Critics of the U.S. health care system frequently point to other countries with government-run, national health care systems as models for reform. However, a closer look shows that nearly all health care systems worldwide are wrestling with problems of rising costs and lack of access to care, writes Michael Tanner. Overall trends from national health care systems around the world suggest the following:

• Health insurance does not mean universal access to health care. In countries weighted heavily toward government control, people are most likely to face long waiting lists for treatment, rationing, restrictions on physician choice, and other obstacles to care.
• Rising health care costs are not a uniquely American phenomenon. Although other countries spend considerably less than the U.S. on health care, costs are rising almost everywhere, leading to budget deficits, tax increases, and benefit reductions.
• Countries with more effective national health care systems are successful to the degree that they incorporate market mechanisms such as competition, cost sharing, market prices, and consumer choice, and eschew centralized government control.  

Although no country with a national health care system is contemplating abandoning universal coverage, the broad and growing trend is to move away from centralized government control and to introduce more market-oriented features.