As excited as American liberals and proponents of expanding access to health care might be about the Supreme Court’s decision to largely uphold the Affordable Care Act, the U.S. still stands out from much of the developed world in state efforts to make medical care available to the public. If universal health care in the U.S. is your goal, then today was a big step forward, but maybe also a reminder of how far behind America still lags.
The above map shows, in green, countries that administer some sort of universal health care plan. Most are through compulsory but government-subsidized public insurance plans, such as the UK’s National Health Service. Some countries that have socialized and ostensibly universal health care systems but do not actually apply them universally, for example in poverty- and corruption-rife states in Africa or Latin America, are not counted.
What’s astonishing is how cleanly the green and grey separate the developed nations from the developing, almost categorically. Nearly the entire developed world is colored, from Europe to the Asian powerhouses to South America’s southern cone to the Anglophone states of Australia, New Zealand, and Canada. The only developed outliers are a few still-troubled Balkan states, the Soviet-style autocracy of Belarus, and the U.S. of A., the richest nation in the world.
When we look at countries with universal healthcare, it seems two factors explain coverage: wealth and population. With one huge exception, the wealthier the country is per capita, the more likely this country has universal healthcare. But we also see that the more a country is populated, the less likely this country has universal healthcare, even if the wealth per capita enable such coverage.
Of the 15 most populated countries, only 3 have universal healthcare: Brazil (5th most populated), Russia (8th) and Japan (10th).
The other 12 most populated countries have failed so far to implement universal healthcare:
China, India, United States, Indonesia, Pakistan, Nigeria, Bangladesh, Mexico, Philippines, Vietnam, Ethiopia, Egypt.
Is that a lack of leadership in these countries? Or, in 11 of them, only a lack of wealth?