the poorest, most crime-ridden cities in the nation. but first, let's talk about the one thing americans are certain is bad. government-run health care, across the atlantic, in great britain. is the nation's health service an evil death panel, as some say? let's take a look. during america's debate over health care reform, critics said britain's government-run system was an orwellian bureaucracy that rationed care to those in need. were they right? britain does have a system that is as close to socialized medicine as any rich country gets. the government pays for everything, own most of the hospitals, and pays most of the doctors. but consider this -- compared to americans, the brits have longer life spans, a lower infant mortality rate, and a health care system that consistently ranks higher on every measure. all this and everyone's care is covered. no payments to doctors, no monthly charges from your insurance company, no co-pays, no fees, nothing. at king's college hospital in london, dr. nigel heton performs a lir trans -- a liver transplant surgery with a live donor. a young man is giving part of his liver to his younger brother. the liver is cut in half with one part for the younger brother and the other part staying in the donor. >> the liver is a remarkable organ, in that it's made up of eight segments. so you can take pieces of the liver, and it will function perfectly well. >> this transplant costs tens of thousands of dollars, but under britain's national health service or nhs, the patient doesn't pay a thing. >> when patients come to us, we only evaluate them from the point of view of their need. do the they need a liver transplant? the cost never comes into it. as a surgeon, i love that. because it means the focus is on the care that i can deliver. >> nobody pays a doctor's bill on the nhs. people will go their entire life without paying a single upfront cost. >> hello. >> dr. claire gerardo is the chair of the royal college's health practitioners. >> our health practice is fair. it means irrespective of what you can afford or irrespective of your illness, you will be able to acquire health services. that is what we require and that is a fair and honest health care system. >> compare that to the u.s., where an estimated 137,000 people died over seven years because they were uninsured. of course, the brits do pay for their health care in another way, with taxes. the sales tax is a whopping 20%. and income taxes are as high as 50%. all of that money feeds a health care behemoth. the nhs is europe's largest employer with well over 1 million people on the payroll. so you'd think it would be inefficient. >> that seems sensible, right? the private sector can do things more efficiently? it doesn't work in health care. >> t.r. reid, a former overseas bureau chief with "the washington post," toured the world's health care systems for his recent book, "the healing of america." >> the least efficient payers in the world are the american private insurance companies. they have administrative costs at 20 to 30%. that's a 30% tax on every dollar you spend on health care. britain is totally socialized medicine, administrative costs, 5%. canada is private doctors and public payers, 6% administrative costs. so it turns out, in health care, governments are doing this more efficiently than our private sector. >> one reason, says reid, private insurers in america spend more money on non-medical costs, like ads and reviewing claims to help them stay profitable. another way governments can be more efficient when they are footing the bill is by having a more coordinated approach to health care. for instance, the nhs rewards primary care doctors with bonuses for achieving certain measures of good health, like getting patients to quit smoking. that's money well spent, because fewer sick people means lower health care costs for the country. on average, the british spend about $3,500 a person on health care. in the united states, we spend around $8,500. what about the argument that the only way to make the system work, the only way to get costs under control is to be, you've got to be a little cruel. you've got to say, we will pay for this and we won't pay for that? >> well, that's absolutely true. no, the british health minister said to me, we cover everybody, but we don't cover everything. >> not covering everything, the so-called rationing of care, is the british system's most controversial element. and one man in particular is at the center of that system. >> occasionally, we do find ourselves up against everybody. the physicians, the patients, the media. it's sometimes a real challenge. >> sir andrew dylan is the chief executive of the national institute for health and clinical excellence, known as "nice" for short. yes, nice. it's the government body that decides which treatments the government will and will not pay for. >> this isn't about politics. it's not about money at the outset. it's about the evidence for what works best, so the clinical studies and the other research that's done in this country and right across the world. >> the evidence is weighed by independent panels that include doctors and patients, not government bureaucrats. and their decision-making process is transparent. the public can weigh in. but the policy nice ponders involves some of the most vexing moral dilemmas in medicine, like whether to fund a last line of defense cancer drug. >> in the end, there's nothing else in life like facing death. and we have to be sensitive to that and we do try hard to be. but equally, we need to make sure that we're keeping our eyes on everything else that we need the nhs to do for us. >> another controversial aspect of british health care, long wait times for certain procedures. in the early 1990s, you could wait more than a year to be admitted to a hospital for a non-emergency. the nhs rule book now gives patients the right to be treated within 18 weeks of being referred. but that's still a long time to be standing in the queue. britain's government-run system provides good care for all and is more cost effective than one might imagine. but the quality of its care can shift as funding waxes and wanes. so is there a way to provide care for all with less government? when we come back, we'll visit a country that went from almost half its population being uninsured to nearly full coverage in less than a year and without breaking the bank. 