Affordability has taken center stage in national political discourse. Foremost in this debate is what to do about our health care system, which nearly everyone agrees is unaffordable for far too many. The mounting frustration is especially visible in renewed calls for “Medicare for All.”

　　Pointing to government intervention as the main culprit behind rapidly rising costs, advocates for market-based reforms are often met with the reflexive objection that “every other developed nation has universal (government) health care coverage, spends less on health care, and gets better health outcomes.” This is typically paired with an argument that the US should increase government control over our health care system. They reason that, since it works in all these other countries, it will work here. Besides, who doesn’t want better outcomes and lower costs?

　　But are their claims even true? Scratch beneath the surface and you’ll quickly discover that they all lack credibility.

　　First, the claim that other countries enjoy better health outcomes is very dubious. The main—and often only—data point raised in evidence for it is life expectancy. It is true that Americans’ life expectancy is lower than that of peer nations. According to the health policy analysis group Peterson/KFF, “Americans had a life expectancy of 78.4 years, compared to an average of 82.5 among peer countries.”

　　Does that fact alone provide proof positive of superior quality of health care in the other nations, which have universal coverage?

　　Not at all. What determines life expectancy can’t be reduced exclusively to health system quality. Not even close. Instead, such measures are heavily influenced by nonmedical causes of death—including higher rates of death at a young age—attributable to how people live and other societal factors. Lower life expectancy in the US appears attributable to those factors.

　　For instance, the US has the highest obesity rate among developed nations, leading to a diabetes death rate 2.5 times higher than comparable countries. This discrepancy is more a reflection of the US food supply along with dietary and lifestyle choices of people, not the health care system. Moreover, higher rates of deaths from substance abuse, traffic accidents, and violence explain much of the rest of the life expectancy differences.

　　Now we can turn to an examination of those countries with universal health care that supposedly enjoy superior levels of care at low cost. Are these countries really the utopias they are made out to be?

　　Canada’s close proximity to the US and reputation as a universal health care success story supplies an instructive case study. The picture is not so rosy after all.

　　In a January 2025 interview, Dr. Joss Reimer, the head of the Canadian Medical Association, said, “It’s very clear that the system is still in crisis. Theres a lot to be frustrated about.”

　　Unsurprisingly, the universal system that provides care for 99.7 percent of Canadians free at the point of service for “most essential medical treatments and services,” including most other typical treatments like doctor visits and hospital stays, is struggling with wait times.

　　Since there is no price at the point of service, there’s little limit to the demands people will put on the system. A 2025 report by the Canadian Fraser Institute revealed that patients have a median wait time of seven months between a referral from a general practitioner and receipt of treatment. The problem has been growing unabated, with current wait times “208% longer than the 9.3 week wait Canadian patients could expect in 1993.”

　　These delays have real consequences for patients. The “Future Health Index 2025” report from Philips, for instance, showed that “more than one-quarter (27%) report worsening health due to not seeing a doctor sooner, and 1 in 5 (19%) have been admitted to a hospital because of long waiting times.”

　　Wait times are further exacerbated by underinvestment in the availability of care. A 2020 Heritage Foundation paper reported that “Canada has 35 percent fewer acute care beds than the U.S., and only one-fourth as many magnetic resonance imaging (MRI) units per capita.” Similarly, a 2024 National Post article reported that, according to a national survey, “6.5 million people in Canada, more than one in five, don’t have a family doctor or nurse practitioner they can see regularly.”

　　The lack of available care in the government system has more Canadians seeking alternatives. Despite 99.7 percent of Canadians being covered by the universal system, nearly three-fourths of Canadians have supplemental insurance through private markets. Meanwhile, a growing number of Canadians are also opting to pay out of pocket for private surgical procedures. Medical tourism is so prevalent that the Canadian government itself offers guidance on traveling to other countries to receive medical care.

　　These aren’t just three cherry-picked outliers. Developed nations with universal health care systems are routinely plagued with long wait times and financial distress.

