We all know the problems with American healthcare. It costs too much, there are gaps in insurance coverage, healthcare markets are uncompetitive, provider payments are often incomprehensible, pricing is opaque, bureaucracy is metastasizing, and our citizens face absurd barriers to personal choice of plans and providers.

These problems cry for solutions. Sen. Bernie Sanders (I-VT) recently restated his timeworn remedy for our ills: a “single payer” system of government-run national health insurance.

His reason to adopt such a system? The United States spends $4.9 trillion on healthcare, more than any other country in the world. But our medical outcomes in certain areas, such as maternal mortality, are substandard.

On that point, Sanders is right.

But our problems are much deeper than flawed financing and insurance arrangements. The root cause of our spending problem is a growing epidemic of chronic disease.

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More than 40% of adults are obese, and, unsurprisingly, over 85% of our healthcare spending goes toward treating and managing often-preventable chronic diseases and mental health conditions. Our raging obesity epidemic fuels cardiovascular diseases, certain cancers, diabetes, and its related comorbidities.

In short: Because of factors such as obesity, Americans are generally sicker than our counterparts in other advanced nations—and that means our doctors and hospitals must work harder than their counterparts in other high-income countries to treat costly chronic diseases.

But the news isn’t all bad.

When Americans get sick, we have reason to be thankful for the high-quality care available to us.  

Our many successes in care delivery are too often overlooked. We should be proud of our ability to respond quickly and effectively to treat major killers like cancer, heart disease, and strokes. And we should celebrate the stunning American advances in basic biomedical research, pharmacology, and technology.

Consider the facts.

First, the U.S. is the undisputed world champion in biomedical research. No other country even comes close.

Since World War II, 74 Americans have won Nobel prizes in physiology and medicine. American achievements have included breakthroughs like the discovery of streptomycin to treat tuberculosis successfully, the discovery of tumor-generating viruses, and research into how cell and organ transplantation can improve disease treatment.

Our Nobel Prize winners have also pioneered breakthroughs in our understanding of genetics, immunology, and virology. In 1988, the U.S. National Academy of Sciences outlined a successful research program to map the human genome, thus ushering in a new age of biomedical research that holds enormous potential to improve and extend human life.

With the ability to isolate the genetic predisposition to disease, the field for future innovation is wide open, including the potential of regenerative medicine such as ethical stem cell or cellular transplants.

Now, rapid advances in artificial intelligence bring a new host of possible clinical applications. Soon, medical professionals may be able to deploy a powerful new weapon in our growing arsenal to diagnose, treat, and even predict disease. 

But the U.S. isn’t just superior in biomedical research. It’s also home to rapidly advancing medical technologies to treat and cure disease such as robotic surgeries, personalized drugs, and advanced therapies that are most effective based on a person’s genetics.  

At the same time, America’s innovative use of telehealth allows tens of millions of patients in rural and “underserved” areas to receive care. Remote patient monitoring devices are now becoming widely available and increasingly affordable. Patients can now monitor their heart rate, blood pressure, and blood sugar — an ability that enables timely medical interventions and fewer visits to hospital emergency departments.  

Globally, no country comes close to developing the number of breakthrough and life-saving medications and therapies as the U.S.

According to 2023 clinical trial data, the U.S. had 8,403 medicines in preclinical and clinical development. The next closest countries were China, with 4,024, and the European Union, with 3,445. The leading “single payer” countries, the United Kingdom and Canada, had only 1,763 and 1,250, respectively.

In those “single payer” countries, the delivery of medical services is undercut by weak research and development, bureaucratic delays, and denials of available drug therapies. For example, one breast cancer therapy was initially approved in 2013 in the U.S. and Europe, but it wasn’t available for British women until 2017.

Similarly, in Canada, as Michael Baker of the American Action Forum notes, “only 11% of new cancer drugs that were approved for marketing in Canada, the United States or the EU between 2016 and 2020 were listed on its public formulary.”

In the U.S., on the other hand, our performance in care delivery is among the best in the world. The U.S. provides outstanding training for physicians and other medical professionals and is home to some of the finest medical facilities in the world, including Massachusetts General Hospital in Boston, Johns Hopkins University Hospital in Baltimore, the MD Anderson Cancer Center in Texas, and the University of California in San Francisco.

Researchers at the Commonwealth Fund of New York, a liberal think tank, routinely give American healthcare a “failing” grade on their metrics. But even they report that among 10 economically advanced countries, the U.S. ranks second in the “care process,” behind the Netherlands, when one considers “prevention, safety, coordination, patient engagement and patient preferences.”

These researchers note that a “concerted focus in the U.S. on patient safety since the beginning of the century has yielded significant reductions in adverse events during hospital stays for heart attack, heart failure, pneumonia and major surgeries between 2010 and 2029.”

Similarly, while cancer is the leading cause of death in the U.S. and worldwide, American cancer survival rates are impressive. A common measure of success is the five-year relative survival rate, meaning the percentage of people in the general population with “the same type and stage of cancer” who live at least five years after diagnosis.

According to data from the National Breast Cancer Foundation, Americans’ relative five-year survival rate for all types of breast cancer is 91%, and for early-stage breast cancer, it’s 99%. According to the data from the American Cancer Society, the five-year “relative survival rate” is 90% for Americans with prostate cancer and 80% for those with colorectal cancer.

Yet under a “single payer” system like the one that Sanders wants, we likely wouldn’t see as much success.

Just look at the U.K.’s “single payer” performance in treating cancer.

Ishani Sarkar, an analyst with MacMillan Cancer Support, observes that “cancer survival rates in the U.K. are as much as 25 years behind other European countries.” According to Sarkar, “analysis suggests if the U.K.’s survival rates matched the best in Europe, thousands more people who are diagnosed each year would survive their cancer for at least five years.”  

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And “single payer” care’s promise of universal coverage means little if one cannot access medical care.

According to a recent report by the British Medical Association, the U.K. has approximately 7.5 million cases on waiting lists. The median wait time is 14.2 weeks, and about 200,000 patients have been waiting for over a year for treatment.

In Canada, wait times from an initial referral from a primary care physician until “receipt of treatment” reached 30 weeks last year—a record high, according to a recent Fraser Institute report.

Americans should celebrate our successes in reducing death from big killers such as cancer and heart disease.

As Douglas Holtz-Eakin, former director of the Congressional Budget Office, said, “Healthcare is about access to good preventive care and, especially, to the most innovative treatments when, God help us, we need them. America does that better than any country in the world.”

While U.S. healthcare financing is far from perfect, those facing diseases such as breast cancer stand far better odds in Massachusetts or Maryland than in London or Liverpool.

And now, the new administration has the chance to make America healthier than ever.

When accepting his nomination, President Donald Trump promised to “unleash the power of American innovation.” In doing this, he said, we’d “soon be on the verge of finding the cures to cancer, Alzheimer’s, and many other diseases.”

Dr. Marty Makary of Johns Hopkins University recently took the reins at the Food and Drug Administration, and Dr. Jay Bhattacharya of Stanford University is now leading the National Institutes of Health. Together, Secretary Robert F. Kennedy Jr. and his new leadership team at the Department of Health and Human Services can reemphasize prevention, delivery of quality care, and rigorous and transparent medical science.

These efforts will unleash a new and prosperous golden age for medical innovation in the U.S.—one that will benefit both us and our friends overseas.