Which nation has the best health system?
- Is it a country with overtly government-run health care, like the United Kingdom?
- Is it Singapore, with its one-of-a-kind system of mandatory private savings?
- Is it the United States, notwithstanding being very expensive and inefficient?
The answer is none of the above, at least according to a new report from The Foundation for Research on Equal Opportunity.
That report says Switzerland has the best system, followed by Ireland, Germany, and the Netherlands.
The United States is in 7th place, sandwiched between Denmark and Sweden.
The worst country, of the 32 that were measured, is Saudi Arabia. Poland, Hungary, Italy, and Slovakia also were in the bottom category.
Notice, however, that the report is not claiming to measure the country with the world’s most-libertarian health system.
It’s simply how the author, Gregg Girvan, estimates how nations rank based on quality, choice, innovation, and fiscal sustainability. But it’s probably safe to say that the report reflects an understanding of free markets.
Since most readers are from the U.S., I’ll specifically note that the United States has the top score (by a big margin) in the category of “Science and Technology.” I suspect that superior outcome is driven in part by the fact that profit still plays a big role in America’s system.
That’s the good news.
The bad news is that the U.S. is in last place on fiscal sustainability (hopefully readers will now understand why I am so critical of Trump’s head-in-the-sand approach to entitlements such as Medicare and Medicaid).
I’ll make two additional observations about the United States.
First, the American system is very expensive, but that’s in part a reflection of the country’s wealth.
Here’s a chart showing a fairly strong correlation between health spending and income.
For what it’s worth, I nonetheless think that America’s health system could have much lower costs if consumers were fully in charge.
Second, the American system gets dinged for spending a lot of money yet having mediocre life expectancy compared to other rich nations.
But the gap is largely because the U.S. has more murder, more obesity, and more traffic deaths. Those numbers don’t reflect well on American society, but one takeaway is that America’s relatively low life expectancy is due to bad personal choices rather than bad health care.
P.S. Interestingly, Switzerland also get the top score when five health experts from all points of views ranked eight major nations back in 2017.
P.P.S. Swiss voters rejected single-payer, government-run healthcare by an overwhelming margin back in 2014.
P.P.P.S. Back in 2016, Bloomberg released a Health Care Efficiency Index that Hong Kong and Singapore at the top, which is an intuitively appealing outcome for supporters of economic liberty. But that Index also shows the United States ranking #50 out of 55 nations. Since I regularly criticize the statist elements of the American health system, I don’t object to the U.S. getting a low score. But the Bloomberg Index is a joke in that it ranks Cuba and Venezuela above the United States.
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