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Don’t Export Europe’s Health Care Failures to American States
The World Cup arrived. With it came millions of visitors from across the globe descending on American cities. They come for the soccer, sure. But while here they discover something more—the kind of abundance that is easy to take for granted if you were born here.
Walk through any American host city, and you’ll see foreign fans posting videos in stunned delight. They talk about the food—enormous portions, every cuisine imaginable, available at midnight. They discover air conditioning, blasting gloriously in July. They experience the highways, the skylines, and the relentless commercial energy of a country that built itself on the premise that more is possible.
Many of these visitors come from wealthy, developed nations. And yet, even they are struck by a realization: America is different, and that difference is worth protecting.
Nowhere is that truer than in medicine.
While fans from the U.K., France, Germany, and Spain enjoy American hospitality, many are also quietly relieved to be somewhere with a functioning health care system. Because back home, the cracks are widening into chasms.
In the U.K., the National Health Service has become a symbol not of compassionate coverage, but of waiting. Waiting for a GP appointment. Waiting for a specialist. Waiting for surgery. Waiting, in too many tragic cases, until it is too late.
NHS waiting lists have ballooned to over seven million cases. Patients with cancer, heart disease, and other serious conditions are routinely delayed for months. Some die before their number is called. According to one study from a British think tank, “between September 2024 and August 2025, around 79,130 names were removed from NHS waiting lists across 127 acute trusts because patients had died before reaching the front of the queue. Of those, 28,908 had been waiting longer than the 18-week statutory standard, and 7,737 had waited more than a year.”
But it isn’t just the U.K. Across Europe, a different and equally damning problem has emerged: Patients can’t access breakthrough treatments even after regulators approve them.
A new study from Germany’s WifOR Institute and Columbia University economist Frank Lichtenberg examined medicines for cancer, diabetes, and respiratory disease across 29 European countries from 2014 to 2022. The findings are stark.
Separate data from the European Federation of Pharmaceutical Industries and Associations shows that once a drug is approved in Europe, it now takes an average of 597 days, nearly 20 months, before patients can actually access it. That’s up from 504 days in 2019. The gap is growing, not shrinking.
Nearly two years. That is how long a European cancer patient may wait after a drug is approved before it becomes available to them. In many cases, that is the difference between life and death.
Meanwhile, in the U.S., FDA-approved drugs typically reach patients in a fraction of that time. America’s system, for all its genuine imperfections and real affordability challenges, is a place where innovation arrives faster; where patients can fight for coverage of cutting-edge treatments; where doctors and patients, not government bureaucrats managing a national budget, make decisions about care.
This is not an argument against reform. American health care has real problems that deserve serious attention, including cost, transparency, and administrative burden. But the answer to those problems is not to import the European model, a model that is demonstrably failing the people it was designed to serve.
Yet that is precisely what some state legislatures are beginning to flirt with. Single-payer proposals, government-run coverage expansions, and price-control schemes modeled on European frameworks are making their way through statehouses across the country.
Colorado, Maine, Maryland, Minnesota, New Jersey, Oregon, and Washington have enacted “Prescription Drug Affordability Boards” or similar drug-affordability review entities. Some of these are able to implement MFN-style price controls. Other states considering their own iterations. New York is considering a single-payer healthcare bill, while California lawmakers have repeatedly introduced single-payer proposals as recently as this year.
Proponents promise European-style universality without European-style consequences. They are wrong.
The consequences follow the model. Price controls reduce investment in new therapies. Centralized systems create bottlenecks. Bureaucratic approval layers add delays. The 597-day wait discussed above is a feature of what happens when governments control access to care.
The World Cup visitors snapping photos of American abundance will go home soon. They’ll tell their friends about the food, the heat, the spectacle. Some will quietly mention that they also visited a walk-in clinic, promptly, without an appointment, for a reasonable fee, and were seen by a doctor the same afternoon.
That story doesn’t make international headlines. But it should.
American health care’s greatest asset is the underlying architecture of a system that still rewards speed, innovation, and patient access. That architecture is what’s at stake when state legislators reach for European blueprints.
The fans know what they found here. Let’s not give it away.
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