The Only Rich Country That Chooses Medical Bankruptcy

The U.S.’s healthcare system is like a game show where the prize is… maybe not dying. But only if you’re insured, in-network, and lucky.

We’re the only high-income country without universal healthcare. We spend more than anyone else—$12,318 per person per year—and still manage to have lower life expectancy, higher infant and maternal mortality, and a system so broken that GoFundMe is now a substitute for insurance.

Author’s Note: I pay $5,280 a year just for the privilege of having health insurance. That’s before I even use it. If I actually go to the doctor? It costs more. I’m young, healthy, and live in a liberal state. It’s even worse elsewhere.

Meanwhile, countries like Canada, Germany, Japan, and even Mexico figured out how to cover their citizens decades ago—some for a fraction of the cost.

And yet, Americans are still debating whether healthcare is a right, or a reward for not smoking and eating kale. Spoiler: you already pay for other people’s bad decisions. That’s literally how insurance works.

This blog isn’t about ideology. It’s about math, mortality, and the fact that every other developed country decided not to let capitalism pick who lives or dies.

Let’s look at how healthcare actually works elsewhere—and what the hell is wrong with ours.

The U.S. the Outlier

Healthcare Models Across the Developed World

Most high-income countries use one of four basic models:

• Beveridge (UK): Government funds and delivers care (think NHS).
• Bismarck (Germany): Employers and employees fund non-profit insurance.
• National Health Insurance (Canada): Private providers, public payer.
• Out-of-Pocket (Congratulations, you’re poor).

The U.S.? A Frankenstein’s monster of all four—depending on who you are, how old you are, and what job you have. It’s not a system. It’s a patchwork of systems, each with its own lobbyists and billing codes.

Here’s how other countries structure care:

Country	Primary Healthcare Model
United Kingdom	Beveridge
Germany	Bismarck
Canada	National Health Insurance
Australia	Hybrid (Public-Private)
Mexico	Multi-payer
Switzerland	Bismarck
Netherlands	Social Health Insurance
Sweden	National Health Insurance / Service Hybrid
United States	Fragmented Multi-model

Source: GoodRx, PNHP

Other countries blend models too—but the U.S. is the only one that turned it into a bureaucratic jackpot for insurers and hospital executives.

Cost Comparison: Dollars and Nonsense

You’d think spending the most would buy us the best. Nope.

Country	Per Capita Spending (USD, 2021)	% of GDP on Healthcare
United States	$12,318	17.8%
Germany	$7,383	11.7%
Canada	$5,631	10.7%
Australia	$6,034	10.9%
Mexico	$1,186	6.2%
Switzerland	$8,998	11.8%
Netherlands	$7,179	10.9%
United Kingdom	$5,381	8.4%
Sweden	$5,754	11.0%

Sources: OECD, Commonwealth Fund

The U.S. spends nearly twice as much per person as Germany—and four times what South Korea spends—but gets worse outcomes. Where’s the money going?

Want to see what “paying more for worse outcomes” looks like? Feast your eyes:

What does this show?

Yes—there’s some correlation between spending and life expectancy. Countries that invest more in healthcare tend to live longer… up to a point.

But the U.S.? We blow past everyone in spending and still trail behind in outcomes.

• Mexico spends one-tenth as much and still outlives us.
• Countries like Sweden, Australia, and Switzerland spend less than the U.S. and live longer.
• The U.S. is the outlier—not because we spend too little, but because we’ve built a system where profit comes before health.

If money bought health, Americans would be immortal.

Administrative Waste: A Feature, Not a Bug

The U.S.’s private insurance-based chaos isn’t just expensive—it’s inefficient by design.

• 30% of the U.S.’s excess health spending vs other nations is pure admin waste [1].
• That’s billing departments, denial management, coding disputes, and armies of humans translating health into spreadsheets.
• $1,055 per person per year just to keep the machine spinning—vs $193 average across OECD countries [1].

