we'll visit great britain, taiwan and switzerland to find out what those nations are doing right and they're doing wrong. we'll show you some really interesting innovation going on back here in america. in one of the most poorest, crime-ridden cities in the nation. but, first, let's talk about the one thing americans are certain is bad. government-run health departmentcare. across the atlantic in great brain t britain, is the nation's health service a devil, as some say? let's take a look. during america's debate over health care reform, britain said the system was bureaucracy to

those in need. were they right? britain does have a system that is close to socialized medicine as any rich country gets. the government pays for everything, owns most of the hospitals and pays most of the doctors. compared to americans, the brits have longer life tiles and a health care system that consistently ranks higher on every measure. all of this, and everyone's care is covered. no pamts to doctors, no co-pays, no fees, nothing. at king's college hospital in london, drmt nigel heaton performs a liver transplant surgery with a donor. the liver is cut in half with one part for the younger brother

and the other part staying in the donor. >> the liver is a remarkable organ. you can take pieces of the liver and it will function perfectly well. >> this transplant costs 10s of thousands of dollars. but the patient doesn't pay a thing. >> when pashltients come to us, only evaluate them as if they need a transplant. the cost doesn't come into play. >> nobody pays a doctor's bill in the nhs. people will go their entire life without paying a single up front cross. >> dr. claire is the chair of britain's royal college of general practitioners. >> our health service is fair. irrespective of what you can afford, you will be able to access health care.

that is what we require. that is what is a fair and honest health system. >> compare that to the u.s. where an estimated 137,000 people died over seven years because they were uninsured. of course, the brits do pay for their health care in another way. with taxes. the sales tax is a whopping 20%. and income taxes are as high as 50%. all of that money feeds a health care bohemoth with well over one million people on the payroll. you would think it would be inefficient. >> that seems sensible, right? the private sector can do things more efficiently? it doesn't work in health care. t.r. reed toured the world's health care systems for his recent book, "the healing of america". the least efficient payers in the world of the insurance

payers. it's a 30% tax on every dollar you spend on health care. britain is totally socialized medicine. 5%. canada is private doctors and public payers, 6%. so it turns out, in health care, governments are doing this more efficiently than our private sector. >> one reason, private insurers in america spend more money on private costs like ads and reviewing claims to help them stay profitable. another way governments can be more e fisfficient is by having more coordinated approach to health care. for instance, the nhs rewards primary care doctors with bonuses for achieving certain measures of good health. like getti inting patients to q smoking. that's money well spent because fewer sick people means lower

health care costs for the whole country. in the united states, we spend around $8500. >> what about the argument that the only way to make the system work -- the only way to get costs under control is to be -- you've got to be a little cruel. you've got to say we will pay for this and we won't pay for that. >> oh, that's absolutely true. the british health minister said to me we cover everybody. but we don't cover every thing. >> not covering everything. the so called rationing of care is the british system's most controversial element. >> we do find ourselves up against everybody. it's a real challenge. >> andrew dillen is the chief executive for clinical excellence known as "nice" for short.

>> this isn't about politics. it's not about money. it's about the evidence for what works best. the clinical studies and the other research that's done in this country and across the worlt. >> it includes doctors and patients. and the decision-making process is transparent. the public can weigh in. but the policy's nice vendors involve some of the most moralizing medicine. like whetherer to fund a cancer drug. >> in the end, there's nothing else in life like facing det. we have to be sensitive to that. but equally, we need to make sure that we're keeping your eyes on everything else. that we need the nhs to do for us. >> i've got monday, the 20th. >> another controversial aspect? long wait times for certain procedures.

in the early '90s, you could wait more than a year. the nhs rule book regulates that. britain's government-run system provides good care for all and is more cost effective than one might imagine. so is there a way to provide care for all with less government? when we come back, we'll visit a country that went from almost half of its population from being uninsured to nearly full coverage in less than a year and without breaking the bank. has helped fund economic and environmental recovery. long-term, bp's made a five hundred million dollar commitment to support scientists studying the environment. and the gulf is open for business - the beaches are beautiful, the seafood is delicious. last year, many areas even reported record tourism seasons.

