text:
Senior Thesis:Creative Writing
Senior Thesis: Creative Writing
Discussions, workshops, tutorials for those undertaking one-term projects in the writing of fiction, poetry, or creative nonfiction.
Discussions, workshops, tutorials for those undertaking one-term projects in the writing of fiction, poetry, or creative nonfiction.
- Term:
- Spring 2019
- Location:
- Main
- Schedule:
- 8:00am-4:59pm on Sunday (Feb 11, 2019 to May 13, 2019)
- Type:
- Senior Work
- Instructors:
- Brett Millier
- Subject:
- Creative Writing
- Department:
- English & American Literatures
- Division:
- Literature
- Requirements Fulfilled:
- Levels:
- Undergraduate
- Availability:
- View availability, prerequisites, and other requirements.
- Course Reference Number (CRN):
- 21189
- Subject Code:
- Course Number:
- 0701
- Section Identifier:
All Sections in Spring 2019
Spring 2019
CRWR0701A-S19 Senior Work
CRWR0701B-S19 Senior Work (Evans)
CRWR0701C-S19 Senior Work (Price)
CRWR0701D-S19 Senior Work (Gottshall)
CRWR0701E-S19 Senior Work (Berg)
CRWR0701F-S19 Senior Work (Bertolini)
CRWR0701G-S19 Senior Work (Baldridge)
CRWR0701H-S19 Senior Work (Wells)
CRWR0701I-S19 Senior Work (Newbury)
CRWR0701J-S19 Senior Work (Napier)
CRWR0701K-S19 Senior Work (Billings)
CRWR0701L-S19 Senior Work (Brayton)
CRWR0701M-S19 Senior Work (Kramer)
CRWR0701N-S19 Senior Work (Siddiqi)
CRWR0701O-S19 Senior Work (Bertolini)
CRWR0701P-S19 Senior Work (Parini)
CRWR0701Q-S19 Senior Work (Cohen)
CRWR0701R-S19 Senior Work (Cooper)
CRWR0701S-S19 Senior Work (Wright)
CRWR0701T-S19 Senior Work (Yeaton)
CRWR0701U-S19 Senior Work (Graves)
CRWR0701V-S19 Senior Work (Losano)
CRWR0701W-S19 Senior Work (Nash)
CRWR0701X-S19 Senior Work (Bain)
CRWR0701Y-S19 Senior Work (Millier)
CRWR0701Z-S19 Senior Work (Shaw)
CRWR0701ZZ-S19 Senior Work (Ulmer)


text:
The end for this round.
The end for this round.
1. Mario Soto
2. " "
3. " "
4. Kurt Stillwell
5. Frank Williams
Mario carrying his own luggage??? Doesn't the kangaroo court give fines for that?
Awesome pictures. Thanks for sharing.
Stick to your guns.
TeamDunn, I am pulling this thread back, 1) because of the great pics, and 2) because I had occasion on another matter to go back and peruse Mr. Soto's stats from his heydey with the Reds.
And they really are remarkable. More so because of the era we are now in.
I was born in 1970, and Soto was easily my favorite Red during the bad years. But time has dimmed my memory as to just how good he was. His overall stats from baseballreference.com:
The years that are eye-popping:
1980: 190 innings, 12 starts, 3 complete games, 182 Ks, 3.07 ERA 1.10 WHIP
1981: 175 innings, 25 starts, 10 complete games, 151 Ks, 3.29 ERA 1.16 WHIP
1982: 257 innings, 34 starts, 13 complete games, 274 Ks, 2.79 ERA 1.06 WHIP
1983: 274 innings, 34 starts, 18 complete games, 242 Ks, 2.70 ERA 1.10 WHIP
1984: 237 innings, 33 starts, 13 complete games, 185 Ks, 3.53 ERA 1.12 WHIP
1985: 256 innings, 36 starts, 9 complete games, 214 Ks, 3.58 ERA 1.16 WHIP
It fell off after that, rather precipitously. I went back and rechecked all of this because of Dowd's finding that Rose never bet on Soto. That would have been the 1986 or 1987 Soto when he had lost it, but surely not before that, because before that, Soto turned in a stretch of pitching nearly unrivaled in this organization's history for power and effectiveness.
I was 16 when he lost it, and don't remember what it was that ended him, I would presume some arm issues. The workload was insane, compared to what we are used to today, and his 1980 is bizarre. That's not a lot of starts to amass those innings and Ks. A lot of long relief outings and the like,I would guess. If Redszone had been around then, we would likely have started a nuclear reaction calling for him to start long before he did that year.
An amazing pitcher.
Sorry for the detour, but this seemed like a decent place to look back at his career...
Last edited by membengal; 03-16-2007 at 10:53 AM.
Wow, these are awesome. Mario Soto was a groovy-looking dude. Thanks for bumping this.
There is no such thing as a pitching prospect.
Did he pitch in relief? Because 190 innings divided by 12 starts isn't anywhere close to being realisic.1980: 190 innings, 12 starts, 3 complete games, 182 Ks, 3.07 ERA 1.10 WHIP
If he had played on decent Reds teams during his time it would have been interesting to see if he would have had a HOF career.
He was my favorite player in Jr High and High School.
Glad you enjoyed the pics! I was at the park when he was inducted into the Reds HOF. I need to get those pics scanned.
lol... I wasn't in the guild at the time, but I always love looking at old screenshots. Thanks for the stroll down memory lane.
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subset: commoncrawl


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PRINCE RUPERT, B.C. – The financial costs of a worst-case scenario tanker spill off the north coast of British Columbia could outweigh the economic rewards of the proposed Northern Gateway pipeline for the region, says a study by the UBC Fisheries Centre.
The study funded by World Wildlife Fund Canada looked at the potential losses to commercial fisheries, tourism, aquaculture and port activities in the area in the event of a tanker accident.
Using the 1989 Exxon Valdez spill as an example, researchers calculated various scenarios, from a spill with no impact to a high-impact spill of 257,000 barrels of crude, in winter, over 52 kilometres of coastline that includes Haida Gwaii and Porcher Island, near Prince Rupert.
