“Seeing modern health care from the other side, I can say that it is clearly not set up for the patient. It is frequently a poor arrangement for doctors as well, but that does not mitigate how little the system accounts for the patient's best interest. Just when you are at your weakest and least able to make all the phone calls, traverse the maze of insurance, and plead for health-care referrals is that one time when you have to — your life may depend on it.”

“Everyone should have health insurance? I say everyone should have health care. I'm not selling insurance.”

“Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that's where you see the sharp limitations of market-based health care. ”

“Believe me," Dr. Tamalet summed up, "if you wanted that operation in France, you could get it"Which is, of course, the boon and the bane of France's health care system. It offers a maximum of free choice among skillful doctors and well-equipped hospitals, with little or not waiting, at bargain-basement prices [in out-of-pocket terms to the consumer]. It's a system that enables the French to live longer and healthier lives, with zero risk of financial loss due to illness. But somebody has to pay for all that high-quality, ready-when-you-need-it care--and the patients, so far, have not been willing to do so. As a result, the major health insurance funds are all operating at a deficit, and the costs of the health care system are increasing significantly faster than the economy as a whole. That's why the doctors keep striking and the sickness funds keep negotiating and the government keeps going back to the drawing board, with a new 'major health care reform' every few years. So far, the saving grace for France's system has been the high level of efficiency, as exemplified by the 'carte vitale,' that keeps administrative costs low--much lower than in the United States.”

“In my opinion, our health care system has failed when a doctor fails to treat an illness that is treatable.”

“I don’t think the people today who start hearing voices, stop eating and sleeping, and run amuck are likely to get good treatment. Having more knowledge, better diagnostic capabilities, better medications with fewer side effects, can’t make up for the fact that most patients are being treated by doctors, therapists, and hospitals, who are operating under constraints and incentives that reward non-treatment, non-hospitalization, non-therapy, non-follow-up, non-care. Lost to follow-up is the best outcome a health insurer can hope for.”