The U.S. is the Only Very Highly Developed Country Without Universal HealthCare fact

Is the United States of America Really the Only Major Developed Industrialized Country in the World Without Universal HealthCare?

The United States of America is the only “very highly developed country” that doesn’t have universal healthcare out of over 50 nations.[1][2][3]

NOTE: There data below is from 2017, it is still generally true, but all data is subject to change over time. You can always check the Human Development Index for the current data.

More specifically, when we look at the top 33 major industrialized and developed countries in the world according to the Human Development Index (which measures “development” based on like GDP, GNP, per capita income, and standard of living), we can confirm:

  • All the top 33 very highly developed countries except for the U.S. have a form of universal healthcare that is generally working to “cover substantially all of their population,”
  • The same is generally true for the top 34 – 51 countries with very high development (with the note that some of the 34 – 51 are in a transition stage, like Qatar, and some have notable problems with healthcare delivery like Russia; meaning some of these countries don’t effectively “cover substantially all of their population” even though they have universal coverage or are moving toward it on-paper).

With that in mind, the list of highly developed countries (who also have some form of universal healthcare) includes: 1 Norway 2 Australia 2 Switzerland 4 Germany 5 Denmark 5 Singapore 7 Netherlands 8 Ireland 9 Iceland 10 Canada 11 United States 12 Hong Kong 13 New Zealand 14 Sweden 15 Liechtenstein 16 United Kingdom 17 Japan 18 South Korea 19 Israel 20 Luxembourg 21 France 22 Belgium 23 Finland 24 Austria 25 Slovenia 26 Italy 27 Spain 28 Czech Republic 29 Greece 30 Brunei 30 Estonia 32 Andorra 33 Cyprus 33 Malta 33 Qatar 36 Poland 37 Lithuania 38 Chile 39 Saudi Arabia 40 Slovakia 41 Portugal 42 United Arab Emirates 43 Hungary 44 Latvia 45 Argentina 45 Croatia 47 Bahrain 48 Montenegro 49 Russia 50 Romania 51 Kuwait…

Not only that, but one can keep going down the list of countries by Human Development Index, and look at all 196 countries, and it won’t be until somewhere mid-way through the high development list that we find a country with as many uninsured as the United States of America.

NOTE: The specifics pertaining to the list above are from the time I referenced it back in 2017. With that in mind, it is important to understand that the countries who make the list and their order of ranking change over time. So in theory a country without universal healthcare could make the top 50 list in future years, in a given year there could be more or less than 50 nations in the “very highly developed country” category, and in a given year there could be more or less developed nations in general who make the list at all. That said, countries who make the top of the list tend to also have universal healthcare. For example, Kazakhstan made the “very highly developed country” category in 2017 after I wrote the above, and they also have a universal healthcare system. Please see the 2018 list for the most recent figures.

TIP: To be very clear, the above doesn’t mean that every one of the aforementioned systems delivers the quality of care the U.S. does, and that doesn’t mean every one of these systems is “working perfectly,” it simply means every other very highly developed country on earth except the United States of America has some form of universal coverage (on-paper at least).

TIP: Sometimes people phrase this as “the only major country,” “the only developed country,” or “the only major industrialized country.” To avoid being vague, one can say, “of the top 50 countries with very high human development according to the Human Development Index[4], the United States is the only country without a Universal HealthCare system [with the note that a few countries are in the process of implementing their universal systems].” The reason we want to say it like this is because the list also includes countries with “high development,” “medium development,” and “low development” (and semantically we could call any stage of development “developed;” so “major” or another qualifier makes sense to use).  In other words, the factoid we often hear that “the U.S. is the only major/developed/industrialized country without universal healthcare” is very much correct, but its accuracy depends on being specific (after-all, speaking loosely, some “developed and industrialized” countries [“developed” not “very highly developed” countries] don’t have universal healthcare, like Mexico for example; although, to be fair, Mexico is making headway).

What is Universal HealthCare?

Universal healthcare is any healthcare system that provides at least basic coverage to substantially all its citizens (some developed countries use models that cover “almost all” citizens; like Slovakia).

