Permabear, you're right to some extent. There's more inequality in the U.S., e.g. in health, education, income, etc. The U.S. has a flatter bell curve, where the two tails are larger, while many European countries attempt to make almost everyone average. Most uninsured Americans can afford health care. However, they choose other goods, while poor Americans qualify for free health care. There's more waste, fraud, and abuse in government health care, doctors complain about government paperwork, there are broad economic trade-offs, etc. So, the true cost of government health care is understated.