Despite areas of excellence, the United States health care system could perform much better than it does. The key questions: what can realistically be expected, and how can the nation get there?
To set expectations, real-world examples are helpful. Cross-national comparisons show that if the US health care system performed like systems in other Western democracies, individuals would live longer lives and spend less, and the United States could provide universal access to care.1 As just one example, if health care costs in the United States had increased since 1980 at the rate of health care costs in Switzerland, where all citizens purchase private insurance from competing plans, an estimated $15.9 trillion dollars could have been saved2—nearly enough to retire the US national debt.