The Premise

COVID-19 Update: This project is currently on hold due to the COVID-19 pandemic.

A common refrain in U.S. health policy conversations is that every other high income nation has figured out how to provide accessible, high-quality care to all of its citizens – so why can’t the U.S.? In 20 years of studying health care policy, Harvard professor Ashish K. Jha and his team at the Harvard Global Health Institute have learned that the reality is rarely so simple, though far more interesting. Since no country or plan can cover everyone for everything all the time, designing a healthcare system requires making difficult choices — yet we all know very little about how these choices are made, and how they affect patients and caregivers.

The Journey

In a groundbreaking new project, Dr. Jha, a practicing physician, and his team at HGHI will take their expertise to the front lines. 200+ research papers into the quest to provide better evidence for decision making in healthcare, they want to know: Beyond the numbers, what is it like to have a disease such as Cystic Fibrosis in the UK, a single payer system, versus Netherlands, which has a large role for private insurance? What are the experiences of a woman with a hip fracture and her care team in Germany, where social insurance is common versus Singapore, where out of pocket spending is common? And across these systems, to what extent do people feel treated with dignity and respect? Are delays in care a real problem? Is access to high-cost medicines and other therapies difficult? And how do health systems interface with social care systems to meet social needs, especially those of the poor?

By traveling to eight countries from January through June 2020 and engaging with patients, families, physicians, nurses, administrators and policy makers, Jha and his team will explore how a diverse set of high-income nations comparable to the United States chooses to care for their people, and what the outcomes created by those decisions feel like for both patients and providers of care. In podcasts, short videos, perspective pieces in medical journals, public talks and social media conversations, this project will weave together numbers and narratives, and make visible the values, customs, hardships and trade-offs that are at the heart of healthcare systems everywhere.


Learn more about our opinions and expertise on international health system comparisons:

Why Is U.S. Health Care So Expensive? Some of the Reasons You’ve Heard Turn Out to Be Myths. The New York Times, 2018.

Why Does the U.S. Spend So Much on Health Care? Learning from World Comparisons. AMA Moving Medicine Podcast, 2019.

This Study Changed How a Harvard Professor Thinks About Health Care. Vox, 2018.

The U.S. Spends Twice as Much On Health Care as Other High-Income Countries. TIME, 2018.

The Best Health Care System in the World: Which One Would You Pick? The New York Times, 2017.


Read our peer-reviewed international comparisons work:

Health Care Spending in the United States and Other High-Income Countries. JAMA, 2018.

The Relationship Between Health Spending and Social Spending in High-Income Countries: How Does the US Compare? Health Affairs, 2019.

Challenges in International Comparison of Health Care Systems. JAMA, 2017.

Performance of UK National Health Service Compared with Other High Income Countries: Observational Study. BMJ, 2019.