"The study highlights that if a tanker spill occurs, the economic gains from the Enbridge (TSX:ENB) Northern Gateway project to the North Coast region would be wiped out by the costs of the spill," said Rashid Sumaila, director of the fisheries centre.
Ocean-based industries directly employ about 10 per cent of the population of the North Coast. When indirect benefits are included, they account for approximately 30 per cent of regional employment.
Total losses due to oil contamination could range from $90- to $300 million in lost output in other ocean industries, thousands of jobs and up to $200 million of lost gross domestic product, said the report released Wednesday by Sumaila and Ngaio Hotte.
That compares to total economic benefits from the project for the region of $628 million in direct output, up to 8,000 jobs and $293 million in GDP.
Overall, the project is expected to boost Canada's GDP by $270 billion over 30 years, $2.6 billion in tax revenues for local, provincial and the federal governments, and generate $81 billion in direct and indirect revenues to the federal and provincial governments.
No one from Enbridge could immediately comment on the report.
But Darcy Dobell, of WWF Canada, said the entire B.C. coast needs a sustainable, long-term plan to get more value with less impact.
"All we have to do is look north to where the Exxon Valdez spilled happened. That was 23 years ago now and the fisheries there have not recovered; communities there have not recovered, and that's a spill from a tanker that was smaller than the projected tankers will be here," Dobell said.
"If you have a major spill like that, things are changed forever."
The loss estimates don't include the cost of spill response, clean-up and litigation, which could run as high as $9.6 billion, the researchers said.
In an area with a relatively high regional unemployment rate of 9.3 per cent, compared to 6.6 per cent provincially, ocean-based industries on the North Coast generate about $1.2 billion in output value and thousands of jobs, the report said.
The researchers looked at potential costs over a 50-year period, but did not weigh in on the potential for the spills they examined.
"If no spill occurs and all of the project benefits are reaped in addition to the value generated by commercial fishing, the Port of Prince Rupert, BC Ferries and marine tourism, the project would generate more than $600 million and up to 8,500 full-time jobs. But if a high impact spill occurs, the picture will be very different. The reality will probably be somewhere in between these two extreme scenarios," Sumaila said.
Art Sterritt, executive director of the Coastal First Nations, said there are budding shellfish aquaculture businesses along the North Coast that would not survive a spill.
Aboriginal groups are trying to build a sustainable fishing industry that risks being overrun by oil, liquified natural gas and coal in the North Coast region.
"Most of those jobs they talk about are for experts who have trained for decades. We don't see them as opportunities for our people," Sterritt said.
The spill scenarios all assumed no spill response — a scenario researchers acknowledged is unlikely. The report also notes that if the Exxon had been a double-hulled tanker like the ones that would be docking in Kitimat, the amount of oil spilled in that incident would have been cut in half.
Sumaila said calculating spill response in the equation wasn't necessary for this analysis, and requires a complex analysis all its own.
The report notes that the Deepwater Horizon oil rig blowout in the Gulf of Mexico in 2010 heightened concerns around the Enbridge proposal, which has emerged as a "contentious issue of national importance."
Whatever the review panel ultimately decides, Sumaila wrote in the report, "the outcome will have far-reaching consequences for Canada's environmental and socio-economic future."


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Six Steps to Fix Credit Report Errors
What's in your credit report?
CardRatings.com recently conducted a poll asking readers whether they had ever found errors on their credit reports. Of 2,142 respondents, 1,568, or approximately three out of four, reported that yes, they have at one time or another found such an error, according to Amber Stubbs, managing editor of CardRatings.com, Foster City, Calif.
With these findings, and the increasingly clever schemes of identity thieves, it shouldn't take much more to convince you to review your credit report regularly, and act promptly if you find errors in the report.
Here are the steps you should take to dispute inaccuracies on your credit report, which you are entitled to do under the Fair Credit Reporting Act.
Get your free credit report. All consumers are allowed one free credit report every year from each of the three credit-reporting agencies, Equifax, Experian and TransUnion, says Gail Cunningham, vice-president of public relations for the National Foundation for Credit Counseling in Washington, D.C. Go to AnnualCreditReport.com to request the free annual reports from each agency. You can either request all three reports at once, or spread them out over different times of the year.
Check for errors and omissions. Review your credit report for errors, Cunningham says. "A poor credit report impacts your ability to obtain credit, obtain insurance, rent an apartment or get a job. So it's very important to make sure the information is correct if it's not."
It's also important that your credit report doesn't short-change your history. Don't see that gas credit card you paid off last year? Make a note to get it added. According to Rod Griffin, director of public education for Costa Mesa, Cal.-based Experian: "An accurate and complete credit report is an important financial tool, and it can be treated just like a bank statement."
If there's an error, gather documentation. This step is critical. Take the time to assemble all the information you'll need to prove your case, such as copies of canceled checks and creditor statements.
If, for instance, the credit report shows that you still owe money on a bill that has been paid in full, include the statement that documents the zero balance, Cunningham says. "You're just stating the facts and making sure they understand your arguments," she adds.
Put it in writing. Contact the agency whose report you believe to be inaccurate, giving your name, Social Security number and date of birth, Cunningham says. If you've moved recently, verify your previous address.
Write professionally as if you were writing to a potential employer. Type or print neatly. Explain that you are disputing certain items, and give clear, factual reasons why. Include all the details of your case such as account numbers, invoice numbers, check numbers and payment dates. Number your attachments to make it easy for the reader to find them. Make it clear what you want changed. Don't forget to sign your letter.
You can send your dispute to the credit reporting agency by snail mail or online. If you use mail, Cunningham advises sending your letter by certified mail, with the return receipt add-on requested, so you can document that the credit reporting agency received the letter. As well, keep a copy of the confirmation of receipt.
However, it may be faster to send the dispute via the Internet. "You can dispute online. It's quick, it's secure and it's the same process," Griffin says. "And you will receive confirmation the dispute was received."
At the same time, let the creditor know you're disputing the report, "so you're coming at this from both sides," Cunningham says. Include copies of the disputed charges and proof you've paid them, just as you did for the agency.
