharmaceutical companies.

Today, Swiss politicians from the right and left enthusiastically support universal health care. “Everybody has a right to health care,” says Pascal Couchepin, the current president of Switzerland. “It is a profound need for people to be sure that if they are struck by destiny … they can have a good health system.”

Here are some pics taken from our time in the city, about a half mile down looking at Times Square. Suppose I can check that experience off the list. We were standing most of the night on around the corner of 53rd and 7th, I think about 4 hours. It was myself, Kalila, her brother Zach, and his girlfriend Krystal. It would have really been boring had Zach not downloaded Monopoly on his cell phone, which we played for about 3 and 1/2 hours. Oh yeah, and 5 minutes before the ball drops, an 8 foot circle emerged next to us around the guy standing next to Zach. It took the guy a second, but then he ralphed into the cleared circle. Needless to say, no one was expecting that, especially 5 minutes before midnight. It began to reek immediately, causing a very unpleasant celebration. We hoofed it out of there right after the ball dropped and took refuge in the closest Famous Original Ray’s Pizza place. Along the way back to Port Authority, I was able to get a snapshot of the Ed Sullivan Theatre, home of the Late Show with David Letterman, and the Laugh Factory, scene of Michael Richards’ (”Kramer” from Seinfeld) infamous tyrade. The link to the album for the entire event is here.