On first glance the American system seems better. You get what you pay for I suppose. I heard somewhere that the German state health system was good with annual check ups for all irrespective of age. Scandi system is good too. In fact iirc Sweden pays for almost any fitness cost like gym membership, cost of bike etc. You claim for it I believe. Gyms often sort the paperwork out for you. A friend moved to work in Sweden and got free gym membership with no strings. His colleagues got bikes and exercise equipment too. None of this C2W scheme bureaucracy based on claiming back tax. Complete reimbursement of full costs without end of scheme fair market value payments like the uk.