The ultimate responsibility for the overall performance of a country's health system lies with government, which in turn should involve all sectors of society in its stewardship. A comparison in structure, financing and function of the health systems of Japan, the USA, Cuba and China, as well as their main health and social-demographic results, is shown here. Two clear examples of inequalities, between regions in China and between ethnic and social groups in the USA, let us see different health indicators of both countries. To achieve and maintain a healthy population with good health results does not necessarily depend on a big budget or richness in a country. Good governmental policies regarding public health and social security are crucial to achieve good quality of life equally distributed to the whole population. Some suggestions are given.