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As a CIGNA marketing exec and later as an independent consultant I travel traveled extensively in Western Europe to establish partnerships with private insurance companies to serve the needs of domestic clients with employees located overseas, and to assist foreign insurers to develop supplemental lines of health coverage’s such as dental insurance. It was an opportunity to observe nationalized health systems up close.

In the broad picture European and Canadian health systems function well. As compared with the U.S. system, they provide basic, life-saving medical insurance coverage to all citizens regardless of health status with loser costs and better outcomes. The U.S. system remains mosty private except for selected segments of the population such as seniors. The World Health Organization ranking for the quality of national health care systems pegs the U.S. # 37, even though we spent nearly twice as much as others to sustain our system.

Increasingly Americans are traveling to foreign countries for major health services. Open heart surgery in India is half the U.S. cost with better outcomes. The number of U.S. citizens going overseas for care now exceeds the number for foreign residents coming to the U.S. for health care services.

It is fair to say that covering everyone as in European and Canadian plans can produce waiting lines and a lower quality of care. For example, an age 80 patient in need of a hip replacement may be assigned to the end of the line to favor a patient half that age that can be expected to quickly return to a productive position in the work force. However, if this is of concern to a covered individual that person often can purchase supplemental insurance coverage from a private insurer at their own expense. For various reasons the private insurance component in Canada is very low, only about 1% of core services.

I know of no health insurance system that works to absolute perfection for everyone all the time. But based on more than 40 years of experience in the private health insurance, and observing how it has developed, I am confident Americans would be much better served by a nationalized health insurance model such as embraced by all the other industrialized nations on this planet. Unfortunately, we have so politicalized the issue the benefits of a nationalized system may be delayed beyond the 80 year effort to do what is right for all Americans.