Wait. Once the credit reporting agency receives your dispute, their team must begin to investigate it immediately, and must finish their investigation within 30 days. The agency will notify the creditor initiating the report that they are investigating your dispute.
"That triggers another investigation on the part of the creditor reporting," Cunningham says. "The creditor has to investigate and confirm the accuracy."
If the creditor finds the information is inaccurate, it must notify all three credit reporting agencies so they can correct information in your file, she says.
When Experian receives a dispute, Griffin says, "we go back to the source of that information, typically a lender, and have them review records and either verify to us the information is reported correctly and should remain the same, or that they agree with the dispute, and the information should be updated."
What if the lender doesn't respond? Griffin says, "If they don't respond in the mandated 30 days, the information will be deleted."
Get your results. In all likelihood, the dispute will be settled in much less time than 30 days. In most instances, just 7 to 10 days are required, Griffin says. "The 30 days go back to the era when everything had to be mailed," he adds.
If you've built a good case in your dispute and you prevail, the credit reporting agency must remove the inaccurate information from your report, Cunningham says.
But if the decision doesn't go your way, and the investigation does not confirm your side of the dispute, you have another option. "You can ask the credit reporting agency to include a copy of the statement of dispute in your file, and that will go out with future credit reports," she says.
This action may or may not make a difference to a future lender, Cunningham adds. But at least it shows you've done all you can to state your case.
Where to start
The best place to start the dispute process is on the credit reporting agency's website. Here is the current contact information for each of the three major credit reporting agencies: Equifax (www.equifax.com): Dispute online with Equifax
Experian (www.experian.com): Dispute online with Experian
TransUnion (www.transunion.com): Dispute online with TransUnion
The original article can be found at CardRatings.com:6 steps to fix credit report errors


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Utah tar sands project gets key go ahead
One Canadian company's plan to extract oil from Utah's tar sands just took a big step forward.
In 2005, U.S. Oil Sands, a small Canadian company already active in Alberta, proposed a project to squeeze oil out of tar sands on Utah's Tavaputs Plateau
On Wednesday, the Utah Water Quality Board voted 9-2 to uphold the state Division of Water Quality's decision to let the company's proposed tar sands mine go ahead without a groundwater pollution permit.
Living Rivers, a nonprofit environmental group based in Moab that has argued the project will pollute groundwater, challenged DWQ's original approval of the project sans pollution permit. They wanted U.S. Oil Sands to do a full groundwater analysis.
The Water Quality Board, however, agrees that the area's groundwater is too deep in the ground to be polluted by any dirty runoff. Living Rivers and legal ally Western Resource Advocates say they will likely challenge the decision in Utah's courts.
As High Country News' contributing editor Jeremy Miller reported this summer, the state's prodigious bitumen deposits, the largest in the U.S., hold between 12 and 30 billion barrels of oil. In hopes of tapping those fossil fuel riches, the company has been wending its way through the state's permit process. This latest decision is a big win for them.
Curiously, as Miller notes in his piece, the company plans to get the water it will use in the project (tar sands extraction is a water-intensive process) from the groundwater lying deep beneath its project site.
Apparently the groundwater is not to deep to drill into as a water source, but still deep enough to be immune from pollution runoff.
Stephanie Paige Ogburn is the online editor at High Country News.


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January 17, 2013
Alternative Service Committee visits University of Kansas, Part II
Submitted by Alternative Service Committee
To Classified Employees and the K-State community:
This communication concludes the summary of the Alternative Service Committee's visit to the University of Kansas with Part II, employment safeguards and other topics. Both, Part I and Part II are available on the Alternative Service Committee's website at http://www.k-state.edu/altservcomm.
Disciplinary Action Board replaced the Civil Service Board
KU was required to develop an appeal board to replace the State Civil Service Board to hear cases involving disciplinary actions of suspension, demotion or dismissal involving any university support staff, or USS. K-State would need to do the same and would keep the highly-respected Peer Review Committee, which KU does not have.
This was not brought up in the meeting, but we feel it is important information to share. In any given fiscal year, more than 95 percent of disciplinary action cases are handled by the Peer Review Committee at K-State. Only a very small number of cases are forwarded to the State Civil Service Board for review — the last case was in April 2011. Of those cases, the State Civil Service Board usually affirms Peer Review Committee's decision. It is a common misconception that the State Civil Service Board protects K-State's classified employees. That perceived protection is actually provided by K-State's Peer Review Committee. State Civil Service Board quarterly reports can be found at http://da.ks.gov/ps/subject/arc/memos/default.htm.
Collective bargaining organizations (aka unions) at KU
K.S.A. 76-715a mandates, "Nothing in this act shall affect the representation rights of collective bargaining organizations that represent the employees of a state institution of higher education, nor shall the provisions of this act affect any term or condition of any collective bargaining agreement in effect on the effective date of this act." University support staff cannot change established memorandum of agreements with collective bargaining organizations, or CBO.
Reorganization issues at KU NOT due to USS option
A lot of rumors circulated that many people were laid off at KU after it adopted the university support staff system. KU panel members confirmed the rumors were 100 percent false. Reorganization did occur, but it was the result of implementing recommendations of an outside consultant firm, not due to university support staff. In fact, KU had undergone a significant re-organization in its Housing and Dining Division when KU was still under the civil service system. Reorganization can happen under either system. Ola Faucher, KU director of human resources, said, "Being a classified (civil service) employee will not help you if your agency decides it is necessary to reorganize or lay off employees."
Kansas Board of Regents enhanced leave option
KU is not currently eligible for the Kansas Board of Regents enhanced leave program for vacation leave accrual. When the enhanced leave program was originally approved, it only applied to classified employees. KU adopted the university support staff system before the KBOR enhanced leave program was approved. KBOR's legal opinion was it excluded KU's university support staff due to the timing and wording of the legislation. There was some discussion that the legislation may have been amended to include KU's university support staff. KU is asking regents to revisit that issue.
