Senator Jeff Sessions' (R-Ala.) statement that Obamacare is destroying “the greatest health care system the world has ever known,” captured growing sentiment among Republicans against the Patient Protection and Affordable Care Act. Some have cited expected reductions in productivity and innovation as reasons for their stance, while others simply don’t think the budget can carry the financial burden of a universal system. While these assertions may make sense theoretically, a look at the facts reveals a different side of the story.
The World Health Organization ranked American health care 37th in the world, and in a recent comprehensive, comparative study, the Commonwealth Fund ranked America’s health care system last on the basis of 21 indicative factors. Analyzing the countries that have surpassed the U.S. in these rankings highlights a puzzling reality: What places these other countries ahead of the U.S. is not just their universal health care systems, but also their significantly lower health care costs and undeniably greater efficiency and equity. How’s that possible? Read about seven of those countries and find out.
1. Australia (Population 22.32 million, GDP US$1.379 trillion)
That’s right, their beaches and exotic wildlife aren’t the only things keeping Australians happy — their medical system is too! In Australia, public coverage is guaranteed to all, but the state encourages wealthier individuals to use a private system by enforcing an additional 1% tax on those who fall above a certain income level but use the public system anyway. The fruits of the government’s innovative techniques are evident in Australia’s death rate from conditions amenable to medical care, which was a startling 50% less than America’s in 2003 and 25% less than the United Kingdom's.
2. Sweden (Population 9.449 million, GDP US$539.7 billion)
Did you know that Sweden’s health care expenditures were as low as US$5,331 per capita in 2011? This rate can in part be attributed to government initiatives in Sweden that disincentivize sending patients to specialists when their illnesses can be treated by general practitioners. The Swedish government’s success with cost efficiency explains why even though public funding accounts for 85% of total Swedish health expenditure, this does not place an unreasonable constraint on taxpayers or the government.
3. France (Population 65.43 million, GDP US$2.773 trillion)
As much as Americans may hate to admit it, there are some lessons they can learn from the French. France's share of GDP spent on health care is 40% than America's, but its public expenditure still accounts for an incredible 79.1% of total healthcare spending. The way the system works there is that a majority of medical bills are taken care of by the government (funding for this comes from payroll and income taxes) and the remaining expenses are paid for by the individual’s supplemental private insurance. Every citizen is entitled to public coverage, and now illegal immigrants are as well.
4. United Kingdom (Population 62.74 million, GDP US$2.445 trillion)
The U.S. and the UK may be just a letter apart by name, but are worlds apart in terms of health care. In the UK, the National Health Service (NHS) publicly covers various costs, including preventative services and mental health care. About 88% of prescriptions there are exempt from charges! Despite American efforts to increase affordability and equity however, the UK ranked first on indicators of efficiency in the aforementioned Commonwealth Fund study. America could learn a lesson or two from its successes at cutting administrative costs and closing loopholes that would otherwise cost the government millions.
5. Germany (Population 81.8 million, GDP US$3.601 trillion)
With the oldest universal health care system in the world, 90% of Germans happily use the public system offered there, and just 10% of the population voluntarily uses the private system. Moving past the mythical tradeoff between time and cost, Germany is one of the few countries to have quick access to specialty services with very little out-of-pocket costs. Germany spends around half as much as America does on health care per capita, with few differences in quality of services between the two countries.
6. Netherlands (Population 16.69 million, GDP US$836.1 billion)
Interestingly, health insurance coverage is statutory in Holland, but provided by private insurers competing for business. Insurers can decide by whom and how the care is delivered, which, to capitalists' great relief allows the insured to choose between alternatives based on quality and costs. This system has proven to be very effective. In 2010, 72% of Dutch adults saw their doctor the same or next day when they were sick, compared with only 57% of adults in America. And, whereas one third of U.S. adults did not see a doctor when sick, went without recommended care, or failed to fill prescriptions due to costs, only 6% of adults in the Netherlands faced these issues.
7. Canada (Population 34.48 million, GDP US$1.736 trillion)
In the realm of health care, America and its neighbor couldn’t be more different. Canada’s national health care system consists of a centralized body that sets standards that the 13 Canadian provinces must follow to receive funding. Hospitals are mainly private nonprofit organizations with their own governance structures, lending Canada an interesting balance between privatization and public ownership.