The Swiss system isn’t perfect, but it is renowned for its high patient satisfaction, low wait times, and access to the latest technology.

Medicaid, on the other hand, provides poor-quality coverage, because many doctors refuse to accept it. Medicare is better off on this metric, but it’s heading down the same path. On the other hand, while private hospital care in the U.S. is wildly expensive, no one disputes that its quality is generally good, and in many instances world-class.

Obamacare expands coverage in two ways: first, by creating Swiss-style exchanges where people can buy subsidized, regulated private insurance plans; and second, by expanding Medicaid. For all of the exchanges’ flaws—especially their high premiums—the quality of coverage they will offer is decent, and we should expect that uninsured people will do reasonably well on them. Medicaid is a different story; the literature shows that Medicaid does not improve health outcomes relative to being uninsured.

But the VA is an altogether different beast. The VA is not merely single-payer health care; its vast network of hospitals is also government-financed and government-operated. And that is why the VA is the worst health-care system in America.