The Price of the Best Care in the World — And Why Americans Don’t Have It

Americans are routinely told a comforting myth about healthcare: that the reason we pay so much is because we have the best care in the world. The implication is moral as much as economic — excellence costs money, and if you want to live longer, healthier, better lives, you should expect to pay more.

The problem is that this story collapses the moment you look at the numbers.

The United States spends roughly $13,000 per person per year on healthcare — by far the highest figure on Earth. And yet when international comparisons are made — life expectancy, maternal mortality, infant mortality, preventable deaths, chronic disease management — the U.S. rarely cracks the top ten. Often it doesn’t crack the top twenty.

This raises a blunt question Americans almost never ask:

How much would it actually cost to give Americans care equivalent to the world’s best national healthcare systems?

Not theoretical perfection. Not some utopian fantasy. Just the best systems that already exist.

What “Best” Actually Means

When people talk about the world’s best healthcare systems, they are usually pointing — implicitly or explicitly — to places like Switzerland, Germany, Norway, and the Netherlands.

These systems differ in structure — some are tax-funded, some insurance-based, some hybrid — but they share several core characteristics:

Universal coverage
Guaranteed access to primary and specialty care
Negotiated prices for drugs and hospital services
Low or zero deductibles for essential care
Strong preventive medicine
Predictable, capped out-of-pocket costs

They are not cheap in absolute terms. Healthcare is labor-intensive. It always will be. But they are efficient — and efficiency matters more than ideology.

The Real Benchmark: What People Actually Pay

Here is the critical distinction Americans almost never make: total system spending versus what individuals actually pay.

In Switzerland — the most expensive of the “best” systems — total healthcare spending runs about $8,000 per person per year. Of that, an average adult pays roughly $3,000–$3,500 annually in premiums, plus a few hundred dollars in cost-sharing.

Germany and the Netherlands are cheaper still. Norway’s system is largely tax-funded, with minimal out-of-pocket costs.

These aren’t abstractions. These are modern, wealthy societies delivering better outcomes than the U.S. at far lower cost.

So What Would Equivalent Care Cost an American?

If the U.S. were to provide care equivalent to the best national healthcare systems, a realistic estimate for the typical American looks like this:

$400–$650 per month
$5,000–$8,500 per year total

That figure includes:

Insurance or tax-equivalent contributions
Routine care
Prescriptions
Hospitalization
Specialist visits
Preventive services

It assumes:

Negotiated drug prices
Regulated hospital pricing
Dramatically lower administrative overhead
Slightly higher physician pay than Europe
America’s higher baseline chronic disease burden

This is not optimistic. If anything, it is conservative.

Why Americans Pay More for Less

If world-class care costs $6,000–$8,000 per person elsewhere, why does the U.S. spend $13,000?

The answer is not better medicine. It is structural waste.

1. Administrative Overhead

The U.S. healthcare system spends roughly 15–20% of its total cost on administration — billing departments, coding specialists, insurer negotiations, prior authorizations. High-performing systems spend 4–8%.

That difference alone accounts for over $1 trillion annually.

2. Price, Not Utilization

Americans do not see doctors dramatically more often. They do not stay in hospitals dramatically longer. They simply pay more for the same services.

A CT scan that costs $300 in Germany costs $1,200 in the U.S.
Insulin that costs $30 elsewhere costs $300 here.
A hospital night that costs $1,500 abroad costs $5,000 domestically.

3. Fragmentation as a Business Model

The U.S. system is not fragmented by accident. Fragmentation allows prices to remain opaque, prevents collective bargaining, and ensures that no single actor has leverage to force efficiency.

Complexity isn’t a bug. It’s the product.

The Middle-Class Illusion

Perhaps the most dangerous aspect of American healthcare is that it hides its cost.

Most working Americans do not see the full premium their employer pays on their behalf. A family plan costing $23,000 per year feels like a $400 payroll deduction. Deductibles and surprise bills feel like bad luck, not systemic failure.

In reality, the average American family already pays more than the high end of world-class care, but receives:

Narrow networks
High deductibles
Financial risk from illness
Medical debt as a leading cause of bankruptcy

We are not paying less for worse care.
We are paying more for worse care, just in a deliberately confusing way.

What Would Change — And What Wouldn’t

A system delivering best-in-class care would not mean:

Doctors earning poverty wages
Innovation grinding to a halt
Long wait times for everything
Government micromanaging medicine

Every one of those claims is disproven by existing systems.

What would change is who captures the surplus.
What would disappear is the ability to extract monopoly rents from human vulnerability.

The Uncomfortable Conclusion

The uncomfortable truth is this:

America already pays enough for the best healthcare system in the world.
We just don’t get it.

We pay more than Switzerland.
More than Germany.
More than Norway.

What we receive in return is complexity, anxiety, and financial risk — not superior care.

The question is no longer whether we can afford a world-class healthcare system.

The question is why we continue choosing not to have one.

The Inner Monologue