# The U.S. lacking UHC **URL:** \ **Category:** Factual Questions\ **Created:** [June 29, 2012, 1:47am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652 "2012-06-29T01:47:22Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![etv78](https://avatars.discourse-cdn.com/v4/letter/e/d78d45/32.png) [@etv78](https://boards.straightdope.com/u/etv78)\ **Post date:** [June 29, 2012, 1:47am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/1 "2012-06-29T01:47:22Z")
Is the US the only 1st world nation that lacks UHC? ---
**Author:** ![coremelt](https://avatars.discourse-cdn.com/v4/letter/c/4491bb/32.png) [@coremelt](https://boards.straightdope.com/u/coremelt)\ **Post date:** [June 29, 2012, 1:56am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/2 "2012-06-29T01:56:49Z")
If this map is accurate then it sure looks like it: > **[File:Universal health care.svg](https://en.wikipedia.org/wiki/File:Universal_health_care.svg)** > > Original file ‎(SVG file, nominally 863 × 443 pixels, file size: 1.59 MB) > Data source: Stuckler, David; Feigl, Andrea B.; Basu, Sanjay; McKee, Martin (November 2010). The political economy of universal health coverage. Background paper for the First Global Symposium on Health Systems Research, 16–19 November 2010, Montreaux, Switzerland. Pacific Health Summit 16. National Bureau of Asian Research. "Figure 2. Global Prevalence of Universal Health Care in 2009; 58 countries: Andorra, Antigua, Arge... ---
**Author:** ![Jas09](https://avatars.discourse-cdn.com/v4/letter/j/d07c76/32.png) [@Jas09](https://boards.straightdope.com/u/Jas09)\ **Post date:** [June 29, 2012, 2:01am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/3 "2012-06-29T02:01:54Z")
I’m pretty sure that the answer is yes unless you attempt to define it in a very narrow way. Some other first-world countries do not have single-payer or completely private systems, but they all aim for (and largely achieve) universal coverage. ---
**Author:** ![John\_H\_1](https://avatars.discourse-cdn.com/v4/letter/j/e9bcb4/32.png) [@John\_H\_1](https://boards.straightdope.com/u/John_H_1)\ **Post date:** [June 29, 2012, 2:27am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/4 "2012-06-29T02:27:50Z")
Some related and interesting information. The US spends more than any other country on health care. Nearly twice as much as the next most spending country. And yet, its average life expectancy is ranked 38, and infant mortality is ranked 49. I’m sure it’s a very complex problem at heart, but health care in the US seems like a huge market failure. > **[List of countries by total health expenditure per capita](https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_%28PPP%29_per_capita)** > > This article includes 2 lists of countries of the world and their total expenditure on health per capita. Total expenditure includes both public and private expenditures. See also: Health spending as a percent of GDP by country (gross domestic product). > The first table and bar chart lists member countries of the Organisation for Economic Co-operation and Development (OECD). It shows each country's total spending (public and private) on health per capita in PPP international dollars. > The next ... > **[List of countries by life expectancy](https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy)** > > The life expectancy is shown separately for males and for females, as well as a combined figure. Several non-sovereign entities and territories are also included in this list. > The figures reflect the quality of healthcare in the countries listed as well as other factors including HIV infections. > From the beginning of the current century there is a tendency to also estimate Healthy life expectancy (HALE) — the average number of years that a person can expect to live in "full health". > **[List of countries by infant and under-five mortality rates](https://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate)** > > The under-five mortality rate (U5MR) is the number of deaths of infants and children under five years old per 1000 live births. The under-five mortality rate for the world is 39 deaths according to the World Bank and the World Health Organization (WHO). 5.3 million children under age five died in 2018, 14,722 every day. > The infant mortality rate is the number of deaths of infants under one year old per 1,000 live births. This rate is often used as an indicator of the level of health in a count... ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 29, 2012, 3:20am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/5 "2012-06-29T03:20:44Z")
Yes. FWIW, a lot of middle income countries are developing UHC plans too. The majority (I believe the majority) of latin american countries have UHC plans or are developing them. India and China are working on plans. Various developing southeast Asian nations have UHC plans or are working on them. However it depends on how you define ‘healthcare’. The US arguably has a universal ‘public health’ health care system, but not a public ‘personal health care system’. Public health involves things like sewage, clean drinking water, vaccines, environmental protections, etc. Even the homeless do not have to worry about infectious diseases in their food or finding clean water. So public health is pretty much universal, while individual health care is not. Mild consolation, but there you go. At least we have got Africa beat in that regard. ---