It doesn’t mean that coverage is free, it doesn’t mean all out-of-pocket costs are covered, it is about providing at least basic health services and ensuring against financial catastrophe due to healthcare costs.

TIP: Learn more about Universal health coverage (UHC) from the World Health Organization.

FACTS: According to the World Health Organization in 2016, every year 100 million people are pushed into poverty and 150 million people suffer financial catastrophe because of out-of-pocket expenditure on health services.[5] Before the Affordable Care Act medical debt was estimated to be the number one cause of bankruptcy. Under the Affordable Care Act filings for bankruptcy dropped about 50 percent, from 1,536,799 in 2010 to 770,846 in 2016.[6]

WHO: Universal Health Coverage – What does it mean?.

TIP: To be clear not all other countries have “single payer,” they all have some form of universal coverage. Single payer is not exactly the same as universal.

TIP: Don’t confuse universal healthcare with single payer or a fully socialized system. Some countries with universal healthcare use a public fund (single payer), some use a hybrid system of public and private insurance, some use public healthcare, some use a mix of public and private providers, some simply subsidize the private system.

Healthcare Around the World.

Why Isn’t the United States HealthCare System Considered Universal?

The American healthcare system isn’t universal because it excludes tens of millions of people based on cost.

The Affordable Care Act (ACA or ObamaCare) made steps toward universal coverage, but the states that blocked Medicaid expansion (which expanded basic coverage to those with lower incomes) ensured that the ACA was not able to cover “substantially all” Americans.

Now, with the ACA being repealed, the United States is moving away even further away from universal healthcare.

What the U.S. Can Learn About Health Care from Other Countries.

FACT: In 2017 the CBO and JCT estimated that enacting the Better Care Reconciliation Act of 2017 (the repeal and replace plan for the ACA) would reduce federal deficits by $321 billion over the coming decade and increase the number of people who are uninsured by 22 million in 2026 relative to current law (for a total of 49 million uninsured). 49 million uninsured out of 320 million citizens isn’t just not universal coverage, it is more uninsured than many undeveloped countries.

“As I see it, the task of government in its relation to business is to assist the development of an economic declaration of rights, an economic constitutional order. This is the common task of statesman and business man. It is the minimum requirement of a more permanently safe order of things.” – FDR talking about “Second Rights“.

FDR Second Bill of Rights Speech Footage.

MYTH: The idea that universal healthcare can’t work in the U.S. due to size alone is a myth. The U.S. has 50 states, each with populations equivalent to nations with universal coverage. It is also a myth that universal healthcare isn’t working in other countries, some systems work better than others, but in general countries with universal healthcare have some of the best healthcare in the world (and many spend less per capita than the U.S.).[7]

FACT: Healthcare was declared a universal human right after America helped the Allies win WWII. The U.K. immediately adopted a universal healthcare system (NIH), and most major countries followed suit (including most of the Axis; Germany, Turkey, and Japan, all have universal healthcare). Today in America we still argue over whether or not healthcare is a human right. The side that says it is not won the 2016 election and has sought to dismantle the current healthcare system (which will result in even more uninsured).

What is a Developed Country?

A developed country (AKA an industrialized country with a developed economy) is a sovereign state that has a highly developed economy and advanced technological infrastructure relative to other less industrialized nations.

Although the criteria for denoting a country as developed is a little vague, we can generally point to 39 countries that meet this standard here in 2017 based on factors like gross domestic product (GDP), gross national product (GNP), the per capita income, level of industrialization, amount of widespread infrastructure and general standard of living (see a definition of “Developed Economy“).

Of those who meet this standard, the United States is the only country that doesn’t have a universal healthcare system.

Below is a list of the top 51 highly developed countries (a wikipedia list pulled from the UNDP Human Development Report 2016), literally every country except the United States on the very high human development list has a universal healthcare system.[8]

NOTE: Some of these countries use a hybrid model where basic care is free and better care comes at a cost. With that said, you can google any country on the list with the term “healthcare” and see proof they have some form of universal healthcare system (I did this for every country on the list already, I can confirm they do). The only other notes is that some countries, like Qatar for example, are transitioning into a universal system.[9]

Very high human development (see List of countries by Human Development Index)

For another list, here is the CIA’s list of 33 developed countries [10]

 Andorra  Faroe Islands  Ireland  Monaco  Spain
 Australia  Finland  Israel  Netherlands  Sweden
 Austria  France  Italy  New Zealand   Switzerland
 Belgium  Germany  Japan  Norway  Turkey
 Bermuda  Greece  Liechtenstein  Portugal  United Kingdom
 Canada  Holy See  Luxembourg  India  United States
 Denmark  Iceland  Malta

FACT: According to the World Health Organization UN Member States (many of which are not on the “very high development” list) have agreed to try to achieve universal health coverage (UHC) by 2030, as part of the Sustainable Development Goals.