　　The country is doing no better at keeping costs down. A 2025 Canadian Institute for Health Information report showed that total spending on health care more than doubled from 2010 to 2025, exceeding the pace of inflation by 47 percentage points.

　　The picture is no better across the pond. England’s National Health Service (NHS) was once supposedly a point of pride for Brits. Like Canada’s universal system, England’s NHS suffers from long wait times and is in financial peril. Frustration with the system has reached all-time highs.

　　The most recent “British Social Attitudes” survey by the King’s Fund found that “6 in 10 people (59%) said they were ‘very’ or ‘quite’ dissatisfied with the NHS” in 2024, with 65 percent of respondents saying they were “dissatisfied with the length of time it takes to get hospital care.” Indeed, a 2025 study by the King’s Fund found that more than 6.2 million people are on waiting lists and around 171,000 people (two percent) had been waiting longer than one year for treatment.

　　Such insufferable wait times have also caused Brits to seek out private insurance options. This 2025 Insurance Business article reported that about 14 percent of UK adults have private medical insurance, noting that “the demand for private healthcare is expected to rise further, given the ongoing NHS treatment backlog.”

　　Also like Canada’s system, England’s NHS is, as described in this March 2026 article in The Independent, “grappling with a ‘perilous’ financial situation.” The article further notes that the local organizations in charge of running medical facilities (known as NHS “trusts”) have been losing money for eight of the last ten years.

　　In response to these massive deficits, the NHS is being asked to find cost savings of seven percent for FY 2025–26, a drastic year-over-year reduction. The desperate need for cost savings will result in significant reductions in care providers. Unison, England’s leading public service union, anticipates “at least 21,000 roles are due to be cut by 2028 in hospitals and other health facilities.” Cutting tens of thousands of health care workers will only make the brutal wait times even worse.

　　Just like in Canada, England’s universal health care system suffers from excessive wait times, emerging and worsening shortages of providers, desperate patients willing to go out of pocket for private alternatives, and financial crises.

　　But what about Sweden?

　　American progressives love to prop up Sweden as a great example of a successful, developed nation with a robust welfare state, including a universal health care system. Sweden’s system is nationally regulated, locally administered, and financed via a combination of local and federal governments.

　　Perhaps unsurprising at this point, according to this 2025 Fortune Journals study, “recent trends indicate a growing crisis in waiting times” for care in Sweden, exacerbated by “healthcare staff shortages, especially among specialists and nurses.”

　　By 2024, Swedes faced wait lists for medical treatment that were the longest since they began tracking them, and a “record number” of people had been waiting for procedures beyond the legal guarantee of 90 days, as revealed in this 2024 Nordic Times article.

　　As in Canada and England, a growing number of people in Sweden are turning to private health care options in a desperate attempt to get timely care.

　　An industry report published in 2024 noted that “private health insurance in Sweden is growing in popularity, especially among individuals seeking faster access to specialized care, elective surgeries, and alternative therapies,” and that demand is expected to continue to grow.

　　Finally, also like the universal health care systems in Canada and England, Sweden’s system is struggling financially. The 21 Swedish regions managing local health care providers combined for billions in budget deficits in 2024, per Euractiv. According to World Bank data, health care costs in Sweden are rapidly consuming a greater share of the economy, rising from 7.3 percent of the nation’s GDP in 2020 to 11.2 percent in 2024.

　　These aren’t just three cherry-picked outliers. Developed nations with universal health care systems are routinely plagued with long wait times and financial distress. The supporters of government-run universal health care need to acknowledge these dangers. Ironically, more and more people in these failing universal systems are turning to private options for access to timely care.

　　All this is not to say that the American health care system is without flaws. The solution, however, is not to be more like these other developed countries suffering from this myriad of problems, but to move toward a market-based system. Once the harsh realities are exposed, the claims of government-run health care advocates lose all credibility.