Why no single health care system is the world’s ‘best’

In the wake of a Supreme Court decision upholding the Affordable Care Act for the third time in a decade, seven leading health economists and public policy experts appeared in a Washington Post video discussing how to improve the U.S. health care system and whether other countries’ systems are better.

Two of the experts featured in the June 17, 2021, video were faculty members from Harvard T.H. Chan School of Public Health: Austin Frakt, senior research scientist in the Department of Health Policy and Management; and John McDonough, professor of the practice of public health. Health economics expert David Cutler of Harvard University was also quoted.

When an interviewer asked the experts which country has the best health care system, none gave a definitive answer. Cutler noted that, in general, the best systems are in Northern Europe—but “what works in one country may not work in another country.” Frakt cited a 2017 New York Times piece he co-authored that featured a bracket tournament of health systems, with five experts weighing in on which was best. For the most part, their choices differed, depending on whether their focus was on cost, equity, access, or quality, Frakt said.

“I don’t think there’s a correct answer to [the question of which is the best health care system],” said McDonough, adding that “the one thing that stands out is that, among all major developed nations, it’s pretty clear that the United States comes in dead last.” In comparison with other wealthy countries, U.S. health costs have increased more over the past several decades, while life expectancy hasn’t kept pace.

McDonough was also quoted in a June 19, 2021, USA Today article about plans being floated by Democrats for improving the U.S. health care system. Ideas being considered include expanding insurance coverage for working-age people and their families, adding new benefits to Medicare, and reducing prescription drug costs.

Watch the Washington Post video: Opinion: ‘I hate that question’: 7 experts try to answer who has the world’s best health-care system

Read the USA Today article: Democrats see springboard for health care in Supreme Court win