They pay more, wait longer to be seen, and suffer a higher rate of medical mistakes

Politicians often boast that the U.S. has the best health-care system in the world. Patients apparently disagree. According to a new survey published on Nov. 1 in the journal Health Affairs, a third of Americans believe the U.S. health-care system needs to be rebuilt completely--double the percentage who want a dramatic overhaul in the six other nations polled. And the U.S. ranked dead last out of the seven countries when residents were asked if only minor changes were needed.

The Commonwealth Fund, a nonprofit that studies health-care issues, surveyed 12,000 adults in Australia, Britain, Canada, Germany, the Netherlands, New Zealand, and the U.S. in an effort to get a handle on actual patient experiences and perceptions. "There are lessons to be learned from looking abroad," says the study's authors. "This survey shows that patients in the U.S. are frustrated by high costs and a complicated health-care system."

All the countries surveyed except the U.S. have universal coverage--and the other six spend about half as much of their GDP as the U.S. does on health care. Americans also pay more out of pocket for health care, with 30% of U.S. respondents having spent $1,000 or more over the past year. The percentage of patients laying out that much in the other six nations ranged from 4% (Britain) to 19% (Australia).