Update: Alternative Service Committee asked K-State's administration to request an opinion from the Kansas Board of Regents on this topic. It was reported by Cindy Bontrager, interim vice president for administration and finance, at the Jan. 9 Alternative Service Committee meeting that KU Med Center classified employees recently approved the university support staff option. She confirmed with KBOR's Office of General Counsel that the new KU Med Center University Support Staff employees kept the enhanced leave benefit. KBOR is checking statute information to see if they can offer the enhanced leave program for all other KU University Support Staff. If K-State were to approve the University Support Staff option by majority vote, we would be doing so after K-State had implemented the KBOR enhanced leave program; therefore, K-State university support staff employees would earn the same amount of vacation leave as they currently do.
University Support Staff work group for implementation
Once KU voted to move to university support staff, a work group was established to create a new policies and procedures handbook. The work group membership includes university support staff and KU administration. For years, the work group was a university committee that was independent from their university Support Staff Senate (similar to K-State's Classified Senate). It was recently moved to the university Support Staff Senate. Some in attendance thought that move was a mistake and could weaken the work group's influence with KU administration.
Administrative-level decision making at KU
Compensation issues are determined (and funded) directly by KU. The Kansas Legislature no longer has a say on how KU financially compensates its university support staff.
Furlough program
When furloughs were being discussed after the financial crisis of 2008, KU university support staff provided input into a furlough plan that gives their highest paid employees a greater proportion of any financial impact from a furlough than those making lower salaries.
Kansas Board of Regents university support staff handbook requirement
After they received a majority vote in support of university support staff, they were required to submit a university support staff handbook to the regents for final approval. The handbook contained more details than the initial white papers they voted on. It was developed by a work group of university support staff and key KU administration.
Town hall meeting opportunities
KU had numerous town hall meetings to inform and seek feedback from their classified employees. Feedback was used to revise their white papers (aka proposals). These meetings were quite spirited with emotional comments from employees on both sides of the issue.
If you have any questions regarding this KU trip summary information, feel free to contact any Alternative Service Committee member, http://www.k-state.edu/altservcomm/committee.html.
Respectfully submitted,
Alternative Service Committee


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(visited by Philipp Funovits and Anna Steiner)
15-Aug-2005 -- We didn't even come close to this one. The confluence lies on the northern shore of the Samkir Reservoir, approximately 15 kilometers from the dam. We took a taxi which brought us to the northern side of the Kur river and a little along the road leading to Yenikand. We started to hike from there along the shore of the enormous Reservoir.
After some time the taxi came back, on board some policemen. They announced that we would be in a "secretna zona" right now, and had to leave immediately. They brought us back to the post at the Bridge over the Samkir, we had driven through unnoticed an hour ago. The post turned out to be the bureau of the local Customs department, acting effectively as border post to Georgia. They explained very politely, that the area is for two reasons out of bounds: 1) the power plant at the reservoir and some of the nearby industrial complex is strategically important, and 2) to control the boarder traffic from and to Georgia. Then they proceeded to interrogate us thoroughly about what the hell we were doing there, scrutinizing our passports and visa, buying us an expensive meal in a nearby restaurant, and packing us in car back to Ganja.
We have to leave this confluence to someone who either knows how to obtain the necessary permissions, or wouldn't be bothered by the local authorities at all. We don't think it is possible to (or advisable) to the avoid police and customs department in Kur.


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Fareed Zakaria GPS
Global Lessons: The GPS Road Map for Saving Health Care
Aired March 24, 2012 - 20:00 ET
FAREED ZAKARIA, CNN HOST: Welcome to a GPS special. "Global Lessons: The GPS Road Map for Saving Health Care." I'm Fareed Zakaria. America's system of bringing us into this world, helping us stay alive, and supporting us as we die is at a major crossroads. Two years ago this week President Obama signed the most comprehensive overhaul of American medicine since Medicare. This month, the highest court in the land will hear arguments for and against Obama's law and could soon strike it down. Meanwhile, our out-of-control health care costs continue to climb. No other nation spends more than 12 percent of its economy on health care. America spends 17 percent. What's more, we don't really benefit from the huge price tag. Our healthy life expectancy, the standard measurement, ranks only 29th in the world, behind Slovenia. Our infant mortality rate ranks 30th. It's more than twice that of Sweden and Japan. So what is our problem? In this hour, and in a "TIME" magazine essay, we're going to take you around the world to study health care systems in other countries. To find out what lessons we can learn from others. We'll visit Great Britain, Taiwan, and Switzerland to find out what those nations are doing right and what they're doing wrong. We'll also show you some really interesting innovation going on back here in America, in one of the poorest, most crime-ridden cities in the nation. But first, let's talk about the one thing Americans are certain is bad. Government-run health care, across the Atlantic, in Great Britain. Is the nation's health service an evil death panel, as some say? Let's take a look. (BEGIN VIDEOTAPE) ZAKARIA (voice-over): During America's debate over health care reform, critics said Britain's government-run system was an Orwellian bureaucracy that rationed care to those in need. Were they right? Britain does have a system that is as 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. But consider this. Compared to Americans, the Brits have longer life spans, a lower infant mortality rate, and a health care system that consistently ranks higher on every measure. All this and everyone's care is covered. No payments to doctors, no monthly charges from your insurance company, no co-pays, no fees, nothing. At King's College Hospital in London, Dr. Nigel Heaton performs a liver transplant surgery with a live donor. A young man is giving part of his liver to his younger brother. The liver is cut in half with one part for the younger brother and the other part staying in the donor. DR. NIGEL HEATON, KING'S COLLEGE HOSPITAL: The liver is a remarkable organ, in that it's made up of eight segments. So you can take pieces of the liver, and it will function perfectly well. ZAKARIA: This transplant costs tens of thousands of dollars, but under Britain's national health service or NHS, the patient doesn't pay a thing. HEATON: When patients come to us, we only evaluate them