[ucaetano]

The US spends 80%-90% of what Germany, Netherlands and Switzerland spend per capita PPP, yet the public services and social welfare in the US are abysmally bad.

Here's one issue with your source:

> The United States is one of the most efficient countries because no other country achieves its level of public sector performance with less government spending.

This is an unfair comparison, since public spending in other countries include national health systems, national pension systems, etc. A fair comparison would be the US vs. other countries including only the same expenditures as the US.

The indicators also seem weird, the US has a higher Education indicator than Germany and Switzerland, a higher infrastructure indicator than Belgium.

Also, the study is from 2007, using data up to 2005. Things changed dramatically in the past 10 years. Take a look at all the government shut-downs, etc.