- We are often told by advocates of universal government health care that “other developed nations have universal coverage, and they spend less and get better health outcomes”
- This claim is designed to persuade people that universal coverage would fix what ails the U.S. health care system
- Under even minimal scrutiny, however, these claims fall apart
A similar version of this article was originally published by Law & Liberty.
In part one of this article, I began to expose the truth behind the claim that “other developed nations have universal government health care coverage, and they spend less and get better health outcomes.”
For starters, the difference in health outcomes being referenced in this claim boils down to life expectancy. These differences, however, can be attributed to societal, dietary, and life choices instead of quality of health systems.
Below, I will continue to expose the truth behind universal health care coverage in other developed nations, revealing that they are far from the utopias universal coverage advocates make them out to be.
England
England’s National Health Service (NHS) was once supposedly a point of pride for Brits. It’s a universal, publicly funded program in which patients are provided care for free at the point of use. Some costs, such as prescriptions and dental care, however, require a copay.
Like Canada’s universal system, England’s NHS suffers from long wait times and is in financial peril. Frustration with the system has reached all-time highs.
This 2024 survey by The King’s Fund found “6 in 10 people (59%) said they were ‘very’ or ‘quite’ dissatisfied with the NHS,” with 65 percent of respondents saying they were dissatisfied with the length of time it takes to get hospital care.
Indeed, a 2025 study by The King’s Fund found that more than 6.2 million people are on waiting lists and around 171,000 people (nearly 3 percent) had been waiting longer than one year for treatment.
The report further notes that the “NHS Constitution sets a standard that 92 percent of patients should wait no longer than 18 weeks from elective (non-urgent) referral to their first treatment (for example cataract surgery or a knee replacement).” But this standard has not been met since 2015.
Such insufferable wait times has more Brits paying for private insurance options. This 2025 Insurance Business article reported that about 14 percent of UK adults have private insurance, noting “The demand for private healthcare is expected to rise further, given the ongoing NHS treatment backlog.”
Also like Canada, England’s NHS is, as described in this March 2026 article in The Independent, “grappling with a ‘perilous’ financial situation.” The article further notes that the local organizations in charge of running medical facilities (known as “trusts”) have been losing money for eight of the last 10 years.
A senior policy analyst for one of those trusts was quoted last year about these deficits showing “just how fragile the financial health of the NHS is, which should sound alarm bells.”
In response to these massive deficits, the NHS is being asked to find cost savings for FY 2025–26 of 7 percent, a drastic year-over-year reduction.
The desperate need for cost savings will result in significant reductions in care providers.
Unison, England’s leading public service union, anticipates “at least 21,000 roles are due to be cut by 2028 in hospitals and other health facilities.” The union further warns that “efforts to meet the government’s demand for trust budgets to break even from this year are driving widespread workforce reductions across hospital, community and mental health services.”
The union warns of a “doom loop, with increased workloads leading to burnout, sickness and even more staff leaving overstretched services so the pattern continues.”
Such staffing reductions would not be new but instead continue a trend. In March 2024, The Times (UK) reported that “Hospitals are preparing to cut spending on doctors and nurses by hundreds of millions of pounds after being ordered to plug a £4.5 billion hole in the NHS budget.”
Cutting tens of thousands of health care workers will only make the brutal wait time problem even worse.
Just like in Canada, England’s universal health care system suffers from excessive wait times, emerging and worsening shortages of providers, desperate patients willing to go out of pocket for private alternatives, and financial crisis.
I’m detecting a pattern.
Sweden
But what about Sweden?
American progressive love to prop up Sweden as a great example of a successful, developed nation with a robust welfare state, including a universal health care system.
Sweden has a universal system that is nationally regulated, locally administered, and financed via a combination of local and federal governments.
At this point, you won’t be surprised to learn that, as described in this 2025 Fortune Journals study, “recent trends indicate a growing crisis in wait times” for care in Sweden, exacerbated by “Healthcare staff shortages, especially among specialists and nurses.”
This is not a trend just cropping up in the last few years or merely continued fallout from Covid. In 2018, this INQUIRER.net article described how “Swedes are frustrated over their universal healthcare, one of the main pillars of their cherished welfare state, with long waiting queues due to a shortage of nurses and available doctors in some areas.”
