View of the U.S. Health Care Debate from Abroad

Some perspective being out of the U.S. as the AHCA is passed in the House (it’s not law yet). While way too many Americans spend way too much time arguing with others and themselves about which government endorsed health insurance scheme is preferred, citizens of Denmark — and I visited with a good handful today — are simply amused. In between a drag of his cigarette and a gulp of his beer, one guy said to me: America is not arguing about providing the best health care, it’s deciding who gets to profit off of sick people.

One woman asked what I do for a living. After explaining my work to solve addiction she said, you know your county has it backwards, right? She explained that there are plenty of people with addiction in Denmark but they tend to be a small group of people with serious mental health problems. Meaning, severe mental health unfortunately allows for the progression to chronic addiction. Because there is a general culture that fosters community, togetherness, and happiness, the sorrow, pain, depression, anxiety that fuels underlying symptoms of most addiction in America does not exist here.

I was just in Iceland — addiction is a non-issue. They’ve solved addiction in their country.

Health care is not about whether one has access to an insurance plan that grants one access to a doctor when one is sick. As one Dane said to me, “that’s just fucked up.” Doctors are health educators here. Sure, they have to practice medicine on sick people — people get sick, get cancer, etc. — but there is a greater emphasis on caring for oneself before you get real sick. Yet, at the same time, this society has decided that their tax dollars should pay for baseline medical care and education accessible for all.

I’ve walked around a lot of Copenhagen over 6 days and been thinking about liberty and freedom. What are those concepts? What did the Founders of America give us 250 yrs ago? The Founders were trying to find a balance between Natural Law on one end of the spectrum (go read your John Locke) and absolute authoritarianism (absolute monarchy) on the other. How much government can be created and maintained by the people that would promote and protect the greatest amount of personal freedom and liberty?

The greatest gift of the American experiment is not absolute personal freedom — that only exists under Natural Law — but it is a demonstration that a political society can be formed and maintained by the people, not a single emperor or king. Thomas Jefferson understood that the framework of American democratic-republicanism could stand the test of time, but that the needs of the people would change over time. “The earth belongs to the living,” Jefferson stated.

So what would Jefferson do if he were here today? Being a student of governments and good governance, he’d likely wonder how it is that the U.S. is the only industrialized country without a single payer medical system. In fact, he’d likely laugh at the existence of Medicaid, Medicare, and Veterans Health — this is already taxpayer supported medical care.

To be fair to Jefferson, he’d then remind us that he was against the centralized banking system created by Alexander Hamilton.

The critical question is what do we as a society want? Another Dane told me that she lived in the U.S. for a time and it was only after moving home that she recognized and felt the constant stress the American healthcare system imposed on her. At home, there’s no stress. If she gets sick — small or big — she can immediately get medical care. This is one thing she does not have to worry about in Denmark.

So, I’m left with this thought: who has more freedom in their life?