I don’t know how many times I’ve read our listened to the statement that Scandinavian democratic…
Mike Meyer
93

And today Paul Ryan, who is somehow very important, said that those 22 million Americans who would lose any healthcare at all were not a problem because they didn’t want healthcare.

I didn’t see Ryan’s statement, but the larger point to be driven home is that the agency that provided that estimate has been off by as much as 100% when giving similar estimates regarding the ACA on that metric.

The CBO is simply not credible on this topic, as I have written in depth HERE:

Further, as we were constantly reminded when the ACA started to fail, none of these major programs (SS, Medicare) was perfect out of the gate. What’s important now is to implement a program that has a better chance of controlling costs than does the ACA, because if we don’t control costs, it doesn’t matter WHAT health insurance scheme you nationalize (ACA, AHCA, single-payer, whatever) ANY and ALL WILL FAIL.

I don’t know how many times I’ve read our listened to the statement that Scandinavian democratic socialism is some kind of farce or wouldn’t work in a real country.

That’s because it won’t.

I have real world experience with this from many angles. You’re correct that there is a lot of ignorance about the Swedish system (it is not socialism at all, so let’s not use that term) on the part of both its American critics and its supporters.

ONE. The “Swedish System” has been on its heels financially for decades. In 1984, the top tax rate in Sweden was 93%. I know this because I was working a job doing analytics (we didn’t call it that then) on how to pay high-income salespeople in various countries to maximize money in their pockets. At 93%, the Swedes didn’t care about getting more money; they cared about perks that were nontaxable under Swedish law, like better company cars to drive and 5-star-hotel vacations in Monaco.

Since then, the top tax rate in Sweden has been lowered incrementally to about 55%, if memory serves. That’s about the same rate as somebody who lives and works in New York City. So, keep in mind that Sweden went trickle-down and supply-side in order to keep their economy afloat.

TWO. The Swedish health care system performs in large part by not paying providers very much. How do I know this? Well, my nephew is a doctor in Sweden. :-). He will earn a very nice upper middle class income from his profession; he will never be a rich man, like doctors in the US are. Money affects the quality of the individual going into the profession. If you want single payer in the US to succeed, then you have to lower the pay to the doctors, and you have to accept that the medical profession will move forward with a lower quality of individual.

The same is true for nurses and allied health. All across the board, these professionals tend to make substantially more in the US (there are of course pockets where this generalization does not hold) all of which supports the quality of care that the US is able to deliver.

You want a national program without controlling costs? Quality of care will drop.

THREE. The Swedish social support system has continued, over the years, to pull back on benefits as it is clear that they are unaffordable in the long term. Again, how do I know this? Well, I have another nephew :-) who was on the dole for a decade because of a relatively minor issue related to scoliosis. A few years ago, he got a note in the mail that said that his condition had been “reclassified” as not qualifying for a dole, and that he better get his ass out of bed and find a job. (Since the bed his ass was in was located in his parents house, and he was in his mid-30’s at the time, his parents were far more pleased to receive that letter than he was.)

In general, it is not a good idea to emulate a system which is still to this day trying to find an equilibrium that can be financially stabilized.

Interestingly, I have colleagues who are young Swedish professionals, who want to see Sweden move in the direction of the United States politically, cutting back further on social infrastructures, and ending the “we accept all refugee” policies of their own government.

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