As I am hunkering down in my social isolation, I’ve been spending way too much time online.
My millennial kids, some conservative relatives, a few aging hippies and a couple Canadian friends have been discussing health care systems — socialized medicine, universal coverage, Medicare for All and the alleged problems in the Canadian system. Repeatedly, Denmark has been floated as an example of how a good, free, universal health care system works.
With time to burn, I started Googling to find out what is unique about Denmark’s system. Although it is true that most Danes pay nothing to see their doctor, it is not free health care. They have a national health tax, 8% of taxable income, which funds universal care.
However, Denmark’s health care costs much less than ours. According to the Organization for Economic Cooperation and Development, Denmark spends 10.5% of their gross domestic product on health care, while the United States spends 16.9%. Their system consistently ranks higher than ours in measures like longevity and infant mortality. Per capita, they have more doctors and more hospitals beds than the U.S. Plus Danish surveys find 90% of Danes are totally satisfied with their healthcare program.
Justin Matus, economics professor at Wilkes University, studies the Danish system and says it is wonderful, but the success and cost-effectiveness are partially related to Danish culture. For example, Danes commonly ride bicycles, which provides exercise and keeps cars off the road generating less pollution. They also have good public transit, which contributes to fewer cars and fewer car crashes. Fewer guns in their culture result in fewer gunshot wounds and fewer hospital visits. Danes eat better, have less obesity and thus require less medical treatment.
Scandinavian countries like Denmark have some of the highest taxes in the world. My conservative friends can’t imagine an average individual paying 45% of their income in taxes plus a hefty sales tax. However, as Thomas L. Friedman, foreign affairs columnist for The New York Times, recently pointed out, these tax rates provide “access for all to child care, medical and parental leave from work, tuition-free college, a living stipend, universal health care and generous pensions.”
As a result, Denmark is consistently rated by the United Nations as one of the happiest countries in the world. According to several scholars, these welfare state protections reduce risks and insecurities. Simply put, there is less to worry about.
No one goes bankrupt due to medical bills. People can change jobs or start a business without fear of losing health insurance. Parents aren’t stressed about parental leave, child care or saving for college. Young adults can start their careers without being burdened by college debt. Everyone who has lived in the country for 40 years will get something better than our Social Security. Less stress and less fear lead to more happiness.
Contrary to some common beliefs, Denmark is not a socialist country. As the former Prime Minister Lars Lokke Rasmussen explained in a speech at Harvard, “Denmark is a market economy. The Nordic model is an expanded welfare state, which provides a high level of security for its citizens, but it is also a successful market economy with much freedom to pursue your dreams and live your life as you wish.”
Friedman notes that it is through capitalism, free trade and globalization that Denmark has created the robust economy that supports their social safety net.
But Friedman pointed out one thing I consider very important. The Danish system works because of a “high-trust social compact.” Danes trust their system. They understand that, with their high taxes, they are purchasing a high quality of life. They value this quality of life, and they trust that the government will uphold its role in this bargain. Can you imagine Americans today having this kind of trust in their government?
Culture is important in the Danish health care system, and culture is also important in trying to understand their economy. Danes take a longer-term view than Americans and have a more collective mentality. They are willing to invest in expensive programs like green energy because it is better for the future. Offering higher education to everyone is costly, but it helps the society as a whole.
In general, Americans take pride in our rugged individualism. We tend to care for ourselves and our families, while Danes are more willing to spend their money on things that serve the entire community.
The Danish system evolved over many years, incorporating their history and culture into their economy and social safety net. There was no revolution, no dictator, no monarch who imposed these systems. They have a representative democracy that created this style of government. They have ownership. Certainly, that helps with their acceptance and trust.
On the other hand, I’ve seen the United States try to bestow our democratic structure and values onto other countries. Often, it doesn’t fit with their society’s history and culture. Our democratic system is wonderful, but there are places where it has failed miserably.
As much as I may like the Danish system, I can see why some of my friends chafe at the idea. It wasn’t invented here. It doesn’t match with our history and culture. Parts of their system are a huge leap from what we have now.
I hope the United States will always be open to look for better ideas. In my opinion, parts of our culture should change. Our health care system, with its archaic ties to a World War II employment model, needs to change. But to get acceptance, we must be sensitive to finding solutions that fit us uniquely. One size does not fit all.