Author Archives: Trudy Lieberman

Trudy Lieberman

About Trudy Lieberman

Trudy Lieberman, a former president of AHCJ, is a contributing editor to the Columbia Journalism Review, where she blogs about health care and income security issues. She is a fellow at the Center for Advancing Health where she blogs about paying for health care. At Consumer Reports, she specialized in health care and health care financing. She has won more than 25 awards and five major fellowships.

Engaged-patient proponent Gruman dies

Jessie Gruman, founder of the Center for Advancing Health, died Monday. She had spent more than 20 years there focused on getting people engaged in their health care from the patient perspective. Longtime AHCJ member Trudy Lieberman, who has spent the last couple of years as a fellow at the center, offers a tribute.

Jessie Gruman, who died Monday, was one of the finest human beings I have ever known. Her loss will be keenly felt by all of us in the health and medical communities who knew her, worked with her, sought her guidance, tried to emulate what she stood for – honesty and integrity come to mind – and who were, most of all, her friends.

Jessie had been dealt a bad hand healthwise, having suffered cancer as a young adult that returned several times over the years. In the last year, when she told us she had metastatic lung cancer, we knew time was short. But as Kate Lorig, one of the William Ziff Fellows at Jessie’s Center for Advancing Health, put it, “Jessie lived until she died.”

Continue reading

U.S., Canadian health care systems share some challenges

Lieberman recently returned from a monthlong visit to Canada as a Fulbright Senior Specialist. She lectured on the American health care system and learned much about how Canadians get their medical care. She interviewed hospital executives, physicians, academic experts, former health ministers, reporters covering health care, and ordinary citizens. Lieberman also toured hospitals and long-term care facilities. This is the second of four posts reporting on that visit. Previously, Lieberman explained misconceptions that Canadians have about the U.S. health care system and the differences in the two systems.

canada-flagBoth countries are historically and practically steeped in fee-for-service medicine, and much of the power to control prices rests in the hands of the medical establishment. While provincial governments have periodic negotiations with medical and hospital groups, and there are global budgets for hospitals that try to constrain costs, the system is relatively expensive.

In 2011, the U.S. won the dubious honor of having the most expensive system in the world, spending about $8,500 per capita. Canada spent about $4,500, making it the third most expensive country among a group of OECD-developed nations.

Still, that number needs perspective. In 1970, a few years before Canada implemented its national health insurance system, both countries were spending about 7 percent of the GDP on health care. Thirty-nine years later the U.S. was spending 50 percent more of its national income on health care, leaving its patients with the highest out-of-pocket expenses in the world. When I explained the high out-of-pocket expenses to Canadians, that notion simply did not compute. There is some talk about imposing copays for some services as a way to help both the federal and provincial governments save money. But the idea of making people pay 50 percent of a bill or a family paying $13,000 out of pocket before insurance benefits kick in is wildly unpopular. Continue reading

Comparing U.S., Canadian health care systems

Lieberman recently returned from a monthlong visit to Canada as a Fulbright Senior Specialist, where she lectured on the American health care system and learned much about how Canadians get their medical care. She interviewed hospital executives, physicians, academic experts, former health ministers, reporters covering health care, and ordinary citizens. Lieberman also toured hospitals and long-term care facilities. This is the first of four posts reporting on that visit.

canada-flagOne thing Americans and Canadians can agree on is that we don’t want each other’s health care systems. In truth, most Americans don’t know how Canada’s system works and Canadians don’t know much about the U.S. system.

What Americans know has come mainly from the negative talking points of politicians and others who have argued for years against national health insurance. Two decades ago The New York Times reported that Canadian women had to wait for Pap smears, a point vigorously refuted by the Canadian ambassador who shot back in a letter to the Times editor: “You, and Americans generally, are free to decide whatever health care system to choose, avoid or adapt, but the choice is not assisted by opinions unrelated to fact.”

Yes, there are waiting lists for some services – as I will explain in another post – but, no, Canadians are not coming across the border in droves to get American care.

There’s misinformation among Canadians, too. Wherever I went, Canadians told me they thought, mostly based on what they said they heard on CNN and Fox, that Obamacare meant America was getting universal health coverage like their country has.

Continue reading