The fundamental problem with almost every health care system is that they actually haven't defined their objective. Unless we know what the health care system is trying to achieve, we can't address whether or not it has achieved that objective well.
The only health care system that does is Australia. Australia actually has a specific statement that the objective of their health care system is to maximize the health of Australians. If that's what they're trying to do, then they also have a process that makes those decisions, especially with respect to drugs, specifically based on whether this funding will increase the overall health of Australians.
However, even in Australia, we have the problem that we focus mainly on new interventions for which there is a commercial sponsor. That's where the pressure on funding comes in. Things that we used to cover, we no longer cover. In Ontario, for example, we don't cover physiotherapy appointments.
I have a chronic degenerative hip condition, so I go to see my physiotherapist every three or four weeks. It's horribly painful and difficult, but it actually helps. It stops me from requiring a hip replacement, which would cost the system thousands of dollars and probably mean that in 10 or 15 years, I'd be in a wheelchair and my quality of life would be pretty poor.
I can afford to pay for that physiotherapy out of my health insurance from my university. There are many Canadians, those from an immigrant background, who can't afford that basic health care, which is not very expensive. You're talking less than a thousand dollars per year. It would save money down the line in terms of the need for surgery, and it would greatly improve the quality of life of the individual.
I could say that no one does it right, because no one really considers health care as a whole. There are many things we can do to greatly improve the health of the population but that are just not funded anymore because there's no advocacy group. There's no commercial sponsor pushing for that coverage.
The easy answer is no. No one does it right. I'd say Australia goes the furthest by at least defining what they want from their health care system. In Canada it would be the first step that we could actually take; we could make a decision about why we have the health care system in the first place and what the underlying objective is that we're trying to achieve.