Self-proclaimed democratic socialist Sen. Bernie Sanders and other Democrats frequently point to the Scandinavian countries as models for health care, but an increasing number of citizens in these nations are opting for private medical insurance, finding the universal government system inadequate.
Kevin Pham, a medical doctor and a former graduate fellow in health policy at the Heritage Foundation, points out in a column for the Daily Signal that Denmark, Sweden and Norway are not socialist countries but highly taxed market economies with large welfare states.
He notes a growing European interest in private health insurance that “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,” he wrote.
Between 2006 and 2016, the portion of the population covered by private insurance increased by 4 percent in Sweden, 7 percent in Norway and 22 percent in Denmark.
A 2009 survey showed 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.
Meanwhile, some Democratic presidential candidates are proposing “Medicare for All,” which is most similar to the Canadian system in which providers bill a regional office administering the program.
The Scandinavian systems use regional offices to administer reimbursements to providers, but they differ from Medicare for All in critical ways, Pham said.
“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,” he wrote.
“These are precisely the things Medicare for All would abolish.”
Private plans in Sweden and Norway largely supplement the government-run plan, covering out-of-pocket costs while guaranteeing prompt access to specialists or elective procedures, which the state plans often fail to provide.
He noted that most of the private health insurance in Denmark, 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, Pham said.
“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.”
Pham pointed out that private insurance plans create value for the government by decreasing public health expenditure.
In the survey, about half had their last hospital visit paid by a private insurer.
That would all be illegal under Medicare for All, he noted.
“Private health insurance would be abolished for everyone.”