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NOVEMBER 12, 2008



by Myriam Miedzian


We have the best health care in the world; I personally know many people in foreign countries who say their health care is bad.”


“Republicans understand that ‘universal health care’ has failed in other nations.”


These comments come straight out of some angry emails in response to a column in which I wrote that Barack Obama believes government should play a role in providing universal healthcare to Americans. I pointed out that the United States is the only advanced industrialized country without universal health care and that special interests want to keep it that way. They oppose government involvement, and favors tax credits for Medical Savings Accounts.


My hunch is that most Americans are not as sure as these folks that our system is the best. Republicans keep telling us that universal health care is socialism; it provides very low quality care and is very expensive, but they don’t provide any facts to back that up. In fact, our own government-run Medicare has administrative costs much lower than those of private insurance companies that make huge profits.


Anecdotes about “people in foreign countries who say their health care is bad,” are not helpful. I know people in Canada, France, and Belgium who are very happy with their medical care. So what? Americans need facts, not name calling or personal anecdotes. So here are some facts:


In 2000, the World Health Organization (WHO) published the results of a study on the quality of health care in 191 countries. WHO’s assessment was based on four factors : the overall level of the population’s health; health inequalities; how well the health system responds to the needs of people of different economic status; and whether the health care system is paid for in a way that is fair to people of all social classes. The study found that while the United States’ health system spends a higher portion of its gross domestic product than any other country, it ranks 37 out of 191 countries in performance. France, Italy, and Spain scored the highest.


In 2008, a research study entitled, “Mirror, Mirror, on the Wall,” sponsored by the Commonwealth Fund, compared U.S. medical care to that of five other nations--Australia, Canada, Germany, New Zealand, the United Kingdom—and concluded that despite having the most costly health system in the world, the United States consistently underperforms. Compared to the five other nations, the U.S. system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives.


When it comes to infant mortality, according to data collected by the Center for Disease Control, in 2006, 22 countries had lower rates than we had.


What about life expectancy? The “CIA World Factbook’s” latest update informs us that the U.S. life expectancy of 78.14 years gives us a rank of 46th out of 223 countries. This places us behind almost all other advanced industrialized countries. Japan, with 82.07, and Canada with 81.16, are near the top.


If universal healthcare is such a disaster and so expensive, how come we score so badly according to both wide ranging studies and specific health care statistics, even though we spend the most money? It doesn’t make sense.


About 10 years ago, Taiwan was in a situation similar to ours--40 percent of its population had no health care. To remedy the situation, the government sent experts around the world to study other countries’ health systems and pick out the best features. Based on these research findings, Taiwan developed a national non-profit single payer system that borrowed a lot from Canada, and some from our Medicare and other countries. Taiwan has now caught up with the rest of the advanced industrialized world. Isn’t it time for Americans to demand that our country do so as well?


Myriam Miedzian is the author of “Boys Will Be Boys,” and writes frequently on social and political issues.


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