the progress continues... but that doesn't mean our job is done. we're still committed to seeing this through. here at the hutchison household. but one dark stormy evening... there were two things i could tell: she needed a good meal and a good family. so we gave her what our other cats love, purina cat chow complete. it's the best because it has something for all of our cats! and after a couple of weeks she was healthy, happy, and definitely part of the family. we're so lucky that lucy picked us. [ female announcer ] purina cat chow complete. always there for you. [ female announcer ] purina cat chow complete. with two times the points onake lunch dining in restaurants,ch? you may find yourself asking

why not, a lot. chase sapphire preferred. there's more to enjoy. ♪ pop goes the world ♪ it goes something like this ♪ everybody here is a friend of mine ♪ ♪ everybody, tell me, have you heard? ♪ [ female announcer ] pop in a whole new kind of clean with new tide pods... a powerful three-in-one detergent that cleans, brightens, and fights stains. just one removes more stains than the 6 next leading pacs combined. pop in. stand out.

i tell mike what i can spend. i do my best to make that work. we're driving safely. and sue saved money on brakes. now that's personal pricing. what would happen if a country were given a blank slate to design its health care system. if it could choose from any nation in the world, which one would it imitate? taiwan had that unique opportunity. and its story provides eye-opening lessons for the united states.

tiger economies like taiwan in south korea skyrocketed out of poverty in the 1980s and '90s. taiwan was growing at 7% a year, joining the ranks of rich countries in no time. >> the country was getting richer. however, the health care insurance system was not all good at the time. >> so mae chang says 41% had no health insurance. >> we paid out of pocket. for the really poor, you paid a lot. >> so taiwan decided to reform its system of care from the ground up. william chow is one of the world's leading health care gurus. >> we invite experts from all

the whole range of countries so we can throw out the lessons and their experience. for taiwan. >> reporter: the panel considered the u.s. its close geopolitical ally as a model for health care. they were not impressed. >> you can learn whatnot to do from the united states rather than learn what to do. >> reporter: they also looked at great britain. but the brit's government-run system was producing long wait times. >> bureaucracy is not the best and the most efficient way of running operations. >> reporter: then there was germany which had private insurance. but they had so many different funds, their administrative costs were just too high. so taiwan went with a single pair insurance model. where there's only one insurer in the market. the government. they combined that with private doctors and hospitals to avoid too much bureaucracy. the system looks like american medicare.

only it's for everyone, not just the elderly. taiwan's president at the time made a huge push to implement the plan quickly in 1995. mir ak louse taiwan has a highld health care system. what's more, it's a rock star when it comes to holding down costs. the taiwanese spend just 7% of their economy on health care. that's a small sum compared to our 17%. the government drives a hard bargain on fees with providers. and taiwan can monitor its spending with this cool dwis. device. the smart card. you swipe it any time you go to the doctor. he can pull up your recent medical history. and when you're done, he'll have a record of that day's visit. and then he'll send an estimate

for your bill to the government right away. so officials know how much has been spent at any given time. compare that to medicare in the u.s., which can only estimate its spending levels two years after the fact. >> in taiwan, all of that is recorded. on a daily basis. >> reporter: but wouldn't all of that make it hard to see the doctor? surprisingly, that's not the case. americans go to the doctor four times a year on average. the taiwanese go 14 times a year. >> and they stay in hospitals much longer. the average length of stay is 10 days. in the u.s., 5 days. >> so how do the taiwanese provide all of that health care for such low costs? one way, the doctors work their tails off. dr. gary lin's primary care

clinic is open 11 hours a day, 6 days a week. >> we might take more than 200 patients a day. >> the fees are very low. dr. lin gets only $14 for each primary care visit. his colleague in the visit makes a hundred dollars per patient. taiwan's legislature just raised the insurance premiums people pay to get more money into the system. but don't expect politicians to do something unpopular like that very often. >> in the 16-year history, prices were raised twice. just twice. >> reporter: no matter which health care system you visit, politics always comes into play. the next country we're going to visit has some remarkably similar politics to our own f. own. it passed a version of obama care 18 years ago. has it worked out? or is it a disaster.

find out when we come back. s, c, verizon 4g lte phone. the global ready one ? yeah, but you won't need... ♪ hajimemashite. hajimemashite. hajimemashite. you guys like football ? thank you so much. i'm stoked. you stoked ? totally. ... and he says, "under the mattress." souse le matelas. ( laughter ) why's the new guy sending me emails from paris ? paris, france ? verizon's 4g lte devices are global-ready. plus, global data for just $25. only from verizon.

