A brief overview of the health care systems of 8 industrialized nations.  


Canada has a single payer system which is funded by both the federal government and by the provincial and territorial governments. The national healthcare system is founded on the five basic principles of the Canada Health Act. The principles are to provide a healthcare system that is: universally available to permanent residents; comprehensive in the services it covers; accessible without income barriers; portable within and outside the country; and publicly administered. Under this system, Canada’s provinces and territories are responsible for administering their own healthcare plans, and must provide residents with prepaid coverage for all medically necessary hospital and physician services.

Infant Mortality Rate: 36th lowest

Life expectancy Ranks: 14th highest


All citizens of Spain have access to free universal health care and the healthcare system is recognized as one of the best public health programs in the world.  In recent years, private insurance has become more popular, and about 15% of the population has some sort of private insurance.

Infant Mortality Rate:  17th Lowest

Life Expectancy:  23rd highest


Rated the number one healthcare system by the World Health Organization.  99% of France is covered by universal healthcare, but there is a 10-40% copayment.  Over 90 percent of French citizens have an additional insurance, usually paid by their employer in one payment, once a year.  The insurance is relatively inexpensive.  The universal healthcare in France pays for most prescriptions while the rest are deeply discounted.  There is no waiting list and patients can see any doctor they choose.

Infant mortality rate:  8th lowest

Life expectancy Ranks: 11th highest


The healthcare system in Germany is decentralized and all medical expenses must be either paid directly by citizens or their private health insurance. This can be very expensive as medical costs in Germany are very high due to the technologically advanced medical facilities in the nation. Currently 85% of the population is covered by a basic ‘Statutory Health Insurance’ plan, which provides the standard level of coverage. The remainder opt for private health insurance, which frequently offers additional benefits. According to the World Health Organization, Germany’s health care system was 77% government-funded and 23% privately funded as of 2004.

Infant Mortality Rate:  15th lowest

Life expectancy Rank: 33rd highest


Singapore has both universal healthcare and private health insurance.  It is considered to be one of the most efficient systems in the world because it uses only 3% of Singapore’s GDP, compared to the US, who uses 14.6% of its GDP on healthcare. The government of Singapore enforces strict price controls and gives mandatory discounts on healthcare.  The Singapore government covers 80% of basic healthcare costs.  The government requires private health insurers to list prices for services to make it competitive with the public healthcare system.  Singapore has the lowest infant mortality rate in the world, as well as well as one of the highest life expectancy rates.

Infant Mortality Rate:  Lowest in the world

Life Expectancy Rate:  4th highest


Cuba has a public universal health care system and is considered to be decades more advanced than any system found in Latin America. Private health insurance does not exist in Cuba. In addition, Cuba now has one doctor per 200 citizens, compared to one per 400 in the US.

Infant Mortality Rate:  44th Lowest Worldwide

Life Expectancy:  56 highest


Healthcare is free for all citizens and is directed by the National Health Service, which is run by the Department of Health. Although each nation does administer their own system, healthcare is reciprocal in all four countries. The general public is taxed in order to fund the system. Private healthcare does exist but is only used by a small percent of people.

Infant Mortality Rate:  32nd lowest worldwide

Life Expectancy Rank: 37th highest

United States of America

Health insurance in the U.S. is available through employees, government funded programs or private companies. Medicare is available for those over age 65 and is widely considered the best aspect of the US health care system.  America spends more money on healthcare per person than any other nation worldwide and is the only industrialized nation that does not ensure that all citizens have coverage.  In fact, the U.S. leaves 47 million completely uninsured and millions inadequately covered and has a higher infant mortality rate than all other developed countries.  The reason the US spends more and gets less than the rest of the world is because of the patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.  As a result of the inadequate health care system in the U.S. nearly 50 percent of bankruptcies occur because of health care bills.  Of those bankrupted by health care bills, 3 out of 4 have health insurance.

Infant Mortality Rate:  46th lowest worldwide

Life expectancy Rank: 45th highest

Insur_OperationFor more information and comparisons of international health systems, visit PNHP’s international resources page.