Thursday, June 6, 2019

Need good healthcare? Need it now? Short on cash? Be Icelandic.

Today on Facebook I posted a link to this article: "An American In Iceland Found A Lump On Her Body And Her Viral Twitter Thread Shows How Much Better Their Healthcare Is." If you've ever encountered the U.S. healthcare system, you might want to read the article too.

A reliably and sometimes knee-jerk conservative friend of mine left this comment on my post:

"Iceland has a population of 338,349, with practically no illegal (excuse me, undocumented) immigration. The Personal Income Tax Rate in Iceland stands at 46.30 percent. In addition, according to the Trip Savvy website, "VAT in Iceland is charged at two rates: the standard rate of 24 percent and the reduced rate of 11 percent on certain products. Since 2015, the 24-percent standard rate has been applied for almost all goods, whereas the 11-percent reduced rate is applied to things such as accommodations; books, newspapers, and magazines; and food and alcohol." One imagines it might be possible for the United States government to fund all sorts of things under a similar tax regime, not including state and local taxes. How much LIVING the average American would be able to do, however, is another question."

I'm not sure what he's saying there. If we had fewer immigrants, our healthcare system would be as good as Iceland's? If we paid more taxes, our lives would somehow be impoverished?

My friend is right, of course, that the U.S. has a much larger population than Iceland. He is also right that the U.S. has a higher percentage of immigrants: the U.S. population is 15.3% immigrant, whereas Iceland's is 12.5%. I don't know how many of those are undocumented; I do know that many economists have found that immigration (documented or un) is mostly beneficial. A report from the Wharton School (President Trump's alma mater) concludes, "Economists generally agree that the effects of immigration on the U.S. economy are broadly positive."

But let's look at some countries with a higher percentage of immigrants than the U.S. and see how they fare with regard to health and happiness. Here are seven. Ireland: 16.9%. Sweden: 17.6%. Austria, 19.0%. Canada, 21.5%. New Zealand, 22.7%. Australia, 28.8%. Switzerland, 29.6%. Golly, their healthcare costs must be enormous!

Well, no. The per capita yearly healthcare cost in those seven countries averaged $5,352 in 2017, or about half the per capita yearly healthcare cost in the United States, which was $10,209. The costs ranged from $3,683 (New Zealand) to $8,009 (Switzerland). (Iceland's cost was $4,581.)

Ah, but the U.S. has better healthcare, right? Maybe not. Interestingly, people in these seven countries have significantly longer lifespans than people in the United States. U.S. residents' average lifespan is 79.772 years. People in the other seven countries, on average, live three years longer, ranging from 81.884 years to 83.706 years (In Iceland, the average resident lives to 83.152 years). And if you think residents of those countries have to wait longer for healthcare, read the comments on the Iceland article.

But sheesh, those taxes! Yes, U.S. residents pay less tax and have more disposable income than residents of those other seven countries, on average. But the difference is not as great as it might appear, partly because those taxes pay for things that U.S. residents pay for out of pocket, and partly because the U.S. has much more inequality (multibillionaires have a way of skewing the averages). The Gini Index ranks 157 countries from #1--the most unequal--to #157, the most nearly equal. On their list, you want a high number. The U.S. is #39. The other seven countries range from #88 to #152 (Iceland is #141).

So how much LIVING can people in these seven countries do, compared with the average American? Well, with enormous healthcare costs and huge educational debt, life can be rough for average Americans. And when you and your neighbors are poor in a country run by obscenely rich people, you may not feel so good either. Maybe that's why Americans aren't as happy as people from those other seven countries. The U.S. took 19th place in the yearly happiness index. The other seven countries ranked at place 16 (Ireland), 11 (Australia), 10 (Austria), 9 (Canada), 8 (New Zealand), 7 (Sweden), and 6 (Switzerland). (Iceland came in at 4th place.)

Summary: Immigrants are not the reason for high healthcare costs. High costs are not a predictor of good care or good results. Low taxes are not a predictor of happiness.

If you want to terrify Europeans, just suggest replacing their healthcare system with one that resembles the U.S. system. President Trump didn't realize that a few days ago when he went to the U.K. and made comments that worried supporters of Britain's National Health System, but the strong blowback made him quickly change his tune.

America deserves a healthcare system that covers more people, costs less, and produces better results. I wonder why more Americans don't pay attention to systems that are already doing that.

No comments: