Sarah Kliff over at Vox wrote an excellent article, Five Ways the American Health Care System Is Literally the Worst. It is based upon a new Commonwealth Fund report that is based upon three different report looking at the healthcare system from the perspectives of sick people, healthy people, and doctors. It compares only the rich countries, and the United States comes out at the bottom of the pack. So what? The United States always comes out at the bottom of the pack. I agree: this is not news.

What is news is that this is a rather new and more thorough way of looking at the question. And the rankings of the other countries are quite different from what other studies have found. So it is of some note that it doesn’t really matter how you look at healthcare systems, the United States always does the worst and it is never close. It is also interesting that the conservatives who want to defend the United States will always point to some kind of anecdotal evidence that even if true only shows that if you can afford it, you can get the best healthcare in the United States. This, by the way, gives the wrong idea. It is also true that if you can afford it, you can get the best healthcare in just about any advanced country.

What I want to focus on is cost. Here is a table of the eleven countries studied, their overall ranks, and the per capita healthcare costs:

Impressive how the great “free market” system we have works! But it’s not just that. Of the top four most expensive systems, three are multi-payer systems. The only multi-payer system on the list that has a low cost is France, and it is rated pretty poorly.

Of course, it isn’t just the fact that we have a multi-payer system that causes our healthcare to cost so much. As Dean Baker likes to point out, there are enormous protectionist tendencies in the US system. For example, we limit the number of doctors who can practice here and as a result, doctors make a whole lot more money in the United States for doing the same work doctors do elsewhere. And the drug patent system makes medications far more expensive than they need to be.

The point is that conservatives may claim that they are out there trying to protect capitalism and the free market. But what they are really protecting is just the status quo. They are protecting a healthcare system that is just a legacy of wage controls during World War II. But most of all, they are protecting the unreasonably high wages of doctors and the ridiculous profits of drug companies. And a little appreciated thing they are protecting is the health insurance industry, even though it isn’t that profitable. It adds a lot to the cost of healthcare, but it doesn’t make much money.

The great irony of this list is that the top rated country, the United Kingdom, has actual socialized medicine. The doctors work for the government; the hospitals are owned by the government. And as a result, they seem to provide great care at 40% of the cost of our system. And here’s an even greater irony: people in the United Kingdom report the lowest amount of dealing with paperwork. And the countries with the most “free market” approaches are the ones where people complain the most about paperwork. This is something that conservatives (Libertarians especially!) can’t seem to understand: bureaucracy is bureaucracy. Whether you are fighting with your insurance company or you are fighting with the government health services. Except it seems that there is much less fighting with the government health services.

The three reports that the data were taken from were from 2011, 2012, and 2013. With the full implementation of Obamacare, things will improve modestly. But I suspect we will still rate at the bottom of the pack. And we will continue to pay a lot more for our inferior care than people do in other countries. The only thing special we get in this country is a bunch of fools who go around saying, “America has the best healthcare system in the world!”