Dear FRONTLINE,

Bravo, A nice review of several countries efforts to make healthcare available for all. In the US some are not aware that to a limited extent we already do this, with the insured paying for the uninsured through uncompensated care driving up the cost for those who can pay; although the system is clearly broken.

Part of the reason the US system is so expensive, as your report notes, is the high cost of administering our endless plans - the paperwork and entropy of the system are hurting us with the very freedoms we cherish.

A partial cure that might avoid the need for more government control and intrusion into the free market here would be for the government to support payment reforms and secure electronic health record access. A simple credit card style system to provide immediate access to records and immediate payment to providers has many advantages and few drawbacks considering the alternatives; it is time to take the administration of medical benefits into the modern era. In my opinion this can cut 5-10% of the overhead and administrative costs from the system, making care safer, more affordable and efficient while freeing up needed dollars to address those without healthcare. In the event that this is not sufficient, we will have laid the groundwork to be able to collect reliable data for future steps that may need to be taken.

Bruce Taylor
Ellicott City, Md

Dear FRONTLINE,

I am glad that the first comment was about malpractice. Although I found the documentary to be excellent I found that not mentioning the malpractice systems in those captialist societies to be a glaring ommission. The burden to prove malpractice is much higher, they have medical courts and there are also caps on payouts. I have an idea. Implement a system of no-fault malpratice or medical courts for Medicare/Caid patients only to see how our legal system would react to such a program. (the VA,mentioned in the program, already has such a system)It is absolutely needed in any type of government-run medical system and wouldbe good practice if we ever implement universal coverage.

Mike Moore
summit, nj

Dear FRONTLINE,

Sorry but the interviews linked really do not go into any significant depth on the issue. There are only two references to the subject, a rough and summary dismissal of it as an issue by Reinhardt and then an attempted comparison with Doctor Badat in London.

$6,000/year for a GP in England vs. $279,000/year for an OB/GYN in Florida IS a significant difference between the two systems, and I can't imagine how any reasonable observer can gloss over it and move on. Furthermore, the only two mentions of malpractice are for the US and England, which makes me wonder what these other countries are doing - do they even allow patients to sue? This omission makes me question the objectivity of your coverage.

Plano, Texas

Dear FRONTLINE,

The Sick Around the World broadcast is a major public service educating Americans about how other developed nations meet their populations needs for health care at less cost and with greater satisfaction and health outcomes then the US. Unfortuantely we are parochial as a nation, uninformed as to how all other developed nations provide health care in a more cost beneficial and effective manner then the US. Hopefully the program will be rebroadcast and perhaps even expanded to include the experience of other nations, as we hopefully enter a national debate after the election, as to how we too can cover everyone and as importantly, control costs, and improve health status.

Our national experince with regulation, currently characterized by the airline safety fiasco and since the Medicare 2003 reform, payment of private insurors an average of 13% more then regular Medicare per patient expenses, raises questions as to our abilty to effectively regulate the private insurance sector in health care. This concern makes a responsible single payer system such as Medicare for everyone, a preferable program for universal coverage as compared to other proposals maintaining the high health insurance

David L Rabin MD
Chevy Cahse, MD

FRONTLINE's editors respond:

For more on Medicare's payment of private insurers, read this interview with health experts Uwe Reinhardt and Tsung-mei Cheng.

Dear FRONTLINE,

As I've read several responses here, for or against changes to our current system, the bottom line still remains: either we pay now, or pay later. Like so many things going wrong in our nation, greed will always be the motivating factor. We, as a nation, seemed to have made that an inalienable right.

We have forgotten or replaced the Golden Rule, of 'Do onto others as we would want done onto us', with 'He who has the most Gold, Rules'.

Tipp City, Ohio

Dear FRONTLINE,

In January I lost my job. Just a few weeks ago my wife lost hers. We found that to continue health insurance under COBRA would cost almost $900 a month, which we cannot afford. Consequently, my wife and I and my children will have to live without health care.

All of our lives we have played by the rules and worked hard. Through no fault of our own we have lost our jobs thanks to the tanking economy. Now we find that even access to health care is impossible. America has the best health care in the world-if you can afford it. If not, its no better than a third world country. As Frontline rightly pointed out, why do we think a government-run public education system is just fine but a government run medical system is evil? Why do my kids have a right to free public education but not medical care?

