For those that follow this blog in any regular fashion, you know that universal healthcare is one of my “big issues”. The long and short of that issue is; I think it is absurd that the wealthiest country in the world seems to have “trouble” caring for the basic needs of its citizens. It is absurd that people should have to choose between a prescription and food. It is absurd that people should have to declare bankruptcy because of outrageous medical bills.
As an animist, I believe that the world is full of people. People deserve basic respect and dignity, and for me this includes healthcare. A good, long, and healthy life should be the right of all, not a privilege.
Especially when you consider most other major industrial countries have already figured this out.
If you want to go into the details, I invite you to listen to the podcast by Dan Carlin here. He does a pretty good job about breaking down some of the more absurd parts of the USA’s healthcare system. In short; we spend a ridiculous amount of money for a relatively low-standard of care.
Now, I’m not going to be able to go into all the nuts and bolts of our healthcare system. It’s a hot mess and there is plenty of information out there are the internet. One of the sources Carlin uses can be found here.
But basically, the takeaway is this;
“Available cross-national pricing data suggest that prices for health care are notably higher in the U.S., potentially explaining a large part of the higher health spending. In contrast, the U.S. devotes a relatively small share of its economy to social services, such as housing assistance, employment programs, disability benefits, and food security. Finally, despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions. “
It was announced last week that Bernie Sanders might unveil his plan for Medicare For All as soon as Wednesday this week, and that it also has been co-sponsored by both Kamala Harris and Elizabeth Warren, who said;
““Everyone is covered,” she said. “Nobody goes broke paying a medical bill. Families don’t have to bear the costs of heartbreaking medical disasters on their own.”
Warren called health care a basic human right, adding that it’s “time to fight for it.” “
I agree whole-heartidly. If I am being frank, I think universal healthcare for the US is one of the most crucial issues of our day. Make no mistakes folks, we are going to have to fight for this one, pretty much like we have had to fight for everything else of value in this country. Whether its Civil Rights, Women’s Suffrage, Labor Rights, or Universal Healthcare; we have had to fight for it.
Yes, we need to accept this is going to be a long fight too. The current Congress and administration will be unlikely to pick up this issue at all. If it makes it out of committee will be partly up to our politicians. But more than that it will be up to us, the people of the nation, as well.
We will have to push this one, because there are a lot of forces that will be against this idea. Some Democrats will not supports this idea, as the vast majority of Republicans will not. It should also go without saying that both the Pharmaceutical Industry as well as Health Insurers will strongly oppose a move towards universal healthcare. All of their profits are invested in the status quo after all.
It is well past time we push for this issue. I don’t yet know the details of Sander’s plan, but we must keep in mind that there are many ways to do universal healthcare. I will talk about that a little later in this piece.
The point is, there is quite a bit of support for a type of universal healthcare.
It will be up to us, the people, to make sure it happens.
Now, let’s look at what the UN has to say about this;
Sustainable Development Goals
“All UN Member States have agreed to try to achieve universal health coverage (UHC) by 2030, as part of the Sustainable Development Goals.” (World Health Organization)
Let’s make now mistake about this, and this is the most important component of this SDG in my opinion. As I have said in the first post in this series, over 193 countries aided in the creation of the Sustainable Development Goals. Per the quote above, every one of them have agreed to try and achieve universal health care coverage.
Now, it has to be admitted that UHC is a broad concept, and there are many different ways to approach this. There are many different models and styles that fall under UHC. The Affordable Care Act, for all its faults, would likely qualify as an attempt.
It should be obvious that a Medicare for All style healthcare system is quite a bit different than the ACA. It would be much more in line with what a lot of Europe and other countries do.
With that in mind, let’s take a deeper look at that;
As far as this series is concerned, most of our focus has been on the Nordic countries. Those too will be the focus here. But I am also going to bring in a few other examples from Europe, as they will serve to give a good survey of the many different ways to do this.
58 countries in all have health systems that would be considered UHC. Wikipedia has this to say about the different funding models of various countries in Europe;
“Almost all European systems are financed through a mix of public and private contributions. Most universal health care systems are funded primarily by tax revenue (like in Portugal Spain, Denmark, and Sweden). Some nations, such as Germany and France and Japan employ a multipayer system in which health care is funded by private and public contributions.” (Wikipedia )
The point being, most UHC systems have mixed revenue sources. Given the complexities of the American healthcare system, it is likely that the US would have to implement a similar system. Right now, Health Insurers are some of the largest private players in the American system. I would expect resistance from them.