from the point of view of their need. Do the they need a liver transplant? The cost never comes into it. As a surgeon, I love that. Because it means the focus is on the care that I can deliver. DR. CLAIRE GERADA, ROYAL COLLEGE OF GENERAL PRACTITIONERS: Nobody pays a doctor's bill on the NHS. People will go their entire life without paying a single upfront cost. ZAKARIA: Dr. Claire Gerada is the chair of Britain's Royal College of General Practitioners. GERADA: Our health service is fair. It means that irrespective of what you can afford, irrespective of your illness, you will be able to access health care. That is what we require. That is what is a fair and honest health system. ZAKARIA: 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 percent. And income taxes are as high as 50 percent. All of that money feeds a health care behemoth. The NHS is Europe's largest employer with well over one million people on the payroll. So you'd think it would be inefficient. TR REID, AUTHOR, "THE HEALING OF AMERICA": That seems sensible, right? The private sector can do things more efficiently? It doesn't work in health care. ZAKARIA: TR Reid, a former overseas bureau chief with "The Washington Post," toured the world's health care systems for his recent book, "The Healing of America." REID: The least efficient payers in the world are the American private insurance companies. They have administrative costs at 20 to 30 percent. That's a 30 percent tax on every dollar you spend on health care. Britain is totally socialized medicine, administrative costs, 5 percent. Canada is private doctors and public payers, 6 percent administrative costs. So it turns out, in health care, governments are doing this more efficiently than our private sector. ZAKARIA: One reason, says Reid, private insurers in America spend more money on non-medical costs, like ads and reviewing claims to help them stay profitable. Another way governments can be more efficient when they are footing the bill is by having a more coordinated approach to health care. For instance, the NHS rewards primary care doctors with bonuses for achieving certain measures of good health, like getting patients to quit smoking. That's money well spent, because fewer sick people means lower health care costs for the country. On average, the British spend about $3500 a person on health care. In the United States, we spend around $8500. (On camera): 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? REID: Well, that's absolutely true. No, the British health minister said to me, we cover everybody, but we don't cover everything. ZAKARIA (voice-over): Not covering everything, the so-called rationing of care, is the British system's most controversial element. And one man in particular is at the center of that system. ANDREW DYLAN, NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE: Occasionally, we do find ourselves up against everybody. The physicians, the patients, the media. It's sometimes a real challenge. ZAKARIA: Sir Andrew Dylan is the chief executive of the National Institute for Health and Clinical Excellence, known as "NICE" for short. Yes, nice. It's the government body that decides which treatments the government will and will not pay for. DYLAN: This isn't about politics. It's not about money at the outset. It's about the evidence for what works best, so the clinical studies and the other research that's done in this country and right across the world. ZAKARIA: The evidence is weighed by independent panels that include doctors and patients, not government bureaucrats. And their decision- making process is transparent. The public can weigh in. But the policies NICE ponders involves some of the most vexing moral dilemmas in medicine, like whether to fund a last line of defense cancer drug. DYLAN: In the end, there's nothing else in life like facing death. And we have to be sensitive to that and we do try hard to be. But equally, we need to make sure that we're keeping our eyes on everything else that we need the NHS to do for us. ZAKARIA: Another controversial aspect of British health care, long wait times for certain procedures. In the early 1990s, you could wait more than a year to be admitted to a hospital for a non-emergency. The NHS rule book now gives patients the right to be treated within 18 weeks of being referred. But that's still a long time to be standing in the queue. (END VIDEOTAPE) ZAKARIA: Britain's government-run system provides good care for all and is more cost effective than one might imagine. But the quality of its care can shift as funding waxes and wanes. 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 its population being uninsured to nearly full coverage in less than a year and without breaking the bank. (COMMERCIAL BREAK) ZAKARIA: 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. (BEGIN VIDEOTAPE) ZAKARIA (voice-over): Asia's tiger economies like Taiwan and Singapore and South Korea skyrocketed out of poverty in the 1980s and '90s. Taiwan was growing at 7 percent to Europe, joining the ranks of rich countries in no time. SUN-YUNG CHANG, PRINCETON UNIVERSITY: The country was getting richer. However, the health care insurance system was not all good at the time. ZAKARIA: Sun-Yung Chang, a health policy expert at Princeton says, 41 percent of Taiwan's population had no health insurance in 1995. CHANG: You paid out of pocket. And for the really poor, then, you pray a lot. ZAKARIA: So Taiwan's government decided to reform its system of care from the ground up. William Hsiao, a professor of economics at Harvard, is one of the world's leading health care gurus. Hsiao proposed a bold approach for Taiwan's health care reform. WILLIAM HSIAO, ECONOMICS PROFESSOR, HARVARD UNIVERSITY: We invited the experts from all the whole range of countries, so we can draw out the lessons and their experience for Taiwan. ZAKARIA: The panel considered the U.S., its close geopolitical ally, as a model for health care. They were not impressed. HSIAO: You can learn what not to do from the United States rather than learn what to do. ZAKARIA: They also looked at Great Britain, but the Brit's government-run system was producing long wait times in the '90s. HSIAO: Bureaucracy is not the best and the most efficient way of running operations. ZAKARIA: Then there was Germany, which had privacy insurance, but they had so many different funds, their administrative costs were just too high. So Taiwan went with a single-payer 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, Lee Teng-hui, made a huge push to implement the plan quickly in 1995. Miraculously, Taiwan's uninsured dropped from 41 percent to 8 percent in less than a year. Taiwan has a highly rated health care system. What's more, it's a rock star when it comes to holding down costs. The Taiwanese spend just 7 percent of their economy on health care. That's a paltry sum considered to our 17 percent. The government drives a hard bargain on fees with providers, and Taiwan can monitor its spending with this cool device, the smart card. You swipe it anytime 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. 