did you know honey nut cheerios is america's favorite cereal? oh, you're good! hey, did you know that honey nut cheerios is... oh you too! ooh, hey america's favorite cereal is... honey nut cheerios ok then off to iceland! honey nut cheerios this is new york state. we built the first railway, the first trade route to the west, the greatest empires. then, some said, we lost our edge. well today, there's a new new york state. one that's working to attract businesses and create jobs. a place where innovation meets determination... and businesses lead the world. the new new york works for business. find out how it can work for yours at thenewny.com.

taiwan showed us that public insurance can work. but let's face it. government insurance for all is probably not a popular campaign slogan for many americans right now. so we searched the world for a completely private model.

no government insurance or state-run hospitals. we found one in europe, of all places. imagine an alternate universe where a version of obama care has been the law of the land for almost two decades. no, you haven't entered the twilight zone. you're in switzerland. >> now, at the congress, you want us to act and act now. >> right around the time president clinton was pushing health care reform in the 1990s, ruth dryfues was pushing her own health care reform. >> will we have to pay for the treatment of the drug addicts? will we have to pay for treatment of obese people? will we have to pay for abortion? >> swit switzerland is not your typical european welfare state. it's extremely business-friendly

and always gone its own weight in health care with private providers and private insurance. that's actually not so rare according to journalist t.r. reed. >> one of the things that m americans believe about health care around the world is that other rich countries in the world all have socialized medicine s. that true? >> no, that's bologna. some countries to have the care and provide it. but a lot of rich germany, switzerland, japan, cover everybody in the private system. private hospitals, private docs, priva p . >> so the swiss were getting fed up with their private insurance system in the early 1990s. costs were rising. premiums were disproportionately higher and those with preexisting conditions had trouble getting coverage. son-in-law were foregoing insurance all together. >> the people were flying out of

the insurance so we had to stop this. >> dryfues pushed for a law that required everyone to buy insurance. to give subsidies to the poor and stop insurance companies from rejecting people for their medical history. sound familiar? that's exactly what president obama's law would do. but in switzerland, it was an uphill battle. the law passed government with 52% of the vote. >> nobody was really happy but everybody could accept. >> so how is the swiss version of president obama's law fair? almost 20 years after it was put in place. >> i'll show you the x-rays. >> reporter: the swiss enjoy one of the longest life expectancies in the world. >> we have an extremely comfortable system. i mean, the access is easy. you don't have to wait.

>> donald was the swiss secretary of health from 1991 to 2009. >> hospitals have become more like five-star hotels offering health departmentcare. . >> reporter: insurance companies were already banned from making a profit on bay e basic health coverage. under the new law, they had to expand that basic package. covering even more procedures. >> even very expensive pharmaceuticals are paid by the insurance plans and have to be paid. >> reporter: the swiss system is world-renowned for the choice it provides its users. >> i chose the doctor i wanted to go to. i went there and it was seemless. >> we caught unwith jocelyn mills. she was expecting at the time. she could go see a specialist right away without waitiing for a referral from her physician like in the u.s. >> i always waited three hours

in an over-crowded waiting room to see somebody than to see a specialist, if anything was wrong. so i don't have that here. >> another bonus? health insurance isn't linked to employment. plus, you can change your insurer every year if you want. >> the choice is such that is sometimes confusing. you know, you're having each time you're living a choice of probably a hundred or two plans. >> experts worry that the swiss don't reap the cost savings from their insurance choices because there are so many of them. that might explain why health care costs in switzerland are still very high. 11% of gdp. >> you can no make it perfect. but you can make a perfectible law. and i would say any law has negative side effects.

and this is ourless soon. we are still working to make this law better. >> health departmentcare costs are rising all over the world. but in the united states, health care is almost twice as expensive as everywhere else. why is that? we'll explore that question next. but they can be really well thexpensive.ted a puppy, so to save money i just found them a possum. dad, i think he's dead. probably just playin' possum. sfx: possum hisses there he is. there's an easier way to save. geico. fifteen minutes could save you fifteen percent or more on car insurance. about how older people are becoming more and more antisocial, so i was really aggressive with my parents about joining facebook. my parents are up to 19 friends now?

