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The Daily Signal
‘Socialist’ Nordic Countries Are Actually Moving Toward Private Health Care
Kevin Pham
June 13, 2019
Rising support for socialism in the United States comes at a time when
politicians like Sen. Bernie Sanders, I-Vt., promise a great many
“free” services, to be provided or guaranteed by the government.
Supporters often point to nations with large social programs, such as
Canada, the United Kingdom, and the Scandinavian states, particularly
when it comes to health care.
Never mind that these are not true socialist countries, but highly
taxed market economies with large welfare states. That aside, they do
offer a government-guaranteed health service that many in America wish
to emulate.
The problem for their argument is that, despite these extremely
generous programs, some of these countries are seeing steady a growth
of private health insurance.
“Medicare for All,” the prominent socialized medicine proposal in the
United States, is most similar to the Canadian system in which
providers bill the regional office administering the program.
In Medicare for All, there would be no cost-sharing schemes and all
coverage would be comprehensive, including prescription drugs, dental,
vision, and other services deemed necessary by the secretary of health
and human services.
The Scandinavian systems are similar to Medicare for All in the respect
that they use regional offices to administer reimbursements to
providers.
Yet they differ in critical ways: They employ cost-sharing for certain
services, they are less comprehensive in their coverage, and they allow
for private health insurance plans to complement or supplement the
government system to cover out-of-pocket expenses and to circumvent
wait times or rationed access to specialists.
These are precisely the things Medicare for All would abolish. It’s
intriguing that while socialists in America would rush to nationalize
the health care system, Norwegians, Swedes, and Danes are all gradually
increasing their use of private health insurance.
Between 2006 and 2016, the portion of the population covered by private
insurance increased by 4% in Sweden, 7% in Norway, and 22% in Denmark.
The increases in Sweden and Norway are modest but noteworthy,
considering that most out-of-pocket payments have a relatively low
annual limit.
Private plans in Sweden and Norway are mainly designed to supplement the government-run plan.
In addition to covering out-of-pocket costs, these plans also guarantee
prompt access to specialists or elective procedures, which the state
plans often fail to provide.
Denmark also allows “complementary” insurance plans, which cover
services that are partially or not at all covered by the national
system, including dental and vision services.
This growing European interest in private health insurance typically
stems from dissatisfaction with the state-run systems, which often
provide poor or incomplete coverage and long wait times.
By contrast, private plans offer wider coverage, shorter wait times,
access to private facilities, and more flexibility in patient choice.
For instance, in a 2009 survey, nearly half of Danes felt waiting times
were unreasonable while only about a third disagreed. In 2007, the
Danish government enacted a wait time guarantee of one month to receive
treatment.
Most of the private health insurance in Denmark, as well as in Sweden
and Norway, is employer-based. In Denmark, the increase in private
insurance is likely due, in part, to employers seeking to recruit
top-tier talent by including health coverage as part of a benefits
package.
In turn, private insurers make a strong pitch to employers, informing
them that having private coverage minimizes their employees’ time lost
to illness and ensures they have prompt access to medical care.
In that 2009 survey, the largest portion of respondents believed the
most important factor driving employer-based coverage was that it
results in “less sickness absence due to quicker treatment.”
The second and third most popular responses were that it provides
access to private hospitals and circumvents long wait times in the
public system.
In this way, private options create value for average Danes getting
premium health coverage as a perk of employment, for Danish employers
who can compete for the high end of the labor market, and for the
insurers who are selling this service.
Private insurance plans even create value for the government because it
decreases public health expenditure. Roughly half of respondents in the
survey had their last hospital visit paid by a private insurer.
Recall: This would all be illegal under Medicare for All. Private health insurance would be abolished for everyone.
Danes are right to deny that they are a socialist country, but their
generous welfare programs, and those of the Swedes and Norwegians, are
clearly objects of envy for American socialists.
While the Scandinavian health care systems are each different in their
own ways, they all offer universal coverage for citizens, and any
cost-sharing comes with low annual limits.
They provide nearly everything that a proponent of socialized health
care could ask for—and yet each of these countries host a growing
private health insurance sector.
It behooves us to ask why this is before we outlaw our own private care.
Read this and other articles at The Daily Signal
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