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. CHANG: In Taiwan, all of that is recorded on a daily basis. ZAKARIA: But wouldn't all of that government stinginess 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 around 14 times a year. CHANG: And they stay in hospitals much longer than Americans stay in hospitals. The average length of stay for a Taiwanese in the hospital is 10 days. In the U.S., were five days. ZAKARIA: So how do the Taiwanese provide all of that care for such low costs? One way, the doctors work their tails off. Dr. Gary Lim's primary care clinic in Taipei is open 11 hours a day, six days a week. DR. GARY LIM, PRIMARY CARE DOCTOR: In my clinic I take care of more than 200 patient a day. ZAKARIA: The fees that government insurance pays doctors are very low. Dr. Lin gets only $14 for each primary care visit. His colleague in the U.S. makes $100 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. CHANG: In the 16-year-old history, Taiwan's government has succeeded in raising premium rates twice. Just twice. (END VIDEOTAPE) ZAKARIA: 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. Its passed a version of Obama-care 18 years ago. Has it worked out? Or is it a disaster? Find out when we come back. (COMMERCIAL BREAK) ZAKARIA: 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. (BEGIN VIDEOTAPE) ZAKARIA (voice-over): Imagine an alternate universe where a version of Obamacare has been the law of the land for almost two decades. No, you haven't entered the "Twilight Zone." You're in Switzerland. BILL CLINTON, FORMER U.S. PRESIDENT: Tell the Congress you want us to act and act now. ZAKARIA: Right around the time President Clinton was pushing health care reform in the 1990s, Ruth Dreifuss, a left-wing Swiss official, was pushing reform in her own country. She faced a lot of tough questions. RUTH DREIFUSS, FORMER SWISS PRESIDENT: Will we have to pay for the treatment of drug addicts? Will we have to pay for treatment of obese people? Will we have to -- to pay for abortion? ZAKARIA: Switzerland is not your typical European welfare state. It's extremely business friendly and it's always gone its own way, shunning the euro and charting its own course in health care, with private providers and private insurance. That's actually not so rare, according to journalist TR Reid. (On camera): One of the things that many Americans believe about health care around the world is that other rich countries in the world all have socialized medicine. Is that true? REID: No, that's baloney. Some countries do have government provide the care and pay for it, but a lot of rich democracies, Germany, Switzerland, Japan, Belgium, the Netherlands, cover everybody in the private system, private docs, private hospitals, private insurance. Germany, Switzerland they don't have Medicare. People stay with the private insurer cradle-to-grave. ZAKARIA (voice-over): But the Swiss were getting fed up with their private insurance system in the early 1990s. Costs were rising, premiums were disproportionately higher for women and the elderly, and those with pre-existing conditions had trouble getting coverage. Some were foregoing insurance altogether. DREIFUSS: The people were flying out of the insurance, so we had to stop this. ZAKARIA: Dreifuss, who would later become Switzerland's first woman president, pushed for a law that required everyone to buy insurance, gave subsidies to the poor, and stopped 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 parliament, but barely squeaked by in a national referendum with 52 percent of the vote. DREIFUSS: Where nobody was really happy, but everybody could accept. ZAKARIA: So how is the Swiss version of President Obama's law faring almost 20 years after it was put in place? UNIDENTIFIED MALE: I'll show you the x-rays we did. ZAKARIA: Everyone is now covered and the the care is still top notch. The Swiss enjoy one of the longest healthy life expectancies in the world. TOM ZELTNER, FORMER SWISS SECRETARY OF HEALTH: We have an extremely comfortable system. I mean, the access is easy, you don't have to wait. ZAKARIA: Tom Zeltner was the Swiss secretary of health from 1991 to 2009. ZELTNER: Hospitals have become more like five-star hotels, offering health care. ZAKARIA: The Swiss law went above and beyond Obamacare. Insurance companies were already banned from making a profit on basic health coverage. Under the new law, they had to expand that basic package, covering even more procedures. ZELTNER: Even very expensive pharmaceuticals are paid by the insurance plans and have to be paid. ZAKARIA: The Swiss system is world renowned for the choice it provides its users. JOCELYN MILLS, PATIENT: I chose the doctor I wanted to go to. I went there, and it was seamless. ZAKARIA: We caught up with Jocelyn Mills and her husband, Phillip Thompson, two Americans living in Switzerland. Jocelyn was expecting at the time. She could go see a specialist right away without waiting for a referral from her physician, like in the U.S. MILLS: I always waited three hours in an overcrowded waiting room, you know, to see somebody, then to see a specialist, if anything was wrong. So I don't have that here. ZAKARIA: Another bonus, health insurance isn't linked to employment. Plus, you can change your insurer every year if you want. ZELTNER: The choice is such that it is sometimes confusing. You know, you have in each town you're living, a choice of probably 100, 200 different plans. And you almost need a coach or someone helping you to choose your health insurance plan. ZAKARIA: 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 percent of GDP. DREIFUSS: You cannot make a perfect law. But you can make a perfectible law. And I would say any law has negative side effects. And this is our lesson. We are still working to make this law better. (END VIDEOTAPE) ZAKARIA: Health care 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. (COMMERCIAL BREAK) ZAKARIA: There is no greater threat to the American dream than the rising cost of health care. It already takes up around one-fifth of our economy. By 2050, it could consume almost two-fifths, 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? (BEGIN VIDEOTAPE) DAVID GOLDHILL, CEO, THE GAME SHOW NETWORK: A big part of the underpinnings of the system is all of us kidding ourselves. Someone else is somehow magically paying for this. Well, there is no one paying for it, except all of us. ZAKARIA (voice-over): David Goldhill, the CEO 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. GOLDHILL: I saw a hospital with less impressive information technology than my dry cleaner has, than my auto mechanic has. A couple of times, my father was taken for procedures meant for other patients. There's trash on the floor. Almost every where, it overflows in patients' room. You're endlessly dealing with personnel who don't know anything about your case. This is the intensive care unit we're talking about. ZAKARIA: The 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. GOLDHILL: Once I got beyond, obviously, the personal elements of the tragedy, 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 to think about the lack of real accountability to customers and the incentives to bad behavior that really dominate the way the industry is structured. ZAKARIA: Unlike many markets, customers don't really pay their own bills in health care. Instead, it's a private insurance company or the government that pays. In the case of Goldhill's father, Medicare picked up most of the tab, which was over $600,000 before a hospital discount. GOLDHILL: To all of us, that seems terrific, right? I look at it a different way. 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. There's no way any of us would pay that bill. ZAKARIA: Goldhill summed up his world view in an article in "The Atlantic," "How American Health Care Killed My Father." He says if patients spent more of their own money on health care, prices in the industry would come down. (On camera): Your basic argument is that the whole idea of using insurance to pay for health care is wrong. GOLDHILL: The problem with insurance is that it's very costly. It's a very costly way to finance anything, which is why it's never used to finance anything outside of health care that isn't major and rare and unpredictable. 