so sad. ♪ i have 687 friends. this is living. what!? that is not a real puppy. that's too small to be a real puppy. [ male announcer ] venza. from toyota. nature valley trail mix bars are made with real ingredients you can see. like whole roasted nuts, chewy granola, and real fruit. nature valley trail mix bars. 100% natural. 100% delicious. 100% natural. last season was the gulf's best tourism season in years. in florida we had more suntans... in alabama we had more beautiful blooms... in mississippi we had more good times...

in louisiana we had more fun on the water. last season we broke all kinds of records on the gulf. this year we are out to do even better... and now is a great time to start. our beatches are even more relaxing... the fishing's great. so pick your favorite spot on the gulf... and come on down. brought to you by bp and all of us who call the gulf home.

there is no greater threat to the american dream than the rising cost of health care. it already takes up around 1/5 of our economy. by 2050, it could consume almost 2/5, crowding out vital spending on education infrastructure, science and technology not to mention the military and social security. how on earth did we get here? and what can we do about it? >> a big part of the underpinnings of the system is someone kidding ourselves. there is no one paying for this except all of us. >> the c.e.o. of the game show network is an unlikely agitator in the health care debate. he got involved after his father went to the hospital with pneumonia and died from an infection while he was there.

>> i saw a hospital with less impressive technology than my dry cleaner house. a couple times, my father was taken for procedures meant for other patients. there's trash on the floor almost everywhere. you're endlessly dealing with personnel that don't know about your case. this is the intensive care unit. >> this fate of goldhill's father is all too common. every year, an estimated 100,000 americans die from an infection they got in a hospital. >> once i got beyond obviously the personal elements, i thought there's something very unusual about this. just in the scope of how the world works today. and as i spent time thinking about health care, i began thinking about the lack of real acountability to customers and the incentives that really dominate the industry. >> unlike many customers, patients don't really pay their own bill. it's a private insurance company or the government that pays. in the case of goldhill's father, medicare picked upmost of the tab.

which was over $600,000 before hospital discount. >> to all of us, that seems terrific. if medicare had said to my mother you pay the bill and the hospital had come to my mother and said here's what we're charging you for killing your husband. the collection would have been zero. there's no way my mother would have paid that bill. >> goldhill summed up his view. "how american health care killed my father." he says if patients spent more of their own money, prices would come down. >> the whole idea of using insurance to pay for health care is wrochk. >> the problem with insurance is that it's very costly. it's a very costly way to finance anything. it's never used outside of health care. i think if you look at the health care system, what you see

is a system that lacks any of the normal disciplines we see in anything else. >> so give me an example of some place where you find market sources can actually work the way you're describing? >> well, you know, around the fringes of health care, we have things that look like health care that aren't in the health care economy. they're not insured. we see it in certain types of cosmetic dental surgery. we see it in medicine for pets. and what we see in all of those markets are urkt markets. >> take lasik eye surgery. prices have dropped considerably despite all of the expensive equipment and well-trained specialists. lasik doctors compete for your business. >> ask a very simple question of your viewers. how many of them know the safest hospital? why is there nobody with a billboard saying don't go to downtown, go to uptown.

downtown will kill you. we've been through 45 years of this and look at the result. >> goldhill's solution? insurance should only cover catastrophic events, serious elnesses. while routine care, like doctor's appointments should be paid for by a health savings account that everyone controls. >> we have to care about the cost because what we're doing in medicine is destroying the american dream. >> a surgeon, a staff writer for the new yorker and the author of several best-selling books on medicine. hep agrees with goldhill that the market in health care isn't working. but he says there's an important factor to consider. >> the sick acount for most of the costs. 5% of the patients are 50% of the costs. and these are folks for whom the bills are 40 and $50,000.

figuring out how to treat the sickest of the sick is the trillion dollar question. >> the average patient who is elderly and on medicare has more than 10 specialist physicians by their last year of their life. and if you've ever taken care of an elderly parent, you know how much you want to tear your hair out. that they just woent tan't talk each other. >> what the government needs is a more coordinated approach to care. some doctors tend to prescribe too much medicine. that's less efficient. but it is more profitable. >> we have focused on getting the best drugs, the best devices, the best special iszs. we think very little about how we fit it together vmt. >> what is wrong with prescribing lots of procedures? i think americans think of this as a case of surely more is better. why not have more m.r.i.s?

