Sharon Goldfarb, the speaker at a recent LWVBAE health care and equity meeting and the organization’s Co-President, emphasized powerful but often overlooked truths about health care systems.

Health care is a fundamental part of any society, shaping the well-being and quality of life of its citizens, Goldfarb explained. Around the world, nations have developed various types of health care systems based on their social values and political structures, building various healthcare models that differ in the way that they are structured and deliver care. Nations like the United Kingdom and Australia have government financed health care that provides free care that is mostly free funded by taxes. Others such as Germany, France, and Japan​ use a multi-payer system funded by employers and employees with universal coverage and private ownership.

The United States is unique in the way that it has constructed its healthcare system. It operates on a heavily privatized model based around the idea of payment being “Out-of-Pocket” with a mix of employer-based and governmental insurance. Major public programs in the country include Medicare and in California, Medi-Cal. And many private programs including UnitedHealth Group and Kaiser Permanente. The result is that millions of Americans remain uninsured, and many struggle with high health care costs

There are many differences when comparing the US healthcare system  to the rest of the world, and one of the most important ones is the cost of health care. Countries like the United Kingdom and Canada provide universal health care, free of cost, without spending billions on a healthcare system. While in the US, the government spends over $12,000 per person annually on health care, which  accounts for about 17% of the nation’s economy. This far exceeds the global average, and Americans still have worse health outcomes than people in their peer nations. The U.S. does not provide substantial health care services, ranking last according to reputable  analyses that compare health care performance among first world countries.

The US, which spends almost more than twice the OECD (Organization for Economic Co-operation and Development) average, still has problems with delivering quality health care. Despite higher spending, the US ranks significantly low in health care outcomes such as life expectancy, infant mortality rates and maternal mortality rates. For example, the U.S ranks last in life expectancy with an expectancy of 78, compared to Canada, at 82, and the leading nation, Japan, with reaching 84 years. 

Another major issue with the healthcare system is health equity. In the United States, health care accessibility is primarily based on the income, race and the geographic location of an individual. Again, low-income people are more likely to opt for delayed care due to the immense amount of money that medical care too often costs, which is notably the leading reason for debt in America. Another crucial issue is drug prescriptions and their availability. The cost of prescribed drugs and medications is also relatively high in the United States, due to the fact that the price of prescriptions is not negotiated at the national level. This causes the prices to double or even triple at times, causing millions of people to skip or ration their prescriptions.

Despite all of these challenges and others, the U.S’s health system excels in other ways. The U.S. is the global leader in medical research, innovation, and advanced treatment. The U.S also leads in cancer research and 5-year survival rates. It has the highest percentage of survivors five years after being affected by cancer. The U.S. plays an integral role in developing new technologies and medications that benefit patients worldwide

Despite all these challenges and others, the U.S’s health system excels in other ways. The U.S. is the global leader in medical research, innovation, and advanced treatment. The U.S also leads in cancer research and 5-year survival rates. It has the highest percentage of survivors five years after being affected by cancer. The U.S. plays an integral role in developing new technologies and medications that benefit patients worldwide.

In comparison to one another, it’s clear that no system is perfect, and that there is always room for improvement. In the U.S, reforms are clearly needed, especially in the areas of affordability and accessibility, which are often intertwined. Ultimately, the health of the citizens should be a central priority of any  nation. While the U.S may lead in innovation, it has a lot of room to improve in providing universal, affordable, high quality health care to all of its residents.

–Himansu Shrestha and Zoe Cloak