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 everything else. ZAKARIA: So give me an example of some place where you find market forces can actually work the way you're describing them? GOLDHILL: 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 that in certain types of cosmetic dental surgery. In cosmetic surgery generally. We see it in medicine for pets. And what we see in all of those markets are markets. ZAKARIA (voice-over): Take LASIK eye surgery, for example. Since the procedure was introduced, prices have dropped considerably, despite all of the expensive equipment and well-trained specialists. LASIK doctors actually compete for your business, with ads that tell you about their safety record and prices. GOLDHILL: Ask a very simple question of your viewers. How many of them know the safest hospital in their neighborhood? Why not? 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 turning over our power to insurers, to Medicare and Medicaid. Look at the result. ZAKARIA: Goldhill's solution -- Insurance should only cover catastrophic events, serious illnesses, while routine care like doctors' appointments should be paid for from a health savings account that each person controls. The poor would get government subsidies for their accounts. DR. ATUL GAWANDE, STAFF WRITER, "THE NEW YORKER": We have to care about the costs, because what we're doing in medicine is destroying the American dream. ZAKARIA: Dr. Atul Gawande is a surgeon, a staff writer for "The New Yorker" and the author of several best-selling books on medicine. He agrees with Goldhill that the market in health care isn't working, but he says there's an important fact to consider. GAWANDE: The sick account for most of the costs, 5 percent of patients are 50 percent of the costs. And these are folks for whom the bills are $40,000 and $50,000. ZAKARIA: Under Goldhill's solution, limiting insurance to catastrophic events and serious illnesses, insurance companies would still be paying for a lot of our health care costs. Figuring out how to treat the sickest of the sick, Gawande says, is the trillion-dollar question. GAWANDE: The average patient who's elderly on Medicaid has more than 10 specialists, 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 won't talk to each other. ZAKARIA: What the country needs, says Gawande, is a more coordinated approach to care. Some doctors tend to prescribe too much medicine, he says. That's less efficient, but it is more profitable. GAWANDE: We have focused on getting the best drugs, the best devices, the best specialists. We think very little about how we fit it together so it works well. ZAKARIA (on camera): What is wrong with prescribing lots of procedures? I mean I think Americans think of this as a case where, surely, more is better. Why not have more MRIs? GAWANDE: Yes, more at the right time is better. But, you know, we're doing 70 million CT scans in a population of 300 million people. We know CT scans cause cancers. And second, 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. ZAKARIA (voice-over): 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. GAWANDE: The concentration on the 5 percent of patients who are the highest cost patients and how badly we take care of them is unleashing enormous innovations, enormous reductions in costs. I think we're about to enter a period of very rapid change. (END VIDEOTAPE) ZAKARIA: When we come back, we'll show you a bold example of that change. A health care experiment being conducted in one of the roughest cities in the country, and it's working. (COMMERCIAL BREAK) DON LEMON, CNN ANCHOR: I'm Don Lemon, and here are your headlines this hour. In the Republican race for the White House, CNN projects Mitt Romney as the winner of today's Puerto Rico presidential primary. A look now at those results for you. It looks like it was a really easy victory for Mitt Romney. Eighty-three percent, 83 percent, he is on top there. Rick Santorum, 8 percent, 2 percent for Gingrich, 1 percent for Paul. Twenty delegates are at stake in the contest. Romney will get all of them if he captures more than 50 percent of the vote. Romney was endorsed by Puerto Rico's governor and he also campaigned there on Friday and Saturday. All eyes now turn to Illinois, which holds its primary on Tuesday. The attorney for Army Staff Sergeant Robert Bales has arrived in Kansas to prepare for his first meetings with his new client. Bales is the soldier accused of killing 16 Afghan civilians last weekend. He is now at Fort Leavenworth, Kansas, and he could be charged in connection with those deaths as soon as this week. Planning your budget for the week? Well, make sure you throw in a bit of extra cash for gas. The national average for a gallon of regular is up to $3.83, that's according to AAA. Prices have climbed nine days in a row in seven states. Prices now have topped four bucks a gallon. Wyoming has the cheapest gas, that is, if you call $3.40 a gallon cheap. Those are your headlines this hour. I'm Don Lemon. I'll see you back at 10:00. The Fareed Zakaria health care special continues right now on CNN. ZAKARIA: Skyrocketing health care costs have created what some say is one of 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. (BEGIN VIDEOTAPE) DR. JEFFREY BRENNER, FOUNDER, CAMDEN COALITION OF HEALTH CARE PROVIDERS: We're spending a whole lot in our country for health care and we're not getting our money's worth. And that's a tragedy. ZAKARIA: Dr. Jeffrey Brenner is on the frontlines, trying to reform a health care system that has been called hopelessly broken. BRENNER: We spend twice as much as other industrialized countries and we cover fewer people in our country. ZAKARIA: Brenner is 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 highest murder rates in the country. BRENNER: I was sitting at my desk one evening and shots rang out. ZAKARIA: Brenner ran outside, where the victim was lying in a pool of his own blood. No one was doing anything. BRENNER: I started yelling at one of the sergeants, you know, why didn't you do anything? And he said, well, 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 sort of the dignity of people's lives. ZAKARIA: The victim was a remarkable product of Camden, a senior at Rutgers University, who had talked about running for mayor one day. His death triggered a passion in Brenner to reform the Camden Police Department. But he says it was mired in dysfunction. BRENNER: 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. ZAKARIA: Brenner 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. So he started mapping health care spending, identifying hot spots where the costs were the highest. Using medical billing records, Brenner found that just 1 percent of the patients accounted for 30 percent of health care costs in Camden. And that's not all he discovered about the city's three hospitals. BRENNER: We learned that someone went 113 times in one year, someone went 324 times in five years. In similar work-up in Trenton, they found someone who went 450 times in one year. ZAKARIA: These were people with complicated medical histories and chronic illnesses. One patient alone racked up $3.5 million in medical bills over a five-year period. BRENNER: They are the difficult patients to treat, and no one is being paid and incentivized to pay attention to them. ZAKARIA: What's more? Camden's problem is America's