U.S. vs. Nordic Health Care

http://www.nytimes.com/2017/03/25/opinion/sunday/us-vs-nordic-health-care.html

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To the Editor:

Re “The Fake Freedom of American Health Care” (Sunday Review, March 19):

Anu Partanen’s observations about the cost and value of American health care are right on target. Very few Americans understand how health care gets paid for. Even fewer know that we in the United States spend about twice as much per capita on health care as other developed nations, yet fewer people are insured and our outcomes tend to be worse. Ignorance of these basic facts is at the root of our stalemate about health care reform.

Ms. Partanen is right to call out the bogus freedom being peddled by the current administration. The only freedom the current proposal protects is freedom of the market. That kind of freedom may be appropriate for buying a new toaster, but it is not appropriate for health care.

CHARLES E. BOUCHARDST. LOUIS

The writer is senior director, theology and ethics, Catholic Health Association.

To the Editor:

The chief problem with President Trump’s and most Republicans’ approach to health care is that it lacks a conscience. So-called free-market health care really just means profit-based health care. Such a system has no qualms about letting someone who lacks access to health care die and is indifferent if someone hesitates to seek treatment because it’s too expensive. The only value is the bottom line, assessed annually at stockholders’ meetings.

Thankfully, since Franklin Delano Roosevelt, Democrats (primarily) have stepped in to provide a collective conscience to supplant the profit motive; that collective conscience has demanded that old people have a minimum income, hence Social Security; that old people have health care, hence Medicare; that poor people should have some health care, hence Medicaid and the Affordable Care Act.

The American people are gambling with their lives if they put their health in the hands of Mr. Trump, other Republicans and big business.

JOHN E. COLBERTARROYO SECO, N.M.

To the Editor:

Anu Partanen makes a cogent case for universal health care. This would be a no-brainer if it weren’t for the fact that Republicans are worried that without the huge contributions they receive from pharmaceutical and health insurance interests, their re-election prospects would be dimmed. It’s always disturbing to see how they rationalize their support for “free market” solutions in an industry devoid of meaningful competition and rife with inherent conflicts of interest.

TOM RYAN, TUCSON

To the Editor:

Thank you for a very informative, first-person account of the differences between our slapdash corporate for-profit health care system and the Scandinavian model. As someone who has spent a lot of time in Northern Europe and has friends who work in the Swedish health care system, I found the essay spot on. I received medical attention free of charge when I needed it, even though I was not a resident, and the hospitals there are just as competent as ours here in the New York area.

All this political posturing about “socialism” as a dirty word shows how uninformed our leaders are. The social democratic societies have the best interests of their citizens as a priority. How do they pay for it? Payroll taxes and high taxes on alcohol and cigarettes, the very root of many of our health problems.

I wonder how many of our representatives in Washington have actually visited Scandinavia? Perhaps a field trip to spend at least two weeks in a Nordic country could open some eyes for our tunnel-visioned members of Congress.

KATHLEEN DWYERSTAMFORD, CONN.

To the Editor:

You don’t have to go so far afield as Finland to find a more efficient health care system than that of the United States. I can speak from experience about the much-derided Canadian system.

Since coming to Canada in 1974, I have probably seen my family doctor 50 times (with no co-payment). I have been to the emergency room at least 20 times; I have had several M.R.I.s, X-rays, sonograms and stress tests; and I’ve had a stent put in and cataract surgery in both eyes.

And what have I had to do for all this? Pay my taxes and show my health card. No voluminous forms to fill out or invasive questions to answer. For us the vocabulary of health care in the United States — co-payments, deductibles, pre-existing conditions — is as foreign as that of those aliens in “Arrival.”

Of course our system is not perfect. But I’ll take ours over the American nightmare of choices any day.

TIM SCHOBERT, OTTAWA

To the Editor:

There are many differences between the United States and Finland. Finland has a population of about 5.5 million, while that of the United States is about 325 million. So the size of a bureaucracy to support a centralized health care system in the United States would be staggeringly large. And there is nothing in our current centralized medical care systems (Veterans Affairs, Medicaid) that would inspire confidence in the efficiency or lack of fraud.

Another difference is that Finland is very homogeneous; the United States is not. According to a 2007 study by Steffen Mau of the University of Bremen, the more mixed the population, the less the people trust or support state welfare. And all this is aside from questions of freedom or rights.

KIM ENDRES, SAN ANTONIO

To the Editor:

The free market has a way of working itself out for most products and services. A person of means can shop for a Cadillac Escalade and not worry much about the cost. Others who are struggling to find a way to get to work can shop for a used Toyota. The wealthy suburbanite can hire a landscaper to tend to the yard, while others will mow the lawn themselves.

The free market does not work as well with medical care. While a wealthy person may be in great health and use medical services for nothing more serious than a tummy tuck, the struggling family across town might be seeking treatment for a sickly child without the means to do so.

When Paul Ryan says, “Freedom is the ability to buy what you want to fit what you need,” this may apply when buying a home entertainment system, but it fails to meet many needs for health care.

RICK MALWITZ, SOMERSET, N.J.

To the Editor:

Anu Partanen is correct that the Republican idea of health care is grounded in “fake freedom.” For women, this pretense of freedom is especially offensive. The “freedom” and “choice” that Representative Paul Ryan and his male Republican colleagues highlight as the greatest pillars of their plan do not extend to women seeking reproductive freedom and reproductive choice.

Instead, the G.O.P. bill seeks to eliminate funding for Planned Parenthood, and to prevent the use of tax credits to purchase health plans that include abortion coverage. Beyond fake, the G.O.P. “freedom” is sexist hypocrisy.

PAMELA J. GRIFFITH, BROOKLYN

To the Editor:

Choosing not to purchase health care coverage when you can afford it is not freedom but rather gross irresponsibility. Everyone is at risk of becoming ill or injured and needing expensive care to recover. To forgo insurance is to leave to others the responsibility of dealing with the costs of your illness or injury — or, worse, to force others to turn a blind eye while you suffer or die without care.

Certainly there are people who foolishly delude themselves into believing they are invincible or choose not to think about the consequences of not having coverage. But the majority of people who fail to purchase health coverage do so not because they don’t want coverage, but because they can’t afford it. Only the most cynical would call this inability to afford coverage freedom.

ROBERT LEWISOAKVILLE, ONTARIO