By Joseph Q. Jarvis | Published: 3 September 2026
Cristina Alphonso Mateo is a 21 year old native of Spain who is living currently in the United States while she attends college. She spoke with me recently about health care in her home country.
Spain has both privately and publicly delivered health care. The public health care system is designed to provide every Spanish citizen with medically necessary care without cost at the point of service. Those who wish to may pay for private care. The per person cost of health care in Spain is less than one-half of the comparable cost in the United States. Highly advanced care is delivered through the Spanish health care system, which is ranked internationally #1 in organ transplant care, as an example.
Cristina has never heard of anyone in Spain ever failing to get needed care for any reason, including if they simply don’t have much money. She has never heard of anyone being bankrupted by the cost of health care in Spain.
Recently, before she left for the US, she was on an outing with her friends and fell, injuring her hand. She went to a local emergency room and waited 3 hours to be seen by a physician. An X-ray was ordered, no fractures were noted, and she was discharged with her hand wrapped and given instructions about further care. She felt that a three hour wait was too long and said that the Spanish health care system has room for improvement. When asked, she said that she could depend upon getting an appointment with her primary care physician in Spain within 3 days of making a request. Again, she felt that that wait was too long and indicated a need for Spanish health care to improve.
In contrast, when I was recently taken to an emergency room (by ambulance) in Chicago, I waited more than three hours before I received definitive care. To be fair, I was triaged by a nurse within the hour of my arrival at the emergency room. So the ER staff knew that I would be able to wait a while for definitive care. I can not get an appointment with my primary care physician within 6 months of making a request to see her. Again, to be fair, if I am acutely ill, I will be seen by someone at clinic that same day.
So, which health care system is functioning well? Spain, where everyone has access and financing for needed care and where the highest level care is top notch on international standards? Where no one is ever bankrupted by health care costs? Where no one ever dies because they can not get the care they need? Or the United States, where care costs more than twice as much as it does in Spain while 200,000 people die prematurely each year because of health system dysfunction and 600,000 personal bankruptcies occur annually because of health care costs? (Most of those bankrupted by health care costs in the US are insured at the time that their injury or illness occurred.) Wait times for emergent and primary care are apprently shorter in Spain than in the US.
It is time for US citizens to acknowledge that our health care system is failing us. No matter where you look elsewhere in the developed world, those health care systems have measurably better function at a lower cost. There is no developed country in the world, except the US, where people can’t get needed care because they can’t afford it and are therefore more likely to die prematurely. There is no first world country, other than the US, where people go bankrupt because of health care costs. Stop making a fuss about wait times being so bad, or death panels killing grandma, or innovation lagging, or whatever other nightmare the medical industrial complex propaganda has told you to anticipate and worry about with universal care. And especially stop making silly statements about how the government in health care will make everything so bad. It is the MARKETIZED US health care system that is failing American patients, not the government.
Without government involvement in health care in the US these past 80 years, there would be no recognizable health care system in our country. No innovative care, no hospitals in many counties, no trained physicians and nurses, nothing resembling modern clinical care. What is the problem in US health care (as opposed to the care Cristina is used to getting at home in Spain), and the major reason why Americans can’t get the care they need at a reasonable price (again, unlike what Cristina is accustomed to in Spain), is the interjection of the private for-profit business model into American health care, stealing the funds necessary to pay for care for all, driving up the prices, and skewing research and development away from what is really needed to improve patient care.
If you are at all persuadable by facts then become acquainted with the real facts about health care and how bad it is in the US. But also how much better it could be if we could learn from other developed nations and finally implement meaningful change in the way we do health care business. For the fact seekers, please go to View source at utahcares.health and learn how we at Utah Cares propose to make a difference in the lives of Utah patients and their families. While you are perusing our website, make a donation to the campaign to put the Utah Cares Act on the ballot.
Many thanks.
Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.