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[ zapping ] [ clang ] this is the next level of performance. the next level of innovation. the next rx. the all-new f sport. this is the pursuit of perfection. the all-new f sport. are you still sleeping? just wanted to check and make sure that we were on schedule. the first technology of its kind... mom and dad, i have great news. is now providing answers families need. siemens. answers. what would happen if a country were given a blank slate to design its health care system? if it could choose from any nation in the world, which one would it imitate? die juan taiwan had that unique opportuni opportunity, and its story provides eye-opening less economies like taiwan and sons for the united states. singapore and south korea skyrocketed out of poverty in the 1980s and '90s. taiwan was growing at 7% to a year, joining the ranks of rich countries in no time. >> the country was getting richer. however, the health care insurance system was not all good at the time. >> a health policy expert at princeton says 41% of taiwan's population had no health insurance in 1995. >> you paid out of pocket. and for the really poor, then, you pray a lot. >> so taiwan's government decided to reform its system of care from the ground up. william shao, a professor of economics at harvard, is one of the world's leading health care gurus. he proposed a controversial broad approach. >> we approached experts from all over so we could get their experience for taiwan. >> the panel considered the u.s., its close geopolitical ally as a model for health care. they were not impressed. >> you can learn what not to do from the united states rather than learn what to do. >> they also looked at great britain, but the brit's government-run system was producing long wait times in the '90s. >> bureaucracy is not the best and most efficient way of running operations. >> then there was germany, which had privacy insurance, but they had so many different funds, their administrative costs were just too high. so taiwan went with a single payer insurance model, where there's only one insurer in the market, the government. they combined that with private doctors and hospitals to avoid too much bureaucracy. the system looks like american medicare, only it's for everyone, not just the elderly. taiwan's president at the time made a huge push to implement the plan quickly in 1995. miraculous, taiwan's uninsured dropped from 41% to 8% in less than a year. taiwan has a highly rated health care system. what's more, it's a rock star when it comes to holding down costs. the taiwanese spend just 7% of their economy on health care. that's a paltry sum considered to our 17%. the government drives a hard bargain on fees with providers, and taiwan can monitor its spending with this cool device, the smart card. you swipe it anytime you go to the doctor. he can pull up your recent medical history and when you're done, he'll have a record of that day's visit. then he'll send an estimate for your bill to the government right away, so officials know how much has been spent at any given time. compare that to medicare in the u.s., which can only estimate its spending levels two years after the fact. >> in taiwan, all of that is recorded, on a daily basis. >> but wouldn't all of that government stinginess make it hard to see the doctor? surprisingly, that's not the case. americans go to the doctor four times a year, on average. the taiwanese go almost 14 times a year. >> and they stay in hospitals much longer than americans stay in hospitals. the average length of stay for a taiwanese in the hospital is ten days. for the u.s., it's five days. >> so how do the taiwanese provide all of that care for such low costs? one way, the doctors work their tails off. dr. gary lin's primary care clinic in taipei is open 11 hours a day, six days a week. >> i might see 200 patients a day. >> fees that the government insurance pays doctors are very low. dr. lin gets only $14 for each primary care visit. his colleague in the u.s. makes $100 per patient. taiwan's legislature just raised the insurance premiums people pay to get more money into the system. but don't expect politicians to do something unpopular like that very often. >> in the 16-year-old history, taiwan's government has succeeded in raising premium rates twice. just twice. >> no matter which health care system you visit, politics always comes into play. the next country we're going to visit has some remarkably similar politics to our own. its passed a version of obama care 18 years ago. has it worked out? 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[ male announcer ] sustainable solutions. fedex. solutions that matter. taiwan showed us that public insurance can work. but let's face it, government insurance for all is not probably a popular campaign slogan for many americans right now, so we searched the world for a completely private model, no government-run insurance or state-run hospitals. we found one in europe of all places. imagine an alternate universe where a version of obama care has been the law of the land for almost two decades. no, you haven't entered the twilight zone. you're in switzerland. >> tell the congress you want us to act and act now! >> right around the time president clinton was pushing health care reform in the 1990s, ruth dreyfuss, a left-wing swiss official, was pushing reform in her own country. she faced a lot of tough questions. >> will we have to pay for the treatment of the drug addicts? will we have to pay for treatment of obese people? will we have to pay for abortion? >> switzerland is not your typical european welfare state. it's extremely business