It’s often claimed that other Western nations achieve as good or better outcomes from their nationalized health care systems as Americans achieve with our strange mix of private and government-funded health insurance—and at far less cost. Assuming that claim is true, it might be true for a reason policymakers haven’t considered. Right now, a hugely disproportionate share of the world’s medical innovation happens at the high end of America’s health care market. People like me benefit hugely from that innovation: I’m a well-insured cancer patient living near Boston, which may have the world’s highest per capita concentration of medical talent outside Rochester, Minnesota. But we’re not the only ones who benefit. The most successful of those medical innovations soon filter down to the rest of America’s unsystematic health care system, and then to other parts of the rich world.
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