problem. Just 5 percent of the Americans accounted for half of our nation's health care costs in 2009. This is perhaps the crucial statistic to understand about America's health care problem. If Brenner could crack his city's cost crisis, maybe his model could help the country. JASON TURI, CAMDEN COALITION OF HEALTH CARE PROVIDERS: We've met with his primary care doc. ZAKARIA: He founded the Camden Coalition of Health Care Providers, a group of nurses, social workers, and volunteers, who treat the city's worst of the worst, one patient at a time. UNIDENTIFIED MALE: And I'm going to visit with her today. ZAKARIA: Every day the group gets data from all of the city's emergency rooms, in real time. That's the first time this has ever happened anywhere in America. TURI: It's a nice day for this. ZAKARIA: Jason Turi, a former teacher and registered nurse, is making a house call to 52-year-old Lillian Perez (ph). She was admitted to the hospital eight times last year, mostly for respiratory distress. She literally has a bucket full of medications for chronic lung disease, sleep apnea and other conditions. TURI: Can I see these prescriptions? ZAKARIA: Jason and her colleagues got a ventilator placed in Lillian's home. LILLIAN PEREZ, PATIENT: And I get my air, I get my machine. TURI: Yes. We're going to talk to you about that. That's the new ventilator. PEREZ: I got what I need to live. TURI: She saw her pulmonologist who only has seen her in the hospital every couple of months and he said, well, we haven't seen you in a while. You look great. ZAKARIA: Lillian has stayed out of the ER for 70 days and counting, a record for her in recent years. But the city's sickest are often hard to reach, some don't have phones, so Jason and his team do routine drive-bys to see patients like Earl. TURI: Hey, Earl. Jason from the Coalition. How you doing? ZAKARIA: Earl is one of the biggest ER users in Camden. Along with a host of social issues, Earl suffers from epilepsy, hypertension, and congestive heart failure. EARL, CAMDEN RESIDENT: Trying to make it through another day, you know what I'm saying? I've seen the three amigos that came earlier. ZAKARIA: The three amigos. That's the term Earl uses to describe the team that visited him earlier in the day. TURI: Yes, you go t-- I know you're busy. ZAKARIA: Despite the long odds, Earl's hospitalizations have decreased by 30 percent. Brenner 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 five years. BRENNER: And the patients were appalled that someone made that much money, and yet they still felt so sick and they still felt like it was so hard for them to access services. ZAKARIA: So Brenner set up a clinic right in the building, so that the residents can get preventive care. BRENNER: This is not a story of bad patients, bad doctors, bad hospitals, and evil insurance companies. It's a story of a broken system that has irrational incentives and misaligned incentives, so that the patients aren't getting their needs met. UNIDENTIFIED FEMALE: Check his height, weight, and I'll be back. ZAKARIA: Brenner says that early evidence suggests his experiment is working. Hospital use is down for participating patients. His model is being replicated in Trenton and Newark, two other New Jersey hot spots. These programs are bolstered by new legislation that rewards caretakers for preventing and controlling illnesses instead of just treating them. It was signed last August by Governor Chris Christie with bipartisan support. BRENNER: Rather than a cycle of failure in health care, it creates a virtuous cycle, where we're rewarded for doing the right thing. ZAKARIA: Now here's the problem. Brenner's coordinated approach to reducing costs is essentially taking away patients and business from hospitals and doctors. That threatens the profits of most of the established players in health care. When we speak of reducing health care costs, remember that for many powerful interests, that translates into taking away my business. But if Brenner does succeed in bending the cost curve here -- BRENNER: It would make the rest of the country look silly if the city of Camden is able to improve quality and reduce costs. And it really shows this is not a technical problem, but it's a political, spiritual, and moral problem. (END VIDEOTAPE) ZAKARIA: When we come back, I'll give you my thoughts on the health care debate. Stay with us. (COMMERCIAL BREAK) ZAKARIA: 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 countryside 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'm a big fan of the free market. I think it has an almost magical ability to allocate resources and generate growth. But precisely 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 very well when it comes to health care. He explained that 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 OK that when people suddenly discover they need health care, they can get it only if they can 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 when they need it. The market would work, just as it works for BMW cars. People who can afford it can 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 are. Just 5 percent of the patients in the United States account for 50 percent 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 Taiwanese found out. Otherwise, only the people who are sick will want to buy insurance, and insurance companies will spend most of their time and effort trying to kick sick people off the system or deny coverage to those who might get sick. 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 why Newt Gingrich praised the Massachusetts model as the most important step forward in health care in years. The Obama health care bill expands access to 30 million Americans. That's good economics, it's also the right thing to do. But it does little by way of controlling costs. There are several experiments and pilot programs in it. There are new trends emerging, such as the one we saw in Camden. But little in the way of systemic cost controls. That's largely a failure of nerve in the entire political establishment. Every expert realizes that no matter what the system of health, you need to have some kind of board that decides what's covered and what's not. Now this has been demagogued as death panels. When it is really the only sensible way to make the system work. No one is saying that you can't get any medical procedure you want. Merely 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 really don't have much knowledge or power. You can decide that you don't want a new car. You can comparison shop for a new TV. But you can't really decide that you don't want a heart bypass. That's why costs have come down in optional areas like LASIK surgery, but not in ones where the consumer really can't walk away. A final thought. One can reason from first principles and that's a good thing. But you must also reason from facts on the ground. And the facts are that all rich countries try to provide affordable health care for their citizens 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. And all of them provide universal health care at much, much lower costs than we do. Maybe there is a theoretical free market model out there that would work perfectly. But 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 not really to abolish it in favor of a utopia that might come, 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 of my thoughts in "TIME" magazine and you can always catch my regular show on Sundays at 10:00 a.m. and 1:00 p.m. Eastern. International viewers can go to our Web site for air times, CNN.com/Fareed.