Country	Admin Costs as % of Hospital Spending
United States	25%
Canada	12%
Scotland	12%
Netherlands	20%

Source: Commonwealth Fund

The U.S. is the only country where you can have a heart attack and get a letter saying the ambulance ride wasn’t pre-approved.

25% of U.S. hospital costs go to admin overhead.

Not care. Not doctors. Just insurance company bullshit, billing departments, and red tape.

In Canada and Scotland? It’s half that.

The more middlemen you pay, the less care you get.

Health Outcomes Don’t Lie

We Pay More, Die Sooner

The U.S. spends more on healthcare than any other nation—and still ranks dead last in life expectancy among high-income countries. Coincidence? Nah.

Country	Life Expectancy at Birth (2021)
Switzerland	83.4 years
Australia	83.0 years
Sweden	82.4 years
Canada	81.7 years
Germany	81.3 years
United Kingdom	80.7 years
United States	77.5 years

Source: OECD

Let that sink in. We spend the most—but get the fewest years of life. What are we buying, exactly? Billing codes and bankruptcy.

Infant and Maternal Mortality: Third World Numbers in a First World Country

If you’re pregnant in the U.S., you’re better off in every single other high-income country.

Country	Infant Mortality (per 1,000)	Maternal Mortality (per 100,000)
Sweden	2.1	4.0
Switzerland	3.0	5.1
Australia	3.1	5.5
Canada	4.5	10.8
Germany	3.2	6.5
United States	5.4	18.6

And for Black women in the U.S.? That maternal mortality rate skyrockets to 50.3 per 100,000 1.

American Mothers Are Dying—Some More Than Others

In no other developed country is giving birth this dangerous—especially if you’re Black.

If you’re Black and pregnant in the U.S., you’re 3x more likely to die than if you’re white.

This isn’t a developing country. This is the richest country in the world.

Our system doesn’t just fail—it fails unequally.

In a country with the world’s most expensive NICUs, giving birth can be a death sentence—but only if you’re poor, uninsured, or not white.

Chronic Illness: We’re Sicker, Younger

Despite all that spending, The Americans are more likely to live with long-standing illnesses—and start earlier in life.

Country	% with Chronic Illness (2021)
Canada	38.5%
Sweden	40.4%
United States	33.0%
Germany	36.3%
Australia	35.9%

Sure, the U.S. isn’t worst here—but it’s up there, and combined with the highest obesity and diabetes rates in the developed world, it’s a sign of systemic failure, not personal sin.

We treat illness reactively—after it gets expensive.

Imagine if your car insurance only kicked in after the engine exploded, but refused to cover oil changes.

Preventable Deaths: The U.S. Leads in Dying for No Reason

The U.S. leads the developed world in avoidable deaths—from untreated conditions, overdoses, suicides, and lack of timely care.

Between 2009 and 2019, every other OECD country saw fewer avoidable deaths. The U.S.? They increased in all 50 states 2.

Despite outspending other nations on healthcare, the U.S. is experiencing a rise in avoidable deaths, while our peers are seeing declines.

Every other developed country reduced preventable deaths over the last decade.

The U.S.? We went backwards. Hard.

Spending more. Dying more. That’s not a policy failure. That’s a design choice.

The only country where people die of curable diseases because they can’t afford the diagnosis.

Medical Bankruptcy: The Price of Survival

In most rich countries, cancer is terrifying. In The U.S., it’s terrifying and financially ruinous.

• 66.5% of bankruptcies in the U.S. are tied to medical debt 3
• $88 billion in medical debt reported to credit agencies 4
• In zero other rich nations is this a thing

Some try to claim Canada has medical bankruptcies too. Sure—if you cherry-pick 2006 data from the Fraser Institute. But actual coverage, protections, and spending caps exist in countries with universal systems. In the U.S., even the insured get screwed by deductibles, exclusions, and network games.

