The Best Health Care System in the World: Which One Would You Pick?

To better understand one of the most heated U.S. policy debates, we created a tournament to judge which of these nations has the best health system: Canada, Britain, Singapore, Germany, Switzerland, France, Australia and the U.S
“Medicare for all,” or “single-payer,” is becoming a rallying cry for Democrats.
This is often accompanied by calls to match the health care coverage of "the rest of the world." But this overlooks a crucial fact: The “rest of the world” is not all alike.
The commonality is universal coverage, but wealthy nations have taken varying approaches to it, some relying heavily on the government (as with single-payer); some relying more on private insurers; others in between.
Experts don’t agree on which is best; a lot depends on perspective. But we thought it would be fun to stage a small tournament.
We selected eight countries, representing a range of health care systems, and established a bracket by randomly assigning seeds.
So that you can play along at home and make your own picks, we’ll describe each system along with our choices (the experts' selections will decide who advances). When we cite hard data, they come from the Commonwealth Fund’s International Country Comparison in 2017.
But enough talk. Let’s play.

Canada vs. Britain: Single-Payer Showdown

Both have single-payer systems, but vary in the government’s role and in what is covered.
In Canada, the government finances health insurance, and the private sector delivers a lot of the care. Insurance is run at the province level. Many Canadians have supplemental private insurance through their jobs to help pay for prescription drugs, dentists and optometry. The government ends up paying for about 70 percent of health care spending in all.
Britain has truly socialized medicine: The government not only finances care, but also provides it through the National Health Service. Coverage is broad, and most services are free to citizens, with the system financed by taxes, though there is a private system that runs alongside the public one. About 10 percent buy private insurance. Government spending accounts for more than 80 percent of all health care spending.
U.S. analogues are Medicare (more like Canada) and the Veterans Health Administration (more like Britain).
Canada and Britain are pretty similar in terms of spending — both spend just over 10 percent of G.D.P. on health care. They also have reasonably similar results on quality, although neither ranks near the top in the usual international comparisons. In terms of access, though, Britain excels, with shorter wait times and fewer access barriers due to cost.
Our pick: Britain, 4-1
AARON: Britain. It’s efficient. Given the rather low spending, it provides great access with acceptable outcomes.
CRAIG: Britain. Patients in Britain have a greater ability to shop across providers (using additional private insurance). This, combined with reforms within the N.H.S., helped increase competition and quality.
AUSTIN: Britain. While the countries are close in spending and quality, Britain has much lower cost-based barriers to access.
SHISH: Britain. Access problems can be profound in Canada — nearly one in five Canadians report waiting four months or more for elective surgery, which can be more than just an inconvenience.
UWE: Canada. The Canadian system is simpler for citizens to understand and highly equitable.















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