Like the U.S. system, the Japanese arrangement is a combination of public and private. Insurance is mandatory, and citizens who can't afford the premiums are assisted by the government. The majority of hospitals are private, as are medical practices. Patients can pick their doctors and hospitals. Patients are not shy about using the system; a 2009 Washington Post article reported that Japanese citizens visit a doctor 14 times a year.
Nor are doctors shy about seeing patients, since they receive a payment for each visit. That's one of the system's flaws, says political science professor T.J. Pempel, a former director of UC-Berkeley's Institute for Asian Studies.
"Doctors have every incentive to move people through quickly," he says. "So you can get the feeling you're part of an assembly line."
The Japanese system doesn't pay for childbirth, nor does it cover cosmetic surgery. The system also has suffered from issues with Japan's aging population. The elderly consume more medical care than the young, and Japan's society hasn't added enough young workers to support retirees. Like other industrialized countries, it's struggling to keep costs under control.
However, the government is particularly committed to care throughout life, whether it's prenatal care or employee health, Pempel says. Pregnant women are given a wealth of information; many corporations, because they have a stake in the system, have clinics on site.
"There's a lot of (primary care), and it's covered. There's strong encouragement to go into a clinic at the first sign of problems," he says.
Indeed, the U.S. individualist tradition in health care generally runs counter to the rest of the industrialized world. Free-marketers like to point to the Swiss system, in which individuals buy their own insurance. But it, too, has a mandate. Many countries have cost controls in place, some more extreme than others. And the culture of the citizenry -- whether it's regarding diet, abortion, gun control, child and elder care traditions or personal responsibility -- can't help but play a role.
In the case of health care, Fruhstuck says, there's something to be said for group accountability.
"In Japan, there's attention to harmony, and the sense that everybody is responsible for everybody," she says. "The way you are has an impact on everybody around you, so you think about your behavior."
Education: Teach to the best
Today, Finland is regularly ranked as having one of the best-performing education systems in the world. The country's literacy rate is tops, its math proficiency second, according to the Organisation for Economic Co-operation and Development, an international trade group. Students from elementary through high school are among the world's best in test scores.
A generation ago, that wasn't the case. In the 1970s, Finland's schools were among the worst in the developed world.
The problem was attacked on all sides, says Pasi Sahlberg, a former official in Finland's education ministry.
The country invested heavily in teacher education, requiring master's degree-based, five-year qualifications instead of three-year bachelor's degrees. Child poverty was addressed with meals, health care, dental care and counseling -- all free of charge for children. Finally, the system pursued what Sahlberg calls "intelligent accountability" that combines standardized testing with teacher assessment and school self-inspection -- with an emphasis on the teachers, not the tests.
Where did they get their ideas? Actually, they got a lot of them from the United States.
"Within your 15,000 districts and 100,000 schools you have probably all the educational innovation that anybody needs to build good schools or well-performing districts," he says. "The Finnish education system owes a lot to these American ideas."
And yet Americans are forever lamenting the state of their schools. As Diane Ravitch, education historian and former assistant secretary of education to President George H.W. Bush, points out, we've been fretting about the American system and looking enviously over our shoulders for decades, whether it's to Germany, England, the former Soviet Union, Japan or China.
"We have this narrative that we're failing, failing, failing. The rest of the world would like to be like us, and we're saying, 'What's wrong with us? We're so terrible.' It must be some kind of American inferiority complex," she says.
Yes, of course there are schools with problems. Some districts have been damaged by cheating scandals, others suffer from poor facilities. The battle to improve test scores, led by federal programs such as No Child Left Behind and Race to the Top, has provoked criticism (including Ravitch's). Some officials want to give more money to charter schools at the expense of the public system or offer "school choice" through vouchers.
Finland, which is small, homogenous and has less income inequality between rich and poor, managed to completely remake its structure. Is that possible in the polyglot, poverty-pocked United States?
It's already happening. West Virginia has instituted some of Finland's ideas -- some of which, of course, originated in the United States. Sahlberg believes they can work throughout the country, but they have to start with respect and training for the teacher.
"I think there is far too much loose rhetoric criticizing public school systems and blaming teachers in the U.S. that has no ground," he says. Finland has such respect for teachers that the job is now seen as being "on par with other academic positions, such as lawyers and doctors," he says. But it's because the country invested in the profession and continues to do so.
Ravitch adds that society has to join in. "There's a youth culture that's very disobedient, and the laws are such that it's very hard to maintain any kind of standard of discipline, and everybody blames the teachers," she says. "But it's kind of a vicious circle, because you have a lot of parents who are not particularly responsible either. The most common complaint at schools is if there's a parent night, there are many schools where nobody shows up."
Business: Making the sale