Article Citations
  1. Dan Gecker says U.S. only wealthy nation without universal health care
  2. Bernie Sanders: U.S. ‘only major country’ that doesn’t guarantee right to health care
  3. Developed country
  4. the Human Development Index – official list
  5. Universal health coverage (UHC)
  6. How the Affordable Care Act Drove Down Personal Bankruptcy Expanded health insurance helped cut the number of filings by half
  7. List of countries by total health expenditure per capita
  8. UNDP Human Development Report 2016
  9. List of countries by Human Development Index

Of the top 51 countries with very high human development according to the Human Development Index[11], the United States is the only country without a Universal HealthCare system [with the note that a few countries are in the process of implementing their universal systems].

Author: Thomas DeMichele

Thomas DeMichele is the content creator behind,,, and other and Massive Dog properties. He also contributes to MakerDAO and other cryptocurrency-based projects. Tom's focus in all...

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Silje Kring Did not vote.

THE ARLINGTON FREE CLINIC, in the American state of Virginia, is a world away from the treatment rooms of sub-Saharan Africa. Thanks to local doctors and nurses who donate their time to the clinic for people without health insurance, the patients get care akin to that in nearby private hospitals. They are fortunate: of the more than 1,000 free clinics in America, few are as well-run or offer such a broad range of services. And even in Arlington getting access is partly a matter of luck. The clinic holds a monthly lottery to decide which locals will be added to its rolls. Out of an estimated number of those without insurance of 20,000, the charity can offer free specialist care to only 1,650. Despite the passage of the Affordable Care Act in 2010, America remains an outlier in health-care provision. It has some of the best hospitals in the world, but it is also the only large rich country without universal health coverage. And health-care costs can be financially ruinous.

William Did not vote.

Affordable health care for the poor working people starts from affordable education at universities , Wich is low cost or free in many countries , yes many countries have free universities Wich is the opposite in USA , plus universal health care at affordable price . any teen trying to be a surgeon in the future he is in a hole of debt before he earns a dime , everything is a business in USA , education and health care , let’s not talk about dentistry that’s another ripp off. I don’t think that at any point will be any hope in fixing the system the system is corrupted because is all about money , not education or Heath care , very sad , and more sad is that everybody at one point will be sick or injure , if you are cough in the wrong system well you got a problem . Example a working average min wage earning 20 k per year hurts his knee out of the blue with a wrong turn so you go to the ER get a x Ray cause if not a death situation you won’t get a MRI , so you get pain killers and a knee bracket , and advice to see a orthopedic next day that will be a $1k bill to pay from the ER , orthopedic visit $170 he will send for a MRI that’s about $2k and bad luck for you also need surgery $5k what you do??? More than 8k to pay if you have the money but if you don’t ?? Well maybe limp for life , it is terrifying just to think about it but nobody does till to late , and let’s not talk about a serious illness OMG . Maybe living in the USA it’s not that attractive anymore , too many good places to choose , the world is very big never get attach to one place that does not cover you when you need it most . Cheers

MARIA BRUNSON Doesn't beleive this myth.

I have lived in the U.S. all my life and am a Grandmother. As I was growing up, my parents did not buy me a car and designer jeans, etc. When I got married, they paid for a modest wedding, I went to College and paid for it myself with summer jobs, I bought my first modest home with 10% down, and drove an old VW bug. We didn’t have a ski Boat or a NEW BMW or Camero, We didn’t have much of anything except hand-me-down furniture and we were grateful for that. Now, we have whatever we want. We saved and didn’t get deductions for child care, college grants and write
offs and we didn’t expect them. Everyone wants everything for free. The kids (up to 30) expect the rest of the country, including the elders to pay for everything that they want so that they get it for nothing. So, we paid for it then, and now as retirees, we are required to do it again. I say, NO. Pay your dues Kids. We Did, and we only made $10 to $15 an hour after graduation from college.

