Emergency! Emergency! America's health care system is broken.

Mirko Illc

The movie-star governor and the feisty homebuilder have something important in common.

The governor, Arnold Schwarzenegger, and the builder, Howard Staab, both know that America's health care system is broken. And they're both doing something about it. Schwarzenegger has proposed an ambitious plan to provide care for every California resident. It calls for commitment and compromise by the major stakeholders in the health system. Employers, hospitals and doctors, the government and all California residents—not least the 6 million now lacking insurance protection against serious illness or injury—all have a stake in the overhaul. State legislators have revised the plan but have retained the concept of a comprehensive solution to fix the system.

Today the debate is at a critical juncture. Insurance companies and restaurant owners oppose the proposals. And the health care focus of legislators and the governor has been diverted by a bitter budget battle. AARP has aggressively supported the overhaul in the belief that what happens in California will shape the nation's health care debate for years to come.

For Howard Staab, the homebuilder from Durham, N.C., the wake-up call about U.S. health care came three years ago when a routine medical checkup disclosed a failing mitral valve that required replacement. The shock was the price tag: $200,000. At that moment, he began seeking an alternative—anywhere.

He isn't alone. U.S. health and hospital costs are the highest in the world. Americans spend more on medical care than on food. The business research firm McKinsey Global Institute compared our health care system with those of 13 industrial nations and found that costs at U.S. hospitals are nearly twice as high as the average costs in the other countries. The study traces that to levels of staffing, salaries paid to doctors and nurses, insurance and the costs of equipment and administration, all of which are significantly higher in the United States than elsewhere.

The alternative for Staab—and for tens of thousands of other Americans needing medical treatment—is to go abroad for affordable care. Instead of a $200,000 bill, Staab paid less than $10,000 for travel, a three-week trip and two operations at the Escorts Heart Institute and Research Center in New Delhi.

The bottom line is clear: "Our system is failing us, failing our friends and families. We cannot ignore this atrocity any longer," says Maggi Ann Grace, Staab's friend who accompanied him to India and has recounted their experiences in a new book, State of the Heart (New Harbinger, 2007). "America's health care system—supposedly the best in the world—failed us, and we were forced to travel halfway around the globe," she says.

For his part, Schwarzenegger hopes to reach an accord with California's legislators that vastly expands the availability of health care in his state. Its success—or failure—will have a dramatic impact on the growing national clamor for overhauling the health care system.

Nearly 3,000 miles away, Howard Staab is building homes, riding his bicycle and "loving my days." He and the governor may also be igniting a national reform movement.