The leading cause of bankruptcy in the richest country in the world? Getting sick.

Who Gets Left Behind?

• 27 million Americans had no health insurance in 2023 5
• Millions more are underinsured, meaning they have insurance that’s effectively useless when it matters

In contrast:

Country	Coverage Rate (2021)
Canada	100%
Germany	>99% (mandatory)
Australia	>99%
UK	>99%
United States	<90%

We don’t just have a healthcare problem. We have a delusion problem. People think we have the best system in the world. We don’t. We have the most expensive failure in the developed world.

The “Personal Responsibility” Myth

You Already Pay for Other People’s Bad Decisions

“I don’t want to pay for people who make unhealthy choices.”
Cool. Then cancel your car insurance, too—you’re probably just funding reckless drivers.

That’s literally how insurance works: shared risk. Everyone pays in. Some people take more out. You don’t get to means-test compassion.

The U.S. already socializes healthcare—just in the dumbest, most expensive way possible. You pay for other people’s ER visits when they’re uninsured. You subsidize employers who underpay their workers while dumping them on Medicaid. And you definitely pay more so insurers and pharma execs can pocket your premiums.

And when a Trumper says, “I’m fine with universal care, but only for the healthy”—what they’re really saying is:

“I don’t understand how math, ethics, or systems work.”

Risk Pooling: Insurance 101

If you think a system should deny people care for smoking or eating fast food, congrats—you just made them uninsurable. And now they’ll show up in the ER, untreated and ten times more expensive.

Insurance needs a big risk pool. You want some people in it who rarely get sick—because that’s how you cover the people who do.

It’s actuarial science, not bootstraps bullshit.

And let’s be real: even “healthy” people get cancer. Accidents. Autoimmune disorders. You want a system that only works for people who never need it?

Go buy one of those “Christian healthshare ministries.” Then pray you never get sick.

What Other Countries Actually Do About Lifestyle

No country with a universal healthcare system denies care to smokers, drug users, or overweight people.

They do this instead:

• UK: Higher taxes on cigarettes, sugar, and booze
• France: State-funded stop-smoking programs
• Canada: Public health campaigns + free behavioral therapy
• Germany: Early interventions, education, and counseling
• Sweden: National programs targeting obesity and inactivity

Most of these countries invest in preventative care—because it’s smarter and cheaper to prevent disease than to treat it later.

The U.S.? Nah. We wait until you’re half-dead, then hit you with a $6,000 deductible.

The System Punishes the Sick, Not the Lazy

Here’s how The U.S. “rewards” personal responsibility:

• You exercise, eat clean, get an annual physical. Your insurer still raises your premiums.
• You get cancer out of nowhere. They deny your claim over a “pre-existing condition.”
• You survive a medical emergency. Congratulations: your credit is now a war crime.

Meanwhile, in Canada, Germany, or Australia? You just get treatment. No copays. No deductible limbo. No “network” riddles.

The U.S. system doesn’t incentivize health. It monetizes misery.

“Healthy” People Still Get Screwed

Let’s say you’re one of the lucky ones. Fit, 35, no chronic conditions. Think you’re safe?

• You crash a bike and need surgery: surprise out-of-network ER bill.
• You change jobs: lose coverage during a medical crisis.
• You’re denied care because of a typo on your medical history.

Private insurance is a gamble, not a guarantee. You only find out what’s covered after the bill hits. And even then, they’ll find a way to deny or delay.

Health shouldn’t be a lottery. It should be a baseline right.

Even the Insured Get Wrecked

Even with insurance, Americans pay more out of pocket than almost anyone.

$1,400+ a year. While still juggling deductibles, co-pays, and surprise bills.

In the U.K.? It’s half that. In Germany? Less.

You’re not insured. You’re in a subscription scam with no customer service.

What About…?

“But I Don’t Want to Wait 6 Months for Surgery!”

You know what sucks more than waiting for surgery?
Never getting it because you can’t afford it.

