The answer, then, isn’t to abandon the narrative form that Cohn uses to such advantage. Rather, it’s to extend it so that it get us thinking about solutions as much as it does about problems—and the obvious place to do this is outside the United States, since that’s where alternatives to the U.S. system exist. In fact, the format of Sick almost begs for narratives about overseas health care systems. The book is basically a tour around America, with each of its eight chapters named after the place in which its story unfolds. So why not include chapters on Manchester, Malmö, and Marseilles, each of them highlighting in narrative form both the good and bad points of the British, Swedish, and French systems? At the very least, France deserves special treatment since, as Cohn correctly points out, its health care system is frequently held up as a model. How does the French system, in which waiting lines are nearly nonexistent and everyone is covered, manage to make smart and reasonable choices about cost, achieving enviable results while spending more than the chronically underfunded British system but less than the chronically inefficient American system?

Moreover, since political attacks on national health care proposals often depend on disparaging comparisons to the state-run systems of other countries (the familiar “hip replacements in Canada” trope), overseas is also the best place to see if those attacks are fair. Are waiting lines for hip replacements in Canada really out of control? Do Swedes really have to wait an average of nearly half a year for heart surgery? Do cancer patients really do poorly in Germany? Whether it’s policy or politics you’re interested in (or both), the best place to find the answers is outside the United States.

That all matters more than usual because a decade after the failure of Bill Clinton’s health care reform proposals, it’s looking more and more like national health care is going to be back on the political—and therefore the journalistic—agenda over the next few years. CEOs are increasingly antsy about rising insurance premiums, the ranks of the uninsured continue to grow, medical costs are plainly out of control, and more and more people are starting to realize that tying health care to employment makes little sense in an era where the average worker changes jobs every seven years.

In an increasingly globalized world, the war on terror has sobered us to the dangers of crippling the foreign reporting and institutional memory of all but a handful of national newspapers. Health care may be about to remind us of this in an entirely new context. Anyone for reopening that Stockholm bureau?


Kevin Drum writes the Political Animal blog for The Washington Monthly.