Description

Critics of the U.S. health care system frequently
point to other countries as models for
reform. They point out that many countries
spend far less on health care than the United
States yet seem to enjoy better health outcomes.
The United States should follow the lead of
those countries, the critics say, and adopt a government-
run, national health care system.

However, a closer look shows that nearly all
health care systems worldwide are wrestling with
problems of rising costs and lack of access to care.
There is no single international model for national
health care, of course. Countries vary dramatically
in the degree of central control, regulation,
and cost sharing they impose, and in the role of
private insurance. Still, overall trends from national
health care systems around the world suggest
the following:


Health insurance does not mean universal
access to health care. In practice, many countries
promise universal coverage but ration
care or have long waiting lists for treatment.

Rising health care costs are not a uniquely
American phenomenon. Although other
countries spend considerably less than the
United States on health care, both as a percentage
of GDP and per capita, costs are rising
almost everywhere, leading to budget
deficits, tax increases, and benefit reductions.

In countries weighted heavily toward government
control, people are most likely to
face waiting lists, rationing, restrictions on
physician choice, and other obstacles to care.

Countries with more effective national
health care systems are successful to the
degree that they incorporate market mechanisms
such as competition, cost sharing,
market prices, and consumer choice, and
eschew centralized government control.

Although no country with a national health
care system is contemplating abandoning universal
coverage, the broad and growing trend is
to move away from centralized government control
and to introduce more market-oriented features.

The answer then to America