“Many countries have state-dominated or state-run systems with little competition. Their historically lower costs and favorable mortality statistics have led some to advocate that the United States move to emulate them. Yet other advanced countries are now facing accelerated rates of cost increase similar to those in the United States, while new evidence is revealing alarming quality problems that appear to be as bad as or worse than the U.S. experience. Leaders in many other countries are now questioning the future structure of their health care systems.”