Americans’ struggles with medical bills are a foreign concept in other countries

Dr. Jako Burgers examines Erik Eikelenstam at his offices in Gorinchem, a small city south of Amsterdam. “The truth is, it’s a real outlier.” Nearly all of America’s global competitors — whether they have government health plans, such as Britain and Canada, or rely on private insurers, such as Germany and the Netherlands — strictly limit out-of-pocket costs. “There isn’t one system that works,” said Thomas Rice, a UCLA health economist who is writing a textbook about health insurance systems around the world. “Lots of different kinds of systems can protect patients from high costs.” In the United Kingdom, care “free at the point of service” was a founding principle of the National Health Service when it was established after World War II to give Britons affordable healthcare “in place of fear,” as health minister Aneurin Bevan explained at the time. Keeping insurance premiums and medical bills in check has helped keep overall healthcare spending far lower in most wealthy countries than in the U.S. Last year, for example, America’s total healthcare tab, including spending on government programs, private health insurance and patients’ out-of-pocket costs, exceeded $10,000 per person, according to government data.