friendly and it's always gone its own way, shunning the euro and charting its own course in health care, with private providers and private insurance. that's actually not so rare, according to journalist t.r. reid. >> one of the things that many americans believe about health care around the world is that other rich countries in the world all have socialized medicine. is that true? >> no, that's baloney. some countries do have government provide the care and pay for it, but a lot of rich democracies, germany, switzerland, japan, belgium, the netherlands, cover everybody in the private system, private docs, private hospitals. private insurance. germany and switzerland don't have medicare. people save with the same insurer cradle to grave. >> the swiss were getting fed up with their private insurance system in the early 1990s. costs were rising, premiums were disproportionately higher for women and the elderly, and those with pre-existing conditions had trouble getting coverage. some were foregoing insurance altogether. >> the people were flying out of the insurance, so we had to stop this. >> dreyfuss, who would later become switzerland's first woman president, pushed for a law that required everyone to buy insurance, gave subsidies to the poor, and stopped insurance companies from rejecting people for their medical history. sound familiar? that's exactly what president obama's law would do. but in switzerland, it was an uphill battle. the law passed parliament, but barely squeaked by in a national referendum with 52% of the vote. >> where nobody was really happy, but everybody could accept. >> so how is the swiss version of president obama's law faring almost 20 years after it was put in place? >> i'll show you the x-rays we did. >> everyone is now covered and the the care is still top-notch. the swiss enjoy one of the longest, healthy life expecta y expectancies in the world. >> we have an extremely comfortable system. i mean, the access is easy, you don't have to wait. >> tom zelckner was the swiss secretary of state from 1991 to 2009. >> hospitals have become more like five-star hotels, offering health care. >> the swiss law went above and beyond obama care. insurance companies were already banned from making a profit on basic health coverage. under the new law, they had to expand that basic package, covering even more procedures. >> even very expensive pharmaceuticals are paid by the insurance plans and have to be paid. >> the swiss system is world renowned for the choice it provides its users. >> i chose the doctor i wanted to go to. i went there, and it was seamless. >> we caught up with jocelyn mills and her husband, phillip thompson, two americans living in switzerland. jocelyn was expecting at the time. she could go see a specialist right away without waiting for a referral from her physician, like in the u.s. >> i always waited three hours in an overcrowded waiting room, you know, to see somebody, then to see a specialist, if anything was wrong. so i don't have that here. >> another bonus, health insurance isn't linked to employment. plus, you can change your insurer every year if you want. >> the choice is such that it is sometimes confusing. you know, you have in each town you're living, a choice of probably 100, 200 different plans. and you also need a coach or someone helping you to choose your health insurance plan. >> experts worry that the swiss don't reap the cost savings from their insurance choices because there are so many of them. that might explain why health care costs in switzerland are still very high. 11% of gdp. >> you cannot make a perfect law. but you can make a perfectible law. and i would say any law has negative side effects. and this is our lesson. we are still working to make this law better. >> health care costs are rising all over the world. but in the united states, health care is almost twice as expensive as everywhere else. why is that? we'll explore that question, next. you kgraduation.exciting? when i look up into my students faces, i see pride. you know, i have done something worthwhile. when i earned my doctorate through university of phoenix, that pride, that was on my face. i am jocelyn taylor. i'm committed to making a difference in people's lives, and i am a phoenix. visit phoenix.edu to find the program that'sight for you. enroll now. there is no greater threat to the american dream than the rising cost of health care. it already takes up around one fifth of our economy. by 2050, it could consume almost two-fifths, crowding out vital spending on education, infrastructure and science and technology and not the mention the military and the social security. how on earth did we get here? what can we do about it? >> a big part of the underpinning of the system is all of us are kidding ourselves. someone else is magically paying for this. well, there is no one paying for it, except all of us. >> david goldhill, the ceo of the game show network, is an unlikely agitator in the health care debate. he got involved after his father went to the hospital with pneumonia and died from an infection while he was there. >> i saw a hospital with less impressive information technology than my dry cleaner has, than my auto mechanic has. a couple times, my father was taken for procedures meant for other patients. there's trash on the floor. almost everywhere, it overflows in patients' room. you're endlessly dealing with personnel that doesn't know anything about your case. this is the intensive care unit we're talking about. >> the fatal of goldhill's father is all too common. every year, an estimated 100,000 americans die from an infection they got in a hospital. >> once i got beyond, obviously, the personal elements of the tragedy, i thought, there's something very unusual about this. just in the scope of how the world works today. and as i spent time thinking about health care, i began to think about the lack of real accountability to customers. and the incentives to bad behavior that really dominate the way the industry is structured. >> unlike many mark