However, depending on how we do it, there still might be a place for them. One thing is clear though; that there needs to be a primarily public revenue stream in any system we develop. Let’s look at some of the options. All that follows is from Wikipedia.
“Denmark has a universal public health system paid largely from taxation with local municipalities delivering health care services in the same way as other Scandinavian countries. Primary care is provided by a general practitioner service run by private doctors contracting with the local municipalities with payment on a mixed per capita and fee for service basis. Most hospitals are run by the municipalities (only 1% of hospital beds are in the private sector).”
“In Finland, public medical services at clinics and hospitals are run by the municipalities (local government) and are funded 76% by taxation, 20% by patients through access charges, and 4% by others. Private provision is mainly in the primary care sector. There are a few private hospitals. The main hospitals are either municipally owned (funded from local taxes) or run by the medical teaching universities (funded jointly by the municipalities and the national government). According to a survey published by the European Commission in 2000, Finland’s is in the top 4 of EU countries in terms of satisfaction with their hospital care system: 88% of Finnish respondents were satisfied…”
“France has a system of universal health care largely financed by government through a system of national health insurance. Nonetheless, not all medical care is paid for by the state, with only 70% of initial GP care covered and anywhere between 35% and 100% of prescription medication covered. It is consistently ranked as one of the best in the world.”
“Norway has a universal public health system paid largely from taxation in the same way as other Scandinavian countries. Norway’s entire population has equal access to health care services. The Norwegian health care system is government-funded and heavily decentralized. The health care system in Norway is financed primarily through taxes levied by county councils and municipalities. Dental care is included for children until 18 years old, and is covered for adults for some ailments.
Norway regularly comes top or close to the top of worldwide healthcare rankings.”
“Sweden has a universal public health system paid largely from taxation in the same way as other Scandinavian countries. Sweden’s entire population has equal access to health care services. The Swedish public health system is funded through taxes levied by the county councils, but partly run by private companies. Government-paid dental care for those under 21 years old is included in the system, and dental care for those older is somewhat subsidised by it.
Sweden also has a smaller private health care sector, mainly in larger cities or as centers for preventive health care financed by employers.
Sweden regularly comes in top in worldwide healthcare rankings”
I hope this makes it abundantly clear that most of the best systems of healthcare in the world are often primarily funded through public means and taxation. The private sector does have a varying role to play in each of the systems, and in an American system is is likely the same would be true.
But first, we have to implement a Universal Health Care system. Then we can debate the details.
For the moment, let’s talk briefly about Drawdown.
Good Health is another one of the SDG’s that pretty much every solution proposed in Drawdown could apply to. Pretty much anything that keeps our air, water, and land clean is going to have benefits for both our individual health, and our health as society.
The economic savings from implementation of Drawdown alone would be significant. In addition, cleaner air and water would increase overall longevity and prevent a lot of treatable conditions such as asthma.
The World Health Organization estimates that millions of premature deaths can be linked to air pollution. This is to say nothing of clean water and land.
As such, I want to focus on just two of Drawdown’s solutions that directly impact individual health and sustainable living. Most other solutions will appear in other posts for this series.
Solution #54: 2.92 gigatons CO2 Reduction. $3.28 Trillion Net Operational Savings
“Walkable cities prioritize two feet over four wheels through careful planning and design. They minimize the need to use a car and make the choice to forego driving appealing, which can reduce greenhouse gases emissions. According to the Urban Land Institute, in more compact developments ripe for walking, people drive 20 to 40 percent less. “
This one is pretty self evident, and the health benefits from being able to walk more regularly cannot be underestimated. In addition, cities that are designed for foot traffic need less cars, and less pollutants are created as a result. The cost savings are substantial as well. As this solution points out; “Health, prosperity, and sustainability go hand in hand.
Solution #59: 2.31 gigtons CO2 Reduction. $400 Billion in Net Operational Savings
“Copenhagen is considered the most livable city in the world, in no small part because it is the most bike-friendly. Thirty percent of Copenhageners ride to work, school, and market on 18 miles of bike lanes, and along three bicycle superhighways connecting Copenhagen to its outlying suburbs… “
I had to use the above quote, because it ties this piece so nicely together. Copenhagen is widely considered to be the greenest city in the world, and such it is a model worthy of emulation.
In addition, bringing together the Nordic health care model with the most sustainable city just reinforces exactly what I am talking about here. Sustainability and health go hand in hand.
There is a lot to learn from the Nordics; social democracy as well as healthcare. At this pojnt, America is well behind the ball, and we have a lot of catch up today. I hope you will join me and help build a better future for us all.
As always, thanks for reading!