Yeah, some countries have wait times. Especially Canada. But let’s compare apples to aneurysms:

Country	Primary Care Wait Time	Specialist Wait Time
Netherlands	< 2 days	Short
Switzerland	< 2 days	Short
Germany	2–5 days	Short
Canada	> 2 weeks	Longest in OECD
United States	2–5 days (if insured)	Long (and $$$)

Source: OECD

Even with wait times, countries like the UK, Sweden, and New Zealand have maximum wait guarantees—like “no more than 18 weeks from GP referral to treatment.”

Meanwhile in the U.S.? You can wait zero weeks… if you have $20,000. If not? You’re just fucked. Or dead.

“But the NHS Is a Mess!”

True. The NHS is a mess—because the UK’s Conservative Party has spent 13+ years defunding and undermining it 1.

• Chronic understaffing
• Long ER wait times
• Administrative delays

But even in its struggling state, nobody in the UK goes bankrupt because they got cancer. Nobody gets denied treatment because of a credit score. No one pays $400 for an EpiPen.

The NHS is a political football. But the principle—free, universal access to care—still polls as one of the most cherished British institutions.

Americans mocking the NHS is like a guy living in a cardboard box dunking on someone with leaky plumbing.

“Mexico? Really?”

Yes, Mexico. It’s not perfect—but at least people don’t go bankrupt when grandma has a heart attack.

Mexico has a hybrid public-private system:

• IMSS and Seguro Popular for public coverage
• Private sector for faster, better service (if you can afford it)
• Expats and the middle class often choose private insurance

You know what that sounds like? A scalable model. One where basic care is guaranteed, and if you want luxury, you can pay extra. Kind of like… every sane country.

The U.S. already sort of has this, too. But the “public” fallback is broken Medicaid and overcrowded ERs, while the “private” side is profit-maximizing trash.

Mexico may not lead the world in health outcomes—but it sure as hell doesn’t lead it in medical bankruptcies either.

“But I Like My Private Insurance!”

That’s adorable. You think you “have” insurance. You don’t.

You have temporary permission to maybe get care, as long as:

• You don’t change jobs
• You stay in-network
• You don’t trigger a pre-existing condition clause
• You pay your premium, copay, deductible, coinsurance, and surprise bills

Private insurance in the U.S. isn’t “coverage”—it’s a roulette wheel rigged by MBAs. It exists to take your money, deny your care, and laugh at your GoFundMe later.

People in France, Germany, and Australia also have private insurance—but as a top-up, not a lifeline. It covers perks like private rooms or faster elective surgeries—not basic survival.

“But We’re Too Big and Complex for Universal Healthcare”

Oh, please.

• Germany: 83 million people
• Japan: 125 million
• U.S.: 332 million
• China: 1.4 billion

Other big-ass countries figured it out. You’re telling me the richest nation in history can’t?

The problem isn’t size. It’s corruption. It’s Congress taking bribes from the health industry, then telling you socialism is scary.

Why It Hasn’t Happened Here

Lobbyists and the Billion-Dollar Bullshit Machine

If you want to know why the U.S. doesn’t have universal healthcare, follow the money.

• The health industry spent over $600 million on lobbying in 2022 alone 1
• That’s more than Big Tech and Big Oil combined
• Top spenders: PhRMA, Blue Cross Blue Shield, The U.S.n Hospital Association

What did all that cash buy?

• Politicians to kill Medicare for All
• Think tanks to frame universal care as “tyranny”
• Endless ads warning of “government-run healthcare” like it’s a horror movie

Remember the “death panels” lie from 2009? That was cooked up by lobbyists, amplified by cable news, and swallowed whole by millions of voters.

The only real death panels are the ones run by private insurers.

Employer-Based Insurance: The Golden Cage

During WWII, wage controls led companies to offer health insurance as a perk. It stuck. Now, nearly half of all Americans get coverage through their jobs 2.

