In from the cold

American medicine is among the best in the world. But for years it has had to compete with the scene stealing awfulness of America’s healthcare system. As the only major industrialised country without universal coverage America has been a sort of rogue state: the world’s richest country spending more on health care per capita than any other, yet dogged by gaping health inequities, poor health outcomes, and social injustice. The evils and absurdities of American health care have filled pages in this and other publications and have been caricatured, as in the film Sicko (BMJ 2007;335:47, doi:10.1136/bmj.39262.638588.59), making America ridiculous outside its borders …