>> yeah, more at the right time is better. but we're doing 70 million ct scans in the population of 300 million people. doing more of these kinds of tests end up raising maybe there's a spot there, maybe there's not, that lead to more surgery and more risks. >> a more coordinated approach to care may reduce needless testing and lower costs. president obama's health care law encourages more coordination, giving funding to providers to come up with more efficient and effective ways to provide care. >> the concentration on the 5% of pashlts w of patients is unleashing enormous innovations, enormous reductions and costs. i think woe're about to enter a period of very rapid change.

>> when we come back, we'll show you a bold example of change. a health care experiment in one of the roughest cities in the country. and it's working. rint direct co. so i can get three times the coverage. [ chirp ] [ manager 2 ] it's like working in a giant sandbox with all these huge toys. and with the fastest push-to-talk... i can keep track of them all. [ chirp ] [ chirp ] [ male announcer ] upgrade to the new "done." with access to the fastest push-to-talk and three times the coverage. now when you buy one kyocera duracore rugged phone, for $49.99, you'll get four free. visit a sprint store, or call 855-878-4biz. [ chirp ] he speaks a weird language... [ gargling ] drinks green stuff. he says he's from albuquerque. i'm not buying it. i mean, just look at him. and one more thing -- he has a spaceship. [ whirring ] the evidence doesn't lie. my dad's an alien. [ male announcer ] the highly advanced audi a6. named to car and driver's 10 best. experience the summer of audi event

and get exceptional values on the audi you've always wanted. experience the summer of audi event how did the nba become the hottest league on the planet? by building on the cisco intelligent network they're able to serve up live video, and instant replays, creating fans from berlin to beijing. what can we help you build? nice shot kid. the nba around the world built by the only company that could. cisco. with two times the points onake lunch dining in restaurants,ch? you may find yourself asking why not, a lot. chase sapphire preferred.

there's more to enjoy. ♪ pop goes the world ♪ it goes something like this ♪ everybody here is a friend of mine ♪ ♪ everybody, tell me, have you heard? ♪ [ female announcer ] pop in a whole new kind of clean with new tide pods... a powerful three-in-one detergent that cleans, brightens, and fights stains. just one removes more stains than the 6 next leading pacs combined. pop in. stand out. it's your teenager's first varsity game. it isn't just your annual exam. it's your daughter's wedding. did you know with your health insurance you may now have some preventive benefits with no co-pays or out-of-pocket costs? it isn't just your cholesterol screening. it's all the tomorrows you're looking forward to.

learn more at healthcare.gov. it's all the tomorrows you're looking forward to. by what's getting done. measure commitment the twenty billion dollars bp committed has helped fund economic and environmental recovery. long-term, bp's made a five hundred million dollar commitment to support scientists studying the environment. and the gulf is open for business - the beaches are beautiful, the seafood is delicious. last year, many areas even reported record tourism seasons. the progress continues... but that doesn't mean our job is done. we're still committed to seeing this through. i'm don lemon. i want to get you up to speed on the headlines. beginning with a deadly disease. some kind of illness that doctors have never seen before and so far can't treat it and they can't stop it. tlooegs 61 children are dead.

all of them in cambodia. medical officials are worried about it spreading to other countries. libya people voting freely and openly. it is the first exercise since the fall of ga gadhafi waiting in long lines to vote at polling stations. serena williams has won her fifth wimbledon title. winning in three sets today, it was the 14th major championship for williams. i'm don lemon, i'll see you back here at 10:00 p.m. eastern. we now return to a cnn special "gps: saving health care." skyrocketing health care costs have created what some say is the biggest economic bubbles in american history. doing nothing could lead to dire

consequences. that's why some providers are experimenting with innovative approaches to health care before it's too late. >> we're spending a whole lot in our country for health care and we're not getting our money's worth. and this's a tragedy. >> dr. jeffrey brenner is on the front lines trying to reform a health care system that has been called hopelessly broken. >> we spend twice as much as another industrialized country. and we cover fewer people in our country. >> tackling this disconnect in camden, new jersey. one of america's poorest cities. he's been a family physician here for 11 years. his mission started on this street in 2001. with a gunshot. an unremarkable sound in camden which has one of the highe eses murder rates in the country. >> i was sitting in my desk and shots rang out. >> no one was doing anything.

