Posted 10/17/11 on the Medical Billing and Coding Blog

There has been much debate in recent years about whether health care is a privilege or right. While securing coverage for every U.S. citizen has been a priority for years, people often overlook the overall quality — or lack thereof — of our health care system. Without question, improvements can be made. Problems such as delays in obtaining care and care coordination persist — according to SocGen’s Albert Edwards, it’s the most inefficient — and surveys have shown dissatisfaction from patients throughout the country. So, how does it stack up against other health care systems around the world? Ultimately, that’s to be decided by those who’ve studied and experienced a multitude of them firsthand. But here’s an informal list — in no particular order — of the world’s best based on positive facts and reviews.

1. Japan

   The two primary factors working in Japan’s favor are its healthy population — a girl born today is expected to live to 86, according to a paper in the Lancet series — and low per capita health care costs. It’s not difficult to find competent, affordable care for an average citizen when problems arise, a distinction that differs from many other first world countries. Japan also boasts excellent recovery rates from most major diseases and a low infant mortality rate — three per 1,000 live births — which is less than half than the United States’ live birth rate of 6.8 per 1,000.

2. France

   With a universal health care system that offers a choice in hospitals, doctors, and care, France has found a happy medium of liberty, quality, and coverage for its citizens. According to a survey conducted by the Commonwealth Fund, 42% of French patients with chronic diseases could secure same-day appointments — compared to just 26% in the United States — and thus the nation has the lowest rate of deaths that could’ve been prevented with the presence of basic health care. Routinely praised for its overall performance, France’s system was ranked No. 1 by the World Health Organization in 2000.

3. Italy

   Most Italians don’t carry health insurance simply because the government covers most of their medical bills, and even still, it boasts low rates of public health care spending per capita compared to countries such as the United Kingdom, Sweden, Canada, France, and the United States. And the results are still good — the nation ranks 12th in life expectancy in the world, with the average Italian living 80.5 years. Recently, regions such as Lombardy have raised their standards and given patients the option to choose between private and public hospitals, either of which can provide excellent care.

4. Switzerland

   Many Americans have said the Swiss system should serve as model for the U.S. system, as insurers are required to offer coverage to each citizen without considering their age or medical history, while each citizen is required to purchase health insurance. Popular with the public, it encourages competition and is low on regulations, attributes certainly valued in the United States. Switzerland has the 16th lowest infant mortality rate (4.19) in the world and fourth best life expectancy rate (81.7) in the world.

5. Spain

   In Spain, universal coverage is a constitutionally guaranteed right, and it contains no out-of-pocket expenses. Patients complain about long waits to see specialists and undergo certain procedures, but Spain has a third fewer deaths due to delayed access than the United States, for example. There’s an abundance of quality clinics and doctors all over the country, which are open to undocumented immigrants and the unemployed. Spain ranks just behind Switzerland in infant mortality rate (4.21) and ranks sixth in the world in life expectancy (80.9).

6. Netherlands

   Patients in the Netherlands who’ve suffered long-term health issues don’t have to experience financial despair, as state-controlled mandatory insurance takes care of them. Low income patients are given assistance so they won’t go without treatment when needed, and children under 18 are covered for free. Premiums are not influenced by age or health status. It’s an egalitarian system, but, if patients wish to opt out, they can have their tax money saved in a private health care savings account. Traditionally, women prefer to give birth at home naturally, and the nation still has a lower infant mortality rate than the United States.

7. Taiwan

   As Taiwan became more economically prosperous during the 1980s and 1990s, it was forced to overhaul its health care system to ensure the entire country was covered. Remarkably, its national insurance system provides equal access for everyone with free choice of doctors and minimal waits before receiving care. Also impressive is the way in which everything is consolidated — the country’s smart card system not only enables doctors to view patients’ history and medications, but allows the government to know if people are abusing the system.

8. Norway

   Norway’s health care system is mostly financed by its government, ensuring affordable doctor’s visits and a yearly cap for patients with mounting medical bills. More unconventional methods of reducing the number patients seeking care have contributed to the efficiency of the system. For example, a major cutback in administering antibiotics resulted in fewer infections and thus fewer deaths caused by the problem. Valuing patient safety is what sets Norway apart from other countries, and now, many are mimicking their methods.

9. Sweden

   Costs are kept at a minimum for patients who utilize Sweden’s health care system. For example, a relatively small sum of money, about the equivalent of $250, covers a patient’s medications for an entire year — the government covers the rest. A cap on health care fees ensures patients can afford to battle long-term health problems without worrying about being financially crippled. The system has been effective, as Sweden’s life expectancy rate is the fifth best in the world (80.9) and infant mortality rate is the third best in the world (2.75).