The U.S. Healthcare System is not the best in the World!- But It Could Be -3/4-

The Impact of Universal Coverage

One of the most glaring differences between the U.S. and countries like Canada, the U.K., France, and Japan is the structure of healthcare coverage. The U.S. operates a mixed system where individuals are dependent on employer-sponsored insurance, government programs like Medicare and Medicaid, or, for some, private insurance plans purchased through the marketplace. However, an estimated 9% of the population remains uninsured (Kaiser Family Foundation, 2020), and many others face underinsurance, leading to significant barriers to access.

In contrast, countries with universal healthcare systems, such as Canada and the U.K., offer access to medical care for all residents, regardless of employment status or income. This universal coverage eliminates the primary financial barrier to access, ensuring that health services are available to everyone, which is linked to better overall health outcomes, including lower rates of preventable diseases and higher life expectancy (OECD, 2021). Moreover, the U.K.'s National Health Service (NHS) and Canada’s single-payer system prioritize equity, aiming to provide the same quality of care to all citizens, thereby reducing disparities based on socio-economic factors.

The presence of universal health coverage has a particularly notable effect on vulnerable populations. In the U.S., low-income individuals, minorities, and those living in rural areas experience considerable challenges in accessing care, leading to poorer health outcomes.

Efficiency and Cost Control

One of the major critiques of the U.S. healthcare system is its inefficiency. Despite the high level of spending—approximately 18% of GDP (OECD, 2021)—the U.S. does not achieve commensurate health outcomes. Administrative costs, high drug prices, and the prevalence of defensive medicine drive up spending without delivering proportional improvements in population health. In comparison, countries like Germany, France, and Switzerland, which also spend a significant portion of their GDP on healthcare, manage to provide higher-quality care with lower overall expenditures.

For instance, Germany’s social health insurance system, which is funded through employer and employee contributions, provides universal coverage and results in a high degree of patient satisfaction. Unlike the U.S. system, which is heavily reliant on private insurance companies, Germany’s system maintains cost control by negotiating lower drug prices and focusing on primary care and preventative services (OECD, 2021). France, with its mix of public and private insurance, also achieves better outcomes while keeping healthcare spending lower than the U.S., thanks to efficient management and a greater emphasis on preventative care.

Switzerland, which operates a hybrid system where residents must purchase private insurance, ensures that no one is left without coverage. The government regulates premiums and provides subsidies to low-income individuals. Despite the private insurance model, Switzerland has succeeded in keeping healthcare costs under control while offering high-quality services and ensuring universal access. This demonstrates that private involvement does not inherently lead to inefficiency or high costs when there is strong regulation and oversight.

Preventative Care and Health Outcomes

A significant factor in the healthcare outcomes disparity between the U.S. and other developed nations is the emphasis on preventative care. Countries such as Japan and the U.K. have healthcare systems that prioritize prevention and early detection, leading to better management of chronic diseases and a focus on improving public health overall. For example, Japan has implemented widespread screening programs for cancer and cardiovascular diseases, resulting in some of the best health outcomes globally, including the longest life expectancy.

In contrast, the U.S. has historically focused more on treatment and advanced medical interventions, often waiting until diseases are more advanced before intervention. This reactive model can be seen in the high rates of chronic conditions like diabetes, hypertension, and obesity in the U.S., which could be better managed with earlier intervention. Countries with stronger primary care infrastructures—such as those in the U.K. and France—tend to have better preventive measures in place, leading to better long-term health outcomes and lower costs.