health care systems at home and abroad

PLoS has some interesting dialogue about what will increasingly become an important discussion. Will global health be mostly driven by a private, profit driven model? Or, will it largely be funded and organized by public sector national governments? My problem here is that this dialogue is being driven by us, the wealthy donors, rather than the countries that will ultimately have ownership over the systems. Shouldn't we be letting the developing nations create systems which will work for them? Why should we dictate the way they organize their health systems? It stinks of subtle colonialism.

Back on the home front, in a recent blog post Paul Farmer discusses some of the opportunities and challenges Obama will face while trying to overhaul the crippled US health care system. Money quote:

"Listening to Drs. Kim, Berwick, and Jarman reflect on what ought to be done gave me hope. They’ve made the right diagnosis—all agreed that it’s the system itself that is broken and tinkering won’t fix it—and had some smart prescriptions. Policies and plans won’t suffice, warned Jim Kim, who’s made a long study of the gap between aspirations and the care that is actually delivered. We need a social strategy, one that will engage Americans eager for a major overhaul of the system."

"... Are Americans today really opposed to FDR-style social insurance? We can learn something from the British on this score (OK, maybe not as regards dental plans) and from groups like IHI and visionaries like Kim. Patients (and who is not one, as some point?) and doctors alike may need to dig deep to find our inner New Dealers, but it’s high time we built a real social movement for a proper health service worthy of the American people."

Finally, the American Prospect has a great article discussing the cost of not seriously reforming our broken system. With leadership from Tom Daschel, Jeanne Lambrew, and Obama, hopefully this time around we'll have a better shot at securing the right of equitable health care for all Americans.