Bismarck, ND

Dear FRONTLINE,

Like T.R. Reid I have experienced health care systems not only in the U.S. but also in other countries where I have lived, i.e. France and the U.K. I have also had to help relatives visiting the U.S. who needed medical attention while they were here. My experiences were mixed in all countries and often directly related to the individual doctors, nurses and hospitals involved as well as of the characteristics of the overall "system." Nevertheless the principle of health care as a normal and basic right has become embedded in many other societies, while its absence remains a negative aspect of American "exceptionalism" that to foreigners (and to me) represents a serious moral flaw, as well as dangerous economic nonsense and a failure of common sense from the perspective of public health. We should all be motivated to ensure that everyone around us should have any medical problems treated promptly, and as far as possible preempted, to minimize our own exposure to sources of disease. Universal and timely access to health care lies in our enlightened self-interest.

Martyn Roetter
Boston, Massachusetts

Dear FRONTLINE,

From the start, Mr. Reid made it clear that he was a proponent of Universal Health Care. Therefore, I did view the program thinking of that bias. However, whenever health care comes up for debate the pro's and con's always seem to be one sided. In particular, why is it never brought up that the cancer survivability rates are higher in the US than in many other countries with Universal Health Care. For example, he touts that the con's of the British NHS is "longer wait times for elective surgery". Why didn't he state that 2000-2002 Cancer Survival Rate for a Scottish Male is 40.2% while the Cancer Survival Rate for a US Male is 66.3%. I find that to be more of a "con" than an extra 4 months wait for a hip transplant. SOURCE: http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/21/ncancer121.xml

The health care debate always leaves out the fundamental issue -- All Health Care is rationed. Either by the state in a Universal Health Care systems, or by the market, as in the US.

Carl Razza
Flemington, NJ

Dear FRONTLINE,

This is exactly what is needed in this country, a debate. Your show was excellant, but more specifics need to be explained. Bankruptcy was touched upon, but this is a major outcome of American style medical care. One bankruptcy every thirty seconds in the US from healthcare bills. That is simply, immoral. I was hoping more information would be given about "end of life" care, long term nursinghome care in the US is too expensive for most families. Lot's of "little fortunes" are wiped out by end of life care in this country, again, an immoral outcome. The bottom line is, the US spends now, 17% of GDP on healthcare. It covers only 83% of the population. Most of the other modern countries in the world, spend less than 11%, and some, as low as 8%. So, National (not for profit) healthcare, wouldn't require MORE money, but less, much less! We spend some 2.2 trillion on healthcare, (Mike Leavitt HHS Sec.) so do a little math in your head, we could save something like a half TRILLION dollars simply by doing our own system. Healthcare will never be free, but the system we have now, is simply an abomination as far as cost and outcomes are concerned. Most people around the world live longer than Americans. Isn't that the ultimate test of a healthcare system? I really liked the way Taiwan went about creating their system, talking to other countries, and taking the best of their systems. We could do the same.

William Horter
Rochester, Pennsylvania

Dear FRONTLINE,

It was interesting to get a glimpse of other countries' health care systems, even if the glimpse was abbreviated, slanted and assumed that our system is poorly executed. Many questions arose while I watched:1. How much is per capita spending by the government of each country for health care? 2. How much emphasis is placed on preventative education and care in each country?3. How are students educated and how much do they pay for their education? 4. It takes American-educated doctors at least 10 years to get through the training period before they can begin to earn independent income. Do other professions take this long? Do they earn comparable salaries? Do they take on as much financial risk to do their jobs?5. Why did the program ignore the lavish expense accounts that drug companies have for promotion of their products? Catered meals, four-page full-color ads in national magazines, high-cost national advertising on television during prime time are all standard as are many other junk advertising objects flooding doctors', hospitals' and other medical tech offices, conferences and seminars. 6. In addition to comparing countries, let's take a look at good programs from state to state within our country - one of the largest in the world. Federal regulation and "control" almost always lead to increased cost, decreased efficiency and decreased incentives to improve a system such as health care. 7. Compare health statistics such as obesity, heart disease and cancer when you compare health care access and cost. A country like Japan has a cultural background that influences its citizen's longevity and health in positive ways, so that may influence the statistics of health care costs overall. 8. Why must we always look for the faults in our own country and not sing our praises? We are a vigorous, productive and generous people. There are many innovative and beneficial aspects of our health-care system and its practitioners. We deserve credit and positive attention, too.

