But Americans don't have to wait for health care ... do we?

[Lovis Corinth, Self-portrait with skeleton, 1896]

The Commonwealth Fund's just-released annual report on health care in 14 developed countries shows that, once again, America spends more than anybody else on health care--50% more per capita than the next-most-expensive nation, Norway, and 182% more than the least expensive nation in this survey, Italy.

Well, yes, say some proud Americans, and we get what we pay for. We have the best health care in the world.

Maybe not. Other surveys regularly report that Americans die younger than people in other developed nations. Commonwealth reports that America leads the pack in avoidable deaths per 100,000 population: 96 in America compared with 55 (France) to 83 (U.K.) in the other nations surveyed. I was surprised to learn that America has fewer doctors per 1000 population than all the other countries except Japan.

OK, say defenders of America's health care, but people in those other countries have to wait much, much longer to see a doctor, and they wait nearly forever for elective surgery such as hip replacement.

Nope.

Commonwealth surveyed wait times in eleven of the countries, and here's where America stands:

• If you're sick and need a same-day or next-day appointment, you're more likely to get it in Australia, France, Germany, the Netherlands, New Zealand, Sweden, or the U.K.
• If you need care after hours, you're more likely to find it in Australia, Germany, the Netherlands, New Zealand, Norway, Switzerland, or the U.K.
• America has a lot of specialists, but you're still more likely to get a speedy appointment with one in Germany or Switzerland.
• America is quick to schedule elective surgery, but not quite as quick as Germany and the Netherlands. France, New Zealand, Switzerland, and the United States are all a little slower than those two, but not by much.

Ethical question: If a nation has poor access to basic health care but good access to expensive specialized health care, what does that say about its priorities?

Practical question: If Germany, which spends about half of what the U.S. spends per capita on health care, can insure nearly everybody and still maintain speedier access to all forms of health care, why can't we?

Hip hip hooray for Belgium!

Opponents of Obamacare like to talk about how long it takes to get a hip replacement in, say, Canada (even though the Affordable Care Act is nothing like the Canadian health plan). Let's put this in perspective. How about a system that charges so much that some middle-class insured people can't afford a hip replacement at all?

Unless they fly to a Western European country with "socialized" medicine and pay out of pocket. Check out this story about Michael Shopenn, a man whose artificial hip was manufactured in Warsaw, Indiana, "a global center of joint manufacturing." Shopenn, who had health insurance, could not get coverage for a hip operation because his insurer deemed it a pre-existing condition (note: that should no longer be a problem now that we have the ACA). So he ended up flying to Belgium.

A Belgian citizen with no supplementary insurance would have paid only 25-50% of what this American paid for "not only a hip joint, made by Warsaw-based Zimmer Holdings, but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, [and] a week in rehab." And the Belgian would not have had to add airfare to the rest of the cost.

But for Schopenn, the Belgian tab was a good deal--far, far less than he would have paid in the U.S., and no more than his co-pay would have been if his insurer had been willing to cover the surgery.

If you're curious about Belgian healthcare, you can read about it here.

And yes, Belgian taxes are high. But if you total up American taxes (income, Social Security, Medicare, property, sales) and add them to the cost of American health insurance (what you pay and what your employer pays), you may notice that we Americans are spending a lot of money for our services, too, whether we can afford to use them or not. Maybe even more than the Belgians.
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I put "socialized" in scare quotes because that's the word Obamacare detractors love to use, even though it's wildly inaccurate. Belgian healthcare is actually based on mutually owned insurance companies that compete for state funding based on membership. A high percentage of the hospitals are private.