How Do Other Countries do Healthcare?

Andrew Heaton (0:07)

Hello, and welcome to The Political Orphanage, a home for plucky misfits and problem solvers. I'm your host, Andrew Heaton. And at this point, I hate to say it, but I am probably never going to become a doctor. I know you should never say never, who knows what tomorrow will bring. But I kind of doubt it's in the cards for Lord Uncle Heaton to become an MD.

Maybe if there's a zombie apocalypse, under that scenario, I could become some kind of grizzled low-level battlefield doctor. But if that happened, I'd like to think that I'd probably become a warlord.

We really should say that at this point, it's significantly less likely that I will become a doctor in another country, like that France thing I keep reading about. Although I do travel a decent amount, often for upstanding and legal purposes. And when I speak to foreigners, they are constantly telling me things like, Your health care system is crazy. Quit calling me chief. Why are you sitting up front in my Uber? So I observed two things about health care when I am in other countries. First, almost everyone abroad that I've ever spoken to thinks the American system is crazy. And when I go back home, and I speak to Americans who agree that it's crazy, and lust after foreign health care, they frequently have no idea how any of that works. They think it's America and socialist.

Is it? What does it look like? How does the planet do it? Do Europeans have different kinds of health care amongst themselves? Like, do Germans have a different system than the French? What about all those Asians? How about them? Do they have a different system? In short, what are our options when we look at health care systems around the world, and what can we steal from them? How the rest of the world does health care today, right here on The Political Orphanage.

My guest today is Sally Primus. She is the author of Slice of Life MD on Substack, which does deep dives and comparisons of health care systems around the world, and she is also an ophthalmologist. Hello, doctor.

Sally Primus (2:30)

Hello. Thank you for having me.

Andrew Heaton (2:32)

Delighted to have you and delighted to learn about what the world is doing. So before we jump into that, who are you?

Are you approaching health care as a doctor? Are you a policy wonk? How did you get into this?

Sally Primus (2:45)

So a little bit of all, of course, first primary, I'm a physician, and I own my own practice. And for, I've been practicing for 10 years, and in the last five, I have been running my own. And so I've really been seeing how the sausage is made, so to speak, and knowing it could be made better. I've also into this because I'm a patient. In my family, we've had some major health issues, and I have learned just how poorly the health system can be for people who don't understand it. And then I'm a little bit of a policy wonk too. I've been, the first time I went to Washington DC was when I was 17

And I got to walk on the floor with Congress and start learning how they do things. And I've been going to DC annually ever since to try to be part of the solution.

Andrew Heaton (3:27)

Great. Well, I read in your sub stack, I believe you say that studying other countries has made you less interested in ideological labels. Why is that?

Sally Primus (3:36)

Absolutely, because ideological labels are talking points that shut down critical thinking sometimes. So everything is so politicized that you say something like universal health care, and you either...

So many people just have the opinion. They will not think, they will not discuss. They just hunker down and say, this is what I was told by my granddad, dick granddad, and this is how it's going to be, and they won't have a conversation about it. And all I want to do with my content is say, hey, open up your eyes, open up your ears. There might be a lot of different ways to understand what universal health care is, or what socialized medicine or free market, any of those terms, could mean so many different things.

Andrew Heaton (4:18)

I love that.

I'm interested in making systems work better. I'm interested in problem solving, and I'm very much interested in critical thinking skills, and I don't want to shut them off. And on top of that, I'm, I don't know, I don't know that we call me a policy want, but I'm the wonkiest comedian at the party. So like if comedians are, if we're all getting drunk in the kitchen, I'm the guy that's like, well, you know, I'm Belgian what they do, I'm that guy. And I have found healthcare policy to be the most complex realm of policy I've ever looked into in about the last 15 years. And so I think being able to come up with, this is the silver bullets, just try socialism, just try free market. Like there's not gonna be any bumper sticker that can solve everything, because it's just this morass of tons of stuff. And so being able to unpack it and talk about the various levers and this affects this, this causes this, and we think this did this over here. That seems like a much more intelligent way of approaching it.