Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries

This position paper concerns improving health care in the United States. Unlike previous highly focused policy papers by the Amer-ican College of Physicians, this article takes a comprehensive ap-proach to improving access, quality, and efficiency of care. The first part describes health care in the United States. The second com-pares it with health care in other countries. The concluding section proposes lessons that the United States can learn from these coun-tries and recommendations for achieving a high-performance health care system in the United States. The articles are based on a position paper developed by the American College of Physicians’ Health and Public Policy Committee. This policy paper (not included in this article) also provides a detailed analysis of health care sys-tems in 12 other industrialized countries. Although we can learn much from other health systems, the College recognizes that our political and social culture, demograph-ics, and form of government will shape any solution for the United States. This caution notwithstanding, we have identified several approaches that have worked well for countries like ours and could probably be adapted to the unique circumstances in the Unite