**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\ **Post date:** [June 29, 2012, 3:33am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/6 "2012-06-29T03:33:33Z")
“Lacking”? No. “Managed to avoid”? Yes. Also, re: this: > [@John\_H\_1](#): > > Some related and interesting information. The US spends more than any other country on health care. Nearly twice as much as the next most spending country. And yet, its average life expectancy is ranked 38, and infant mortality is ranked 49. I’m sure it’s a very complex problem at heart, but health care in the US seems like a huge market failure. > [List of countries by total health expenditure per capita - Wikipedia](http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_%28PPP%29_per_capita) > [List of countries by life expectancy - Wikipedia](http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy) > [List of countries by infant and under-five mortality rates - Wikipedia](http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate) As has been explained to people like you many times on these boards, average life expectancy and infant mortality have many more inputs than simply the quality of the health care provided in this country. You can’t use those two statistics alone to make a “we pay more for less” argument. ---
**Author:** ![GreasyJack](https://avatars.discourse-cdn.com/v4/letter/g/df705f/32.png) [@GreasyJack](https://boards.straightdope.com/u/GreasyJack)\ **Post date:** [June 29, 2012, 3:43am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/7 "2012-06-29T03:43:09Z")
> [@coremelt](#): > > If this map is accurate then it sure looks like it: > [File:Universal health care.svg - Wikipedia](http://en.wikipedia.org/wiki/File:Universal_health_care.svg) Shouldn’t we be in the yellow “attempting to obtain universal healthcare” category now? ---
**Author:** ![DrCube](https://avatars.discourse-cdn.com/v4/letter/d/a3d4f5/32.png) [@DrCube](https://boards.straightdope.com/u/DrCube)\ **Post date:** [June 29, 2012, 4:25am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/8 "2012-06-29T04:25:34Z")
> [@GreasyJack](#): > > Shouldn’t we be in the yellow “attempting to obtain universal healthcare” category now? How does a country “attempt” to do something of that nature? They either do it or they don’t, and the US hasn’t. What did Iran, Mexico, South America and Venezuela do to deserve the “attempt” categorization? ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [June 29, 2012, 8:24am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/9 "2012-06-29T08:24:17Z")
> [@Rand\_Rover](#): > > As has been explained to people like you many times on these boards, average life expectancy and infant mortality have many more inputs than simply the quality of the health care provided in this country. You can’t use those two statistics alone to make a “we pay more for less” argument. They do indeed, horrendously complex to account for all contributing variables to those but I’ve yet to see a convincing argument that the US system gives better outcomes for less money. Surely if you were certain your system is better you would be screaming the fact from the top of the roof? Ultimately those arguing against healthcare like to shy away from the inconvenient successes of pretty much every other civilised nation and boil it down to ideological roots. Fine, I understand that and would have more respect for people if they admitted other systems were better but felt the US way was a better ideological fit for them. That is defendable at least but in the real world ideology is not an FDA approved treatment for diabetes or cancer. ---
**Author:** ![MrDibble](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mrdibble/32/114_2.png) [@MrDibble](https://boards.straightdope.com/u/MrDibble)\ **Post date:** [June 29, 2012, 8:57am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/10 "2012-06-29T08:57:38Z")
> [@Wesley\_Clark](#): > > At least we have got Africa beat in that regard. Not entirely - South Africa is in the process of implementing UHC. What’s ironic in that Wiki map is the status of Iraq and Afghanistan… ---
**Author:** ![MrDibble](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mrdibble/32/114_2.png) [@MrDibble](https://boards.straightdope.com/u/MrDibble)\ **Post date:** [June 29, 2012, 8:59am UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/11 "2012-06-29T08:59:14Z")
> [@DrCube](#): > > How does a country “attempt” to do something of that nature? They either do it or they don’t, and the US hasn’t. What did Iran, Mexico, South America and Venezuela do to deserve the “attempt” categorization? Have legislation for UHC in the pipeline, I guess. At least that’s the case with us. Not sure why the US situation technically doesn’t scan as attempting UHC. ---
**Author:** ![Candyman74](https://avatars.discourse-cdn.com/v4/letter/c/ad7895/32.png) [@Candyman74](https://boards.straightdope.com/u/Candyman74)\ **Post date:** [June 29, 2012, 12:26pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/12 "2012-06-29T12:26:45Z")
> [@John\_H\_1](#): > > And yet, its average life expectancy is ranked 38, and infant mortality is ranked 49. I can’t for the life of me remeber where I heard this (Freakonomics, maybe?) but I was under the impression that that infant mortality rate is deceptive simply because it’s counted differently in different countries - linked somehow to the inclusion of fetuses or not in the numbers, or something like that. Anyone know any more about that? ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [June 29, 2012, 1:47pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/13 "2012-06-29T13:47:28Z")
