This is the Cato Daily Podcast for Tuesday, March 18th, 2008.

I'm Caleb Brown.

How does the U.S. healthcare system compare to national systems around the globe?

In his new policy analysis, the Cato Institute's Director of Health and Welfare Studies, Michael Tanner,

suggests that the grass is not always greener on the other side of the border.

The WHO rankings of health care systems actually punishes the United States and other countries

for out-of-pocket costs. That seems a little backwards. Well part of the way the

WHO ranks countries is based on how little or how free the health care actually is to people.

They count it as a fairness issue.

So things like out-of-pocket expenses count against a country. So do such things as not having a progressive

enough tax code or not having sufficient anti-smoking campaigns. I mean, there's all sorts of things that have nothing

whatsoever to do with a health care system that are part of the WHO rankings.

Now many countries control costs better than the United States but that seems a bit of a distraction since those

costs. The controls on those costs come at the expense of patients being able to

decide when and where they see a doctor. How does the US compare to national systems in terms of the government having the ability to restrict patient access to physicians?

It's very cheap not to provide health care. If you don't provide the services you can save a great deal of money.

The US gives people much more choice of physicians than many other health care systems. You can look at

countries like Spain for example where your doctor is assigned by virtue of

where you live. You have a geographic assignment. You move into a neighborhood, you

get a doctor assigned to you, you don't get a choice of physicians.

Like a public school?

Sort of like a public school and with about the same impact on quality in many cases.

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