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When traveling overseas to countries that have national health programs, I make it a point to satisfy my idle curiosity by asking people what they think of their health care.

In Scotland years ago, a caddie answered in a thick burr I could not possibly imitate, “It’s a great system, but it doesn’t work.” Another caddie, who had been on the women’s professional golf circuit, said that her arm had been pulled out of its socket after getting caught between two banisters when she fell down the stairs. The care and the reconstructive surgery had been fabulous. She was swinging a golf club again and expected to continue her professional career.

I just returned from New Zealand, where conversations with an American doctor who has worked in that country’s national health system gave me some anecdotal insight into the components that worked. He was also clear about where that system would fall short of an American’s expectations. Most national health care systems, however, are buttressed by private insurance that can be purchased by people who want to supplement what the state provides free for everyone.

To begin with, doctors never have malpractice claims levied against either them or an insurance company. The government just pays out of pocket for malpractice cases with a maximum lump sum benefit of $70,000. There are other compensation components, such as lost income, but all have comparatively modest maximum amounts. The administrative cost of the system is 10 percent of what is paid out, while in our country, including insurance premiums and legal fees, the cost is 50 percent of what gets paid to victims.

My friend said that he had seen instances in which treatment that may have triggered a malpractice claim in the U.S. was not considered to be inadequate by the national system. By extension, we can assume that the quality of care was not what it might have been here. But who knows for sure?

Those who want to have a “Cadillac plan” can pay for private insurance and use it to supplement what the government provides for free. Someone wanting a hip operation immediately might not want to have to endure a long waiting list for treatment considered discretionary.

A New Zealander pointed out that he had always had a supplemental policy but that he had used both the private and public systems for different problems over the years. The private policy has a high deductible, which explains why someone might choose to use the government system for routine health issues.

While this individual was happy with the system, overall, he was a little annoyed at having to pay (with taxes) for the public insurance and add an out-of-pocket expense for the private policy. The total cost per covered individual is about half what we pay in this country.

Cobbled together, the combination of the two systems seems to work well. In this country, the big idea of the moment is to expand so-called health savings accounts. These are accounts that allow tax deductible contributions into a savings account that then can grow tax-free at whatever the account earns (next to nothing currently) and then allows you to remove the money tax free if you spend it on medical expenses or Medicare premiums.

This is not insurance. It’s more like those old Christmas clubs in which you saved for 12 months to have enough for presents. For the moment, expanding this benefit is probably the only sure thing to come out of the effort to “repeal and replace” Obamacare. Obviously, it’s of value only for those who are in a high enough tax bracket for the tax benefit to mean anything.

Meanwhile, back in New Zealand, everyone has coverage regardless of health conditions and can change jobs anytime or retire early without worrying about coverage. Younger people can start a business and be covered even if one of their dependents might otherwise have been uninsurable.

Here, we are left waiting on pins and needles to see if “replace” preserves what has been a great benefit for the 20 million otherwise uninsured and perhaps as many as 40 million who, in the old days, were shackled to a job kept mostly for health insurance reasons. Let’s see what fate has in store for us.