Michelle Did not vote.

You have a warped and inaccurate sense of reality. Fact.

Andrew Frederick Wilks Supports this as a Fact.

Knowing now how the USA is compared to rest of developed world here makes me resent being born and raised here in the USA! For almost the last 10 years I have learned about things from healthcare here in USA compared to rest of developed world and also have learned many other things about USA compared to rest of developed world. The more I learn about USA and these other developed countries, the more I hate living in this country.

PSC Supports this as a Fact.

Not only that but US policy makers of both parties are also misleading the entire nation as to the true causes of this impasse. The real cause is arguably a trade agreement we signed in the 1990s, the General Agreement on Trade in Services.

Why don’t you fact check me on that one? You can find lots of resources about it on my web site, and elsewhere, although precious litte when you consider how important this question is to the country and the world.

My web site is policyspace dot xyz .

Please let me know the outcome of your investigations at my email address. It’s hard to believe we have been so gullible. But I think we have been.

The leaderships of both major US parties are playing us, our whole country, for fools. These trick agreements lock in so we’re in very grave danger.

If we do a number of quite likely things, our status silently changes.

We could also lose millions of jobs.

its complicated how the GATS works, but its not rocket science.

We found out the hard way in the US Gambling case, between Antigua-Barbuda and the US over the supply of online gambing services, a case that kind of has the smell of a test case to establish a legal precedent to be used later. There is even an anonymous letter that led to its filing. Why does that matter? Its all about hidden traps, and can they be lethal. To democracy.

The same thing seems to be happening with India and the UK.

We’re being set up for a big heist of our democratic policy space.

The oligarchies of all these countries can’t just come out and say “we’re getting rid of democracy because we’re afraid it might happen for a change” Instead they help each other get rid of it, by pretending to be adversaries, in the WTO and similar trade bodies. You’ll see. (<<<Speculation but supported so far by Brexit and some other cases pending in the WTO)

The GATS also threatens Social Security and Medicare. Please read the beginning of the Annex on Financial Services to see how that might happen. It also is the reason behind the repeal of the good parts of the ACA, (which appears to likely have been overshadowed from the start by a freeze on financial services regulation after 1998, a so called standstill clause in the Understanding on Commitments in Financial Services. There we also pledged to dismantle or reduce in scope any non conforming monopolies.)

Basically, the 'GATS' agreement as its called trades 'services' a very very broad term that encompasses 80% of a modern economy. "Everything you cannot drop on your foot" the UN has a short course in its scope and how disputes work, here.

It regulates governments for corporations, framing (increasingly endangered) public services as trade barriers, pushing countries to give up public services like healthcare, higher education, water, etc. so that multinational corporations can make money off of them.

The GATS may have also been behind the 2008 financial crash What do you think? Is a single line at the top of the very last page in the US SoC supplement 3 filed Feb 26, 1998 in Geneva (SC/90/S3) where the US cited the GATS as the reason we repealed the Glass-Steagall Act – "proof" that an obscure trade agreement 'caused' the largest financial disaster since the Great Depression? Or not?

Seems a lot of effort has been devoted to have people blame other things-anything but that. And now they want to deregulate more.

Carol M. Supports this as a Fact.

Pharmaceutical companies in US are very corrupt. We have our share of corruption in this country. I work for a Corporation that supposedly provides us with health care coverage, yet it still costs just me 200.00 per month to cover the basics. My deductible is very high; in the thousands, and it’s going to get worse. Americans will all finally pray for universal health coverage the day that Corporations decide to not provide for Health Coverage at all, the same way they chose to not provide pensions anymore. That day is coming. My parents were not educated, they were blue collar workers. My mom retired from a dept store 30 years ago with a pension. My dad retired from a grocery store with a pension. That doesn’t happen anymore. No pensions, no medical benefits when you retire (when we will need them the most). The U.S. govt has allowed the Pharmaceutical companies, hospitals, and doctors control the high cost of health care. It’s a shame and it’s plain old corruption hiding behind government and the medical industry. It’s extortion and corruption hiding behind a so called legitimate industry. And our politicians are no less corrupt than other country’s politicians.

