The United States health system falls short, bluntly declares the Commonwealth Fund in its recent report, “Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better US Health Care.” The study compares the US to ten other high-income countries. The US is by far the top spender, but sinks to the bottom when it comes to measures of outcome, access, and equity. The three nations that rank highest in overall health system performance – United Kingdom, Australia, and the Netherlands – all provide universal coverage. In contrast, poorer nations such as Rwanda show dramatic decreases in child and maternal mortality and increases in life span. What can the US learn from other approaches?