> [@Rand\_Rover](#): > > “Lacking”? No. “Managed to avoid”? Yes. > > Also, re: this: > As has been explained to people like you many times on these boards, average life expectancy and infant mortality have many more inputs than simply the quality of the health care provided in this country. You can’t use those two statistics alone to make a “we pay more for less” argument. I accept part of that claim, namely that you pay more. I also think you get less, but I can arguments against that interpretation of the stats. We do pay considerably higher taxes that Americans will apparently put up with and a lot of that does go for universal health care up here in the frozen northland. ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [June 29, 2012, 3:14pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/14 "2012-06-29T15:14:57Z")
> [@Candyman74](#): > > I can’t for the life of me remeber where I heard this (Freakonomics, maybe?) but I was under the impression that that infant mortality rate is deceptive simply because it’s counted differently in different countries - linked somehow to the inclusion of fetuses or not in the numbers, or something like that. Anyone know any more about that? I’m not sure about this particular notion, but socioeconomic status is a better fit. Suburban teenage mothers don’t see such high infant mortality rates, inclusion of fetuses or not. Unwed teenage mothers living under the poverty line are a different matter. You see corresponding differences in rates of teenage pregnancy, too. ---
**Author:** ![Kevbo](https://avatars.discourse-cdn.com/v4/letter/k/e47774/32.png) [@Kevbo](https://boards.straightdope.com/u/Kevbo)\ **Post date:** [June 29, 2012, 3:42pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/15 "2012-06-29T15:42:20Z")
It is also worth noting that even many second and third tier nations have some form of UHC. Mexico and Cuba being nearby examples. ---
**Author:** ![Shosy](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@Shosy](https://boards.straightdope.com/u/Shosy)\ **Post date:** [June 29, 2012, 3:52pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/16 "2012-06-29T15:52:06Z")
If by “UHC” for _citizens_ primary healthcare, which is often enforced to be only citizens and legal immigrants through universal insurance, than yes, the US is way behind the curve. After I got my EU residency I was often irritated by a friend who kept complaining when she fell in Barcelona that the hospital billed her. “I thought health care was free here” ---
**Author:** ![njtt](https://avatars.discourse-cdn.com/v4/letter/n/ecd19e/32.png) [@njtt](https://boards.straightdope.com/u/njtt)\ **Post date:** [June 29, 2012, 4:30pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/17 "2012-06-29T16:30:00Z")
> [@Shosy](#): > > If by “UHC” for _citizens_ primary healthcare, which is often enforced to be only citizens and legal immigrants through universal insurance, than yes, the US is way behind the curve. > > After I got my EU residency I was often irritated by a friend who kept complaining when she fell in Barcelona that the hospital billed her. “I thought health care was free here” Mind you, even US citizens who have to pay directly for their health care in the EC generally wind up paying a lot less then they would if they were paying directly for the same services in the USA. There is a lot less waste, market distortion, and bureaucracy in UHC systems than in the tangled morass of US health care. ---
**Author:** ![etv78](https://avatars.discourse-cdn.com/v4/letter/e/d78d45/32.png) [@etv78](https://boards.straightdope.com/u/etv78)\ **Post date:** [June 29, 2012, 5:13pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/18 "2012-06-29T17:13:13Z")
> [@Kevbo](#): > > It is also worth noting that even many second and third tier nations have some form of UHC. Mexico and Cuba being nearby examples. Yeah, the notion that CUBA has UHC made my head hurt! ---
**Author:** ![Shosy](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@Shosy](https://boards.straightdope.com/u/Shosy)\ **Post date:** [June 29, 2012, 5:18pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/19 "2012-06-29T17:18:11Z")
> [@njtt](#): > > Mind you, even US citizens who have to pay directly for their health care in the EC generally wind up paying a lot less then they would if they were paying directly for the same services in the USA. There is a lot less waste, market distortion, and bureaucracy in UHC systems than in the tangled morass of US health care. I’m not sure about other countries, let alone most, but it helps that medical school is essentially free, but at the same time you’re required to essentially work for the state and opening a private practice before 10 years is quite curtailed. ---
**Author:** ![dracoi](https://avatars.discourse-cdn.com/v4/letter/d/90db22/32.png) [@dracoi](https://boards.straightdope.com/u/dracoi)\ **Post date:** [June 29, 2012, 6:38pm UTC](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652/20 "2012-06-29T18:38:22Z")
> [@GreasyJack](#): > > Shouldn’t we be in the yellow “attempting to obtain universal healthcare” category now? I see that the map was dated July 2009. So it clearly needs an update in regards to the US at least. [Next page](https://boards.straightdope.com/t/the-u-s-lacking-uhc/626652.md?page=2)