Steve Doesn't beleive this myth.

We fail to take into account the fact that the U.S. is the worlds marketplace for pharmecauticals as well as everything else. The price fixing required to support universal health care in other countries is only possible in many cases because foreign pharmaceutical companies are able to make up shortfalls by selling to the U.S. at inflated prices. If we go to Universal health care a number of “highly developed”countries will find it very difficult indeed to support their universal health care because WE are no longer paying for it once we implement the same obviously necessary price fixing required to make pharmeceuticals and other health care related consumables affordable in the zero sum downward spiral that socialized medicine always turns into IF any subject contiguous ethnicity demands a high quality of care. Simply put, you can only rarely have good fast and cheap all at the same time. You typically have to sacrifice one or more for the others. Socialized medicine pretends to “have it all” by robbing peter to pay paul to the temporary political advantage of some few leaders, but it always eventually outs itself like the VA or Canada’s confession of a broken healthcare system (something their citizens knew many years ago, and something I’ve personally witnessed). My contention is that the U.S. may be the only highly developed country without universal health care, but it’s only because we can afford better generally speaking. I would even contend that the poor were being better served by medicare, medicaid before Obamacare as they had a much lower premium with an equal level of care.

lili Supports this as a Fact.

I lived in France for 17 years with universal healthcare and appreciate it so much more now that I don’t have it anymore. I won’t go into the details of how their healthcare system functions but I will say that most Americans have a lot of misconceptions about social healthcare; that it is free and subsidized by the government…Americans are afraid of big government interference. I do not know how the health care system works in other countries but I can say that in France they have universal healthcare in which a portion the healthcare is reimbursed by the government and much of the rest is reimbursed by a private insurance you take with your employer or you purchase independently. There are so many other factors involved, such as the fact that doctor’s fees are fixed and determined by the government; 23 euros (which is equivalent to about $23) for a visit with a general practitioner. Just penny’s compared to a doctor’s visit in the U.S. and at least you know how much you are going to pay, no surprises.
What I have noticed the most since my return to the U.S is the enormous stress I feel in regards to finances and bills, something I never experienced in France. I think Americans are under great stress levels to make money because they have to plan for retirement, pay for their children’s college education (also free in France if attending a public school) and pay for health insurance.

Jim Basta Did not vote.

You can’t vote on whether or not something is fact. It is or it isn’t. Opinion has nothing to do with it. But this is America in the 21st century. “Facts” are subjective and we can make up our own to support our ignorance.

tim allen Supports this as a Fact.


Michael Genius Did not vote.

Interestingly, none of the countries listed besides the US have tens of millions of unhealthy, low-iq, welfare-dependent black and hispanic people who love to abuse emergency rooms and clinics. That’s the problem.

Shelly Supports this as a Fact.

It’s a shame that the American people have bought hook line and sinker the sham that the United States of America is the greatest country on earth and we don’t have UH let alone affordable education! Americans spend their whole life worried about paying for health care, education and retirement! Crazy!!

WILLIAM HORVATH Supports this as a Fact.

The strong American ethic of individualism is contrary to universal healthcare coverage. The Calvinist notion persists that God-fearing, hard workers will take care of their own needs. If not, it is due to earned punishment by God. Another factor is the widespread myth that people who don’t work and are lazy, especially minorities, should not be indulged and enabled. The Ayn Rand books package these ideas as survivaĺ of the fittest. The weak are on their own, and that’s just life. Finally, the history of health insurance as a work benefit fuels the myth that only the lazy and on-the-dole Americans don’t have such insurance. Many, if not most, Americans ignore the possibility of catastrophic illness to themselves or family members. Funny how people suddenly impoverished for the rest of their lives due to astronomical medical costs not covered by their
insurance, reconsider and regret their stance agaist universal coverage. Many Americans are willing to gamble that they won’t need health insurance until they are 35 or 40 years old. “I’m alright, Jack. I’ll take my chances.” I hope I live to see universal health care.