Introduction

The American health care system is in trouble, and if nothing is done to change it, will soon be in crisis. Perhaps it would be more accurate to say it will be in crisis everywhere, whereas now the crisis is localized to only some areas. The situation was bad before HMOs were touted as "the solution" to rising costs, and has only gotten worse. When emergency rooms in an area are closed, they are closed for everyone. When hospitals in the cities are closed and not replaced, the system has failed, plain and simple. Where it has not yet failed, it costs too much and does too little.

Patients are not satisfied with their care and go broke trying to pay for prescription medication. Doctors argue with insurance companies over treatments and payments. Nurses have to fight for decent pay and fight to avoid excessive overtime, but don't get to use much of their time on patient care. Untrained workers in hospitals fear the responsibilities involved in dealing with IVs, dressings, blood draws, and a host of things that nurses should be doing, but find it difficult to speak out because they need their jobs. The government's idea of patients' rights is to make a compromise on who can sue whom for how much.

It does not have to be this way. It is not this way in most industrialized countries around the world. If we could pay a bit of attention to the health care systems in these other countries, perhaps we could see how to fix our own.

This booklet attempts to do a very rough comparison of the health care system of the United States with the health care systems of seventeen other nations. We are only looking at how good a given health care system is for the patients, the citizens of the country. We are not looking to see how well it treats insurance companies or drug companies, or how much money it generates for politicians.

Certainly, more sophisticated and analytical studies have been done. This booklet is only an attempt to highlight the most basic facts relevant to health care, without resorting to a single chart, graph or table of numbers.