A policy expert who worked for the Obama administration explains why there’s no model for the perfect healthcare system

Sherry Glied, Dean of New York University's Robert F Wagner Graduate School of Public Service, and former assistant secretary for planning and evaluation at the Department of Health and Human Services, explains why there is no perfect healthcare system. Following is a transcript of the video.

Healthcare systems are very much a creature of their context and every healthcare system in the world is strange and messed up in its own way. Ours is just even more strange and messed up than most of them. Some of the things that are strange and messed up about our system that are uniquely so have to do with the prices in our system. One of the things that neither the Affordable Care Act nor either the Senate or House bills deal with is the fact that health care prices — the price for an MRI, the price paid to an orthopedic surgeon for replacing your knee, the price for a hospital stay —all of those prices are much, much higher in the United States — the price for a prescription drug — than the corresponding prices in other countries. If we really wanted to bring down the cost of healthcare in this country, probably we would have to think about what to do about those prices.

Now, leaving that piece of it aside, is there a best healthcare system in the world? I would say no. What I would say is that every healthcare system needs to be repaired all the time. I like to tell people the first universal health insurance system, or nearly universal health insurance system, that ever existed in the world was started by Otto von Bismarck in Germany in 1883 and Angela Merkel, who’s the Chancellor of Germany now, she’s still fixing that system. So, it’s not like it’s something that you do and then you’re done.

I hate to say this to the Congress right now because I know they’re struggling with it, but this is something where you have to keep modifying it, keep changing it, because healthcare is so extraordinarily innovative and we’re learning so much on the medical side every year, we have to have a healthcare policy system that’s equally flexible and actually can accommodate those changes. We haven’t done a very good job of that.