>> i started yelling at one of the sergeants, you know, why didn't you do anything? and he said we didn't want to dislodge the bullet. which was a complete blow off and just showed such lack of compassion and lack of concern for a dignity of people's lives. >> it was a remarkable product of camden. a senior at rutgers university who had talked about being mayor. his death reformed the camden police department. but he says it was mired and dysfunctioned. >> i threw my hands up and said i give up on helping to reform the police department in camden. but i think i can take a lot of the ideas that i learned in the process and bring them to health care. >> brenna had been mapping crime data to locate the city's most violent corners just like the new york city police department did in the '90s producing great success.

he started identifying hot spots where the costs were the highest. using medical billing records, brenner found that just 1% of the patients accounted for 30% of health care costs in camden. and that's not all he discovered about the city's three hospitals. >> we learned that someone went 113 times in one year, someone went 325 times in five years. they found someone who went 450 times in one year. >> these were people with cor complicated medical illnesses. one patient alone racked up $3.5 million. >> no one is being paid and incentivized to pay attention to them. >> what's more? camden's problem is america's problem. gist 5% of americans accounted for half of our nation's health care costs in 2009.

this is perhaps the crucial statistic to understand. if brenner could crack his city's cost crisis, maybe his model could help the country. >> we've met with his primary care doc. >> he founded the camden coalition of health care providers. they treat the city's worst of the worst one patient at a time. >> every day the group gets data from all of the city's emergency rooms in realtime. that's the fwiirst time this ha ever happened anywhere in america. jason, a former teacher and registered nurse is making a house call. she was admitted to the hospital algt times last year mostly for respiratory distress.

she literally has a bucket full of medication. >> jason and his colleagues got a ventilator placed in her heart. >> she saw her pulmonariologist. you look great. >> l yurks dia has staid out of the e.r. for 70 days and counting. but the sick are hard to reach. some don't have phones. so jason and his team do routine drive byes. >> jason from the coalition. how are you doing? >> okay. >> earl is one of the biggest e.r. use rs in camden. he suffers from ep lilepsy and heart failure.

>> the three amigioes. that's the team he uses to describe the team that visited him earlier in the day. despite the long odds, earl's hospitalizations have decreased by 30%. brener found that many expensive patients like earl were concentrated in certain areas of the city. one building alone. a subsidized apartment tower accounted for $12 million in hospital costs over 5 years. >> and the patients were appa appalled that someone made that much money and they still felt so sick and it was so hard for them to access services. >> so brenner set up a clinic right in the building so that the residents can get preventive care. >> this is not a story of bad patients. it's a story of a broken system that has irrational incentives and misaligned incentives so

that patients aren't getting their needs met. >> brenner suggests that early evidence suggests his experiment is working. hospital use is down for participating pashlts. his model is being replicated to new jersey and newark. it was signed last august by governor chris christie. >> we're rewarded pr e for doing the right thing. >> now, here's the problem. it ee's essentially taking away business from hospitalings and doctors. that threatens the profits of the most of the established players in health care. when we speak of reducing health care costs, remember, fur many powerful interests, that

translates into taking away my business. but if brenner succeeds. >> it would make the rest of the country look silly. it really shows that this is not a technical probable, but it's a political, spiritual and moral problem. >> wen we come back, i'll give you my thoughts on the health care debate. stay with us. until i got a job in the big apple. adjusting to city life was hard for me. and becoming a fulltime indoor cat wasn't easy for atti. but we had each other and he had purina cat chow indoor. he absolutely loved it. and i knew he was getting everything he needed to stay healthy indoors. and after a couple of weeks, i knew we were finally home! [ female announcer ] purina cat chow indoor. always there for you.

in here, every powerful collaboration is backed by an equally powerful and secure cloud. that cloud is in the network, so it can deliver all the power of the network itself. bringing people together to develop the best ideas -- and providing the apps and computing power to make new ideas real. it's the cloud from at&t. with new ways to work together, business works better. ♪

with new ways to work together, business works better. this is new york state. we built the first railway, the first trade route to the west, the greatest empires. then, some said, we lost our edge. well today, there's a new new york state. one that's working to attract businesses and create jobs. a place where innovation meets determination... and businesses lead the world. the new new york works for business. find out how it can work for yours at thenewny.com.

