For years, I believed that American healthcare was the best in the world. I am embarrassed by how readily I accepted that claim. Perhaps I, too, was susceptible to that familiar American malady of exceptionalism.
At the Yale School of Public Health, I am the director of the Center for Infectious Disease Modeling and Analysis and hold an endowed chair in epidemiology. My research evaluates the effectiveness and cost efficiency of public health policies in the United States and around the world. Yet I had not sufficiently questioned this premise about my own country.
Over three decades of research across dozens of countries, the evidence gradually unsettled that conviction. Nations with far fewer resources were providing care to everyone, often achieving better outcomes while spending much less. Patients see a doctor, receive treatment, and go home. No deductibles. No invoice in the mail. The cost was shared collectively, much as we fund public schools and fire departments.
Why were we unable to do the same? And what would it take to change that?