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U.S. could learn a lot from Norwegian health care system

  • Published in Letters

To The Daily Sun,

I have been online chatting with my Norwegian relatives (in Norwegian) about their government and its highly successful health care system. Before I enumerate the numerous differences in the two systems, we need to compare the two countries and their comparative abilities to support such an endeavor. A good comprehensive measure would be the Legatum Prosperity Index (check it out online), which measures such things as national wealth and economy, entrepreneurship and opportunity, governance, health, safety and security, personal freedom and social capital. Each category has a number of criteria to meet and all point to a measure of quality of life and well being within a country. Norway is ranked #1 in the world, the U.S. #11. Norway has held steady at #1 for the last five years.

Now for a comparison of fiscal management. Checking the U.S. debt clock website (it contains an amazing display of running data), the U.S. has a national debt of $17.1 trillion. That comes to over $54,000 for every man, woman and child among our population of 317 million people. Norway has a SURPLUS of over 800 billion U.S. dollars, which is about $160,000 for each of their five million people. With a gross domestic product of about $15.7 trillion, our national DEBT is 1.1 times GDP. Norway's GDP is about $500 billion so their SURPLUS is about 1.6 times GDP. To get a grip on the enormity of this, consider that if our nation had a national surplus of 1.6 times GDP, that SURPLUS would be 25.1 trillion dollars. Norway has displayed a long history of fiscal responsibility and has maintained an average yearly surplus of about 13.5 percent over expenditures for the last dozen years. The surplus was not built overnight. Norway wisely did not join the European Union or else this little country would have been bled dry propping up the several fiscally irresponsible and much larger EU nations. Norway can afford full uniform (meaning it is the same for each and every person) healthcare to ALL of their people. Their government has managed their wealth in an entirely different way than our government has managed ours.

Now for the comparison of health care plans. Norway has a single pay system with the government reimbursing the health providers DIRECTLY. The U.S. system must utilize the trillion dollar plus insurance industry as an intermediary that stands between the government bureaucracy and the health care providers. This intermediary is a big fat cat that must be fed. All these insurance companies add another massive bureaucracy and expense that the Norwegian system does not have. All the many different insurance companies involved must pay for their operations, their management, their employees and show a profit for themselves and their stockholders. If they are not profitable, our system provides for a subsidy at taxpayer expense. The whole scenario is a bonanza for the insurance industry. Participation is mandated (except for those politically granted exemptions) and federal subsidy is provided for those who can't pay.

The Norwegian system is uniform and nation-wide in its application and the U.S. system is a patchwork of an uncountable number of different and complicated non-uniform insurance policies, with fines for non-compliance. The Norwegian system covers everyone, the U.S. system does not.

Here are few other related facts you may consider important relating to the way our government and our nation functions. The Forbes Happiness Index, just out this past week, puts Norway #1 in the world, the U.S. #11. The United Nations Human Development Index has ranked Norway #1 for the last three years running. The U.S. trails but is presently a respectable #3. Norway's life expectancy is listed at 81.3 years and the US 78.7. The Democracy Index, compiled by The Economist Intelligence Unit (google it), ranks Norway at #1 in the world and the U.S. #21. The land of the free has suffered setbacks in our First Amendment rights of free expression and speech at the hands of executive actions and court rulings (legislation from the bench by politically appointed judges) that bypass the electorate and the will of the people. We have a two party system (in function, but not constitutionally mandated), which limits representation choices, and the parliamentary system has room for multiple parties and a better chance for diverse expression at the top. The Scandinavian countries are at the top of the democracy list. Also it is obvious that the functionality of our government at present is not what it was created to be and should be.

In summary, several things stand out. First, we are in such a financial mess that we are not in a position to afford the health care system we (our elected representatives) have voted in. Secondly, the system we have voted in is too expensive and inefficient due to the unnecessary addition of insurance companies and their bureaucracy. It is an unfair patchwork of non-uniform insurance policies that do not cover everyone equally and some not at all. The system is flawed.

George Eric Brunstad