after taking this tour of the globe and america, what is the best way to reform american health care? i'm reminded of the old irish joke. a couple is lost in the irish country side and stops to ask a local the best way to get to dublin. well, i wouldn't start from here, he replies.

america's health care system is really a mess. it is partly free enterprise, partly state subsidized and overall, highly inefficient in delivering quality care at a reasonable price. let me step back before making specific suggestions and outline a few general principles. i am a big fan of the free mark. i think it has an almost magical aebl ability to allocate resources. but because it is so powerful, in places where it doesn't work well, it can cause huge distortions. the nobel prize-winning economist kenneth arrow outlined in the 1960s why markets don't work really well when it comes to health care. he explained people don't know when they will need health care. and that when they do need it, the cost is often prohibitive. that means you need some kind of insurance or a government-run system.

now, if we decided as a society that it is okay that when people suddenly discovered they needed health care they can get it if they pay for it, that would work. but it would mean that the vast majority of americans wouldn't be able to pay for that triple bypass or hip replacement. the market would work just as it works for bmw cars. people who can afford it, get it. people who can't. don't. but every rich country in the world and many not so rich ones have decided that all citizens should have access to basic health care. and given that, a pure free market model simply can't work. and, remember, even if one were to have only a catastrophic insurance model, that's where all the costs were. just 5% of the patients in the united states account for 50% of health care costs. and taking care of these catastrophic illnesses is what drives america's costs up.

now a general insurance system can only work if everyone is insured. that's what the swiss and the taiw taiwanese found out. otherwise, only people who are sick will want to buy insurance. that's why the heritage foundation, a conservative think tank came up with the idea of the individual mandate, requiring that people buy health insurance in exactly the same way that people are required to buy car insurance. that's why mitt romney chose this model as a market-friendly system for massachusetts when he was governor. and that's praised the model. the obama health care bill now upheld by the supreme court expands access to 30 million americans. that's good economics.

and it eegs also the right thing to do. but it does little in the way of controlling costs. there are several pie lat programs in it. there are new trends emerging. but little in the way of systemic cost controls. every expert realizes that no matter what the system of health, you need to have some kind of board that decides what's coverend and what's not. now, this has been demagogue as death panels. it's really the only sensible way to make the system work. no one is saying that you can't get any medical procedure you want. peerly that there are some that your insurance won't pay for. the other unusual aspect of health care, kenneth arrow points out, is that buyers don't have much knowledge or power. you can decide that you don't want a new car.

you can comparison shop for a tv. but you can't dtz that you don't want a heart bypass. that's why surgeries have come down in areas like in lasik surgery, but not in ones where the consumer knt walk away. a final thought, one can reason from most principles. and that's a good thing. but you must alsz reason from facts on the ground. and the facts are that all rich countries try to provide affordable health care in some way or the other. all of them, including free market havens like taiwan have found that they need to use an insurance or government-sponsored model. all of them provide universal health care at much, much lower costs. may believe there is a theoretical free model out there that would work perfectly. right now, in the world we are actually living in, some kind of

mixed, messy health care system is what we have. and our task is really not to abolish it, but to improve it so that americans can get good care at reasonable prices like so much of the rest of the world. thanks for tuning in to this "gps" special. you can read more in "time magazi magazine" and you can always catch my shows. international viewers cogo to our web site for air times. tonight, a man who changed television forever. >> this new service will be c l called a cable news network. >> ted turner has never been shy about speaking his mind. tonight, he tells all. >> the moneyed interests are taking over the country. >> now, for the south. >> i lost my fortune, most of

it. i have a billion or two left: you can get by on that if you economize. >> and a man whose ex-wife says this about it. i'm so proud of him. he's done so much good work in the world. >> george w. bush. >> i want to stay connected to the better of community. i'm not going to be a public person. this is a rare interview for me. >> this is "piers morgan tonight" . >> good ef ening the first ted turner, a tv pioneer. but, also, a very out spoken man and a rare interview for president george w. bush. if anyone knows about keeping america great is a former american president.