Achieving Universal Coverage without Turning to a Single Payer: Lessons from 3 Other Countries

A primary obstacle to achieving affordable universal coverage is the high costs of those with diseases or costly traumatic events — approximately 20% of patients account for approximately 80% of all health care spending. Although many OECD nations rely on a governmental single-payer model to achieve universal coverage, three other countries — Switzerland, Germany, and Singapore — use use private sector insurance to offer affordable universal coverage. We review potentially helpful lessons from these nations to inform American health policy.