54 www.wpma.com / Fall 2026 Australia: Australia operates a universal public program called Medicare, primarily funded through taxation, but private insurance remains an impor- tant part of the system. Life expectancy is approxi- mately 83 years, while preventable mortality is 99 per 100,000 and treatable mortality only 47. Australia demonstrates that universal coverage can coexist with private insurance. The trade-off is that patients can experience longer waits for certain elective procedures and specialist care. The Netherlands: The Netherlands takes a different approach. Residents are required to purchase basic health insurance from regulated private insurers. The government establishes the rules, while private companies provide the coverage. Life expectancy is approximately 81.9 years, while preventable mortality is 100 per 100,000 and treatable mortal- ity 49. The Dutch system provides an important lesson for Americans: Universal coverage and private insurance are not mutually exclusive. Japan: Japan has universal health coverage through mandatory public insurance, but it is not a government-run hospital system. Patients retain broad freedom to choose their doctors and hospitals. Japan spends approximately 10.6% of GDP on health care, compared with 17.2% in the United States, yet Japanese life expectancy is approximately 84.1 years. Preventable mortality is only 86 per 100,000, while treatable mortality is approximately 49. As you can see, Japan demonstrates that universal coverage can coexist with consumer choice, private providers and relatively modest spending. The United Kingdom: The United Kingdom takes a much different approach. The National Health Service (NHS) provides health care largely free at the point of service and is primarily financed through taxation. The advantage is obvious: patients generally don’t face insurance deduct- ibles or large medical bills when they receive care. The disadvantage is also obvious: the NHS struggles with capacity, waiting times, and rationing. Nonetheless, the U.K. has a life expectancy of approximately 81 years, with preventable mortality of 156 and treatable mortality of 71 per 100,000. The British system demon- strates that you can reduce financial barriers to care, but you may ration services through waiting times rather than price. Switzerland: Switzerland may be the most interesting comparison for Americans. Every resident is required to purchase basic health insurance from regulated private insurers. Patients pay deductibles and coinsurance, and government subsidies help lower-income residents. It isn’t cheap, but the results are impressive. Switzerland has a life expectancy of approximately 84.3 years, preventable mortality of only 80 per 100,000 and treatable mortality of just 34 per 100,000. Switzerland demonstrates that universal coverage can coexist with private insurers, consumer responsibility and cost sharing. Mexico: Mexico is worth including because it provides an important counterexample. Mexico has broad public health coverage, but its system is fragmented among government programs, social insurance and private providers. It also spends far less on health care than the United States, and ™Word Word w w w . w m i m u t u a l . c o m AMERICAN AMERICAN HEALTHCARE: Are We Getting What We Pay For?
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