Problem is:

• You lose your job = you lose your healthcare
• Changing jobs = surprise coverage gap
• Your employer picks the plan—not you

It’s a system designed to trap you, not protect you. You stay in dead-end jobs because COBRA costs more than your rent. You don’t start that small business because you’ll lose your meds.

Freedom? There’s nothing “free” about tying healthcare to your boss’s payroll department.

The Cult of The U.S.n Exceptionalism

The U.S. has a religion. It’s not Christianity. It’s “I got mine, screw you.”

We’ve been brainwashed to believe that collective solutions = communism, and that needing help = moral failure. That’s why people say things like:

“Why should I pay for someone else’s insulin?”

Because they’re already paying for yours, genius. And if they can’t afford it, you’ll pay more when they land in the ICU.

Other countries see healthcare as a right. We see it as a luxury. And then we wonder why we lead the world in bankruptcies, deaths of despair, and GoFundMe cancer campaigns.

Exceptional? Only in our delusions.

But the Real Reason? It Works Too Damn Well

Universal healthcare isn’t a fantasy. It already exists—in every other rich country on Earth. And the reason we don’t have it here is because…

Too many people make too much money keeping it broken.

Insurers profit by denying care.

Hospitals profit by overcharging.

Pharma profits by lobbying away regulation.

And politicians profit by keeping it all just confusing enough to keep you angry—but not at them.

Almost Every Other Country Covers Everyone. We Still Don’t.

In the U.S., healthcare is a job perk. In other countries, it’s a birthright.

Most rich countries cover everyone. The U.S.? Still stuck under 90%.

Even Mexico has a public fallback. In the U.S., you lose your job, you lose your care.

This isn’t just inefficient. It’s cruel.

It’s Not Radical. It’s Rational.

Universal healthcare isn’t a fantasy. It’s not socialism. It’s not radical.
It’s standard. Everywhere. Except here.

• The UK figured it out in 1948.
• Canada in the ’60s.
• Germany in 1883, for God’s sake.
• Even Mexico has a public fallback.

Meanwhile, The U.S.—the richest nation in human history—lets people die over missed premiums and unaffordable insulin. Our “system” is a patchwork of greed, with more middlemen than doctors, and more denials than treatments.

We don’t have a healthcare problem. We have a profit problem. And a cowardice problem. Politicians won’t fix this until voters make it their political death sentence not to.

Want real freedom?

• The freedom to change jobs without risking death.
• The freedom to care for your parents without choosing between rent and chemo.
• The freedom to stay alive, even if you’re poor, sick, addicted, or unlucky.

That’s what universal healthcare gives you.

So no—you’re not paying for “other people’s bad choices.”
You’re paying for a system designed to fleece you.

And it doesn’t have to be this way.

Voting Is Minimum Effort. Do More.

Don’t just nod along. Do something. Talk louder. Vote harder. Burn the myth that this is the best we can do.

Because until we fix this, we are not a civilized country.

We’re just an ATM with a flag.

Sources

[1] Lobbying Data: Health Industry – OpenSecrets
[2] Health Insurance Coverage by Employment – KFF
[3] Medical Bankruptcy in the United States – American Journal of Public Health
[4] $88 Billion in Medical Debt on Credit Reports – CFPB
[5] 2022 Health Insurance Coverage – U.S. Census Bureau
[6] Lost in the System: NHS Admin Failures – The King’s Fund
[7] U.S. Health Care in a Global Perspective – Commonwealth Fund
[8] Comparison of Hospital Administrative Costs – Commonwealth Fund
[9] Life Expectancy at Birth – World Bank
[10] Maternal Mortality Report 2023 – CDC
[11] Waiting Times for Health Services – OECD
[12] The Four Models of Healthcare – PNHP
[13] Health Expenditure Per Capita – World Bank
[14] Chronic Disease Prevention & Behavioral Health – National Academy of Medicine