In a recent post — prompted by Bernie Sanders’s call for America to be more like Sweden, Denmark, and Norway — I discussed some popular misconceptions about the Nordic model. One of the biggest fallacies peddled by many American liberals is the notion that adopting Scandinavian policies in the United States would yield Scandinavian outcomes. As I noted in my post, it is impossible to disentangle a nation’s social and economic outcomes from its demography and culture. In other words, we should not expect Swedish policies to produce Swedish outcomes in any country where most people are non-Swedes.
That’s worth remembering in all policy debates, but particularly when it comes to health care.
Consider the latest OECD data on weight and obesity, which were released earlier this month as part of the organization’s 2015 “How’s Life?” report. Among the OECD member countries surveyed, America has far and away the highest percentage of overweight or obese children, along with the highest percentage of obese adults, whereas Sweden, Denmark, and Norway have among the lowest percentages. This is surely a significant reason that America spends a larger share of GDP on health care than the three Nordic countries do. (In 2013, America spent 16.4 percent of GDP, Sweden spent 11 percent, Denmark spent 10.4 percent, and Norway spent 8.9 percent.)
And yet, American liberals often argue that the lower level of health-care spending and/or the long life expectancy at birth in Sweden are attributable to the wonders of “universal health care.” In reality, as Swedish economist Andreas Bergh observed in a 2010 interview with Reason magazine, “Sweden does not prove that socialized health care works — I would say rather the opposite. The health-care part of the Swedish public sector is where many of the problems are.” Indeed, the public health system is plagued by “huge waiting times,” even for routine surgeries. Sweden has tried to address these problems by privatizing the delivery of many public health-care services. Meanwhile, more and more Swedes are acquiring private health insurance.
If we want to understand why Sweden has one of the healthiest populations in the world, we need to look beyond public policy and consider factors such as diet and culture. As Bergh explained, Swedes “eat healthy; they don’t drink much; they don’t smoke much; and they don’t eat crappy, fatty food — which is the major reason for the long life expectancy. It is not that Swedish health care is super-efficient or highly successful.”