Despite Swedes paying, on average, half their income in tax, roughly 80 percent of the health care sector suffered from shortages of nurses in 2018. Sweden even has a law “stipulating that patients should wait no more than 90 days to undergo surgery or see a specialist.” Yet, one-third of patients were waiting longer at that time.
By 2024, waiting lists for medical care were the longest since they began tracking them, and a record number of people had been waiting for procedures longer than the supposed guarantee of 90 days, as revealed in this 2024 Nordic Times article.
Frustration over mounting wait times has been bubbling over. As reported in this 2024 Euractiv.com article, overcrowding in care wards has gotten so bad in some hospitals that reports emerged about “patients who use spoons and pans to make themselves heard in hospital corridors, unattended deaths, and a lack of specialised doctors and nurses.”
Like Canada and England, a growing number of Swedes are turning to private health care options in a desperate attempt to get timely care.
An industry report published in 2024 noted that “private health insurance in Sweden is growing in popularity, especially among individuals seeking faster access to specialized care, elective surgeries, and alternative therapies,” and that demand is expected to continue to grow.
Current estimates by the Commonwealth Fund report that “Approximately 13 percent of employed residents have private supplemental coverage, mostly for improved access to private specialists.”
Finally, also like Canada and England, Sweden’s system is struggling financially. The 21 regions, which manage their local health care providers, combined for billions in budget deficits in 2024, per Euractiv.com.
According to World Bank data, health care costs in Sweden are rapidly consuming a greater share of the economy, rising from 7.3 percent of the nation’s GDP in 2020 to 11.2 percent in 2024.
Even this small country with a population smaller than the state of North Carolina can’t avoid excessive wait times, provider shortages, and sizeable fiscal deficits in its universal health care system.
Other examples
These aren’t just three cherry-picked outliers. Developed nations with universal health care systems are routinely plagued with long wait times and financial distress.
In Italy, articles report on a “growing crisis” caused by years of neglect and underfunding. “Reports of extreme waitlists are constantly emerging,” declares this 2025 Herrisezine article, citing estimates of more than 4 million Italians foregoing treatment due to long waiting lists.
French budget writers are proposing billions in cuts to their health care program, because spending has become unsustainable. Some of these cuts would shift more of the burden on patients via increased out-of-pocket expenses for medicine. Moreover, French private doctors were threatening to strike earlier this year, a move that reportedly served “as a reminder to the severity of the crisis facing medical professionals and the fragility of the French healthcare system.”
As The Guardian reported in 2024, the French system “is creaking under staff shortages, increasing costs and growing demand.”
This 2025 article published in the National Library of Medicine reported that three out of four hospitals in Germany ended 2024 in deficit, “with nearly 89% of public facilities facing serious financial distress,” leading the German government to impose further cuts to hospital funding, which will likely lead to closures and downsizing.
The article further noted that “[s]taff shortages, inflation, and outdated infrastructure are pushing the system toward a structural collapse” and that “Germany already reports over 35,000 vacant nursing positions and a deficit of 15,000 physicians.”
A 2023 article observed that the “trend of nurse shortages in Germany has been evident for years, and for this reason, the authorities are trying to attract more foreign nurses to the country through the international recruitment programme,”
Conclusion
All this is not to say that the American health care system is without flaws. It suffers from doctor shortages — especially in rural areas — along with affordability issues. What is a point of debate is whether the problems in the U.S. stem from too much or too little government intervention.
Those who argue that more government intervention will improve things commonly point to other developed nations with universal government coverage as systems we should emulate.
But upon closer inspection, these systems suffer from significant systemic problems and are often described as being in crisis. Extreme wait times, rapidly rising spending with massive budget deficits, and staffing shortages all plague these supposed health care utopias. The supporters of government-run universal health care need to acknowledge these dangers. And, ironically, more and more people in these failing universal systems are turning to private options for access to timely care.
The solution is not to be more like these other developed countries suffering from this myriad of problems, but to move toward a market-based system. Once the harsh realities are exposed, the claims of government-run health care advocates lose all their weight.