Pacific Grove, CA

FRONTLINE's editors respond:

These graphs track what percentage of GDP the U.S., U.K., Germany, Japan and Switzerland spend on health care, and how those countries fare on such health indicators as life expectancy and infant mortality.

Dear FRONTLINE,

This was absolutely the worst Frontline I have ever seen. There was no attempt to be objective. There were no facts and no analysis. It was an hour of T. Reid asking leading questions with a big old smirk on his face when he got the answers he knew he would get before he asked. You should be ashamed to even air this piece. It really scares me when I see the number of positive responses that you have published.

Larry Duncan
Cranberry Tep., PA

Dear FRONTLINE,

The report was on target and as a family physician I think it accurately portrayed a lot of the issues that we as a nation face in the healthcare debate. In such a vast topic there was a lot that could only be touched upon but a few points are critical to frame the controversy:1. If the US is to revamp its failing system, taxes will go up - a lot. Not mentioned is that each of these countries have much higher tax rates for the average system. Think double what we pay now for the average citizen.2. Medical students in these countries go to medical school and college for free (and are even paid a living stipend)and therefore don't come out of school with the debt and need to earn big salaries that US graduates do.3. Our country is not nearly as homogeneous as most of the countries mentioned. We have a much larger underclass with a de facto two tiered system.4. Our "free market" approach to medicine (in my 30 year career) has caused good and bad. We are innovators of drugs and medical equipment but also at the mercy of for profit pharmaceutical, insurance and health system profit goals. The bottom line is that at present no one has started a healthy debate about the true costs and implications of a new health system for America. And until that occurs all of us remain at the mercy of political and financial interests.

David Neuburger
Seven Valleys, PA

Dear FRONTLINE,

I enjoyed watching Sick Around The World. I thought it was fair and balanced for the most part. However, the show left out any discussion of lawyers and medical malpractice lawsuits. Many US doctors have left some specialities or the medical field altogether because of the lawsuits or the high insurance costs. Almost all of the countries that have universal health care, severely limit lawsuits, and most ban punitive damages and class action lawsuits. The US lawyers would never go for that. Most of the health systems mentioned in the show are slowly going broke, because they are unable to control costs. There are no easy or cheap solutions. We still need to have a debate on reforming our health care system. I thought this show was a good start.

Larry Carrell
Austin, Texas

Dear FRONTLINE,

When we stop giving our elected officials free lifetime medical care, they might begin to understand what it is like to pay a lot of money, out of pocket, for insurance. As someone who is self-employed, unless I buy my own insurance, I don't have it.

It's disgraceful that this country is so unwilling to really try and figure out how to fix this system. Washington is the problem, unwilling to talk to each other, only willing to shout, walk away, or complain that we pay too many taxes. Well, taxes make a society run and this is one of the major failings of our society.

Sure we have some programs in place now, and they could be expanded to cover everyone if there was the will in Congress to do so but why should they do it? They're not directly affected by the issues. My big question is, "Why can't I receive the same quality of care that my Senators and Congresswoman gets and at the same out of pocket cost?" Bet they won't talk about that one, will they?

Health insurance companies and hospitals should not be for profit entities. Health care should be a given right to all of us in this country but with the quality of leadership we seem to elect I don't believe I'll see it in my lifetime and I, hopefully, could live another 35 or 40 years.

I don't feel that business should be paying for health insurance for their employees and families. It's hurting business. If we all paid a little more each month in taxes, we would all have health insurance that is affordable. I like the German system. Basic insurance for all. If you want special stuff, pay a little more for it. Makes sense to me.

Foster City, CA

Dear FRONTLINE,

As a primary care provider (nurse practitioner), working with the underserved/uninsured, I see, every day, the effects of a "market-driven" health care system.

As long as health care is a profit-based business, we will leave out those without funds. It is unbelievable to me that we don't feel that health care is a right, and that a business's bottom line is more important than the health of our people. I don't think universal health care will be instituted in this country until it costs too much for companies to pay for their employees' insurance. We are headed there, but not over the edge yet. I hope our presidential candidates are paying attention.

Serena W
kennewick, Washington