Does America’s Large Population Make Universal Health-care Impraticable?

Individuals with an affinity to small government incessantly make the claim that universal health-care only works in Germany, France, or other western European countries because they have fewer people. But they almost always say this without ever providing evidence for why they believe population correlates with per capita health-care cost. Japan is larger than Germany, France, or the UK, has universal health-care, and spends 10.9% GDP on health-care (Germany 11%). Looking at the OECD data, there doesn’t appear to be any correlation with a country’s size and the amount it spends on universal health-care (for the countries that have universal health-care). Indeed, there is a slew of tiny countries filling the space between the US and Germany, between Germany and France, and France and the UK. The UK has Europe’s 3rd largest population (second largest depending on year), most socialized health-care system (govt-owned hospitals and insurance), and nearly its cheapest health-care system. There’s no reason to believe the US’s population changes the feasibility of universal health-care there(here). To put it into cold hard numbers I’d run the data through a Pearson Correlation Coefficient, but I don’t have time for that; feel free to do it yourself.

There’s really no fundamental trait about America that prevents us from applying the same drug price-control mechanisms and any one of the universal healthcare systems at the Western European buffet. Even Right-wing sources like The American Conservative are admitting this now. You could say our politicians won’t do it because they are too partisan, but that is a reason to reject our politicians, not universal healthcare.

What about the amount of doctors and health-care practitioners that exist in a nation compared to the population overall you ask?

There also doesn’t appear to be any statistically significant relationship between population size and number of physicians per capita. The largest Western country other than the US, Germany, is close to the top of the list in number of physicians per capita. The UK has more than Canada, and France has more than those in tiny Belgium. Even when using a different, much larger dataset, again no correlation with doctors and population is found.

“I’ve read the problems in the British health-care system have been dramatically worsening since 2015.”

It seems, on the new Legatum index (2018), the US and UK health-care systems have both declined from 30 to 35 and 19 to 26 respectively. The UK is thus still superior to the US’s in price and performance. France and Canada have both increased from 18 to 15 and from 24 to 21 respectively. Every top country from Ireland (27) and up have universal health-care. I didn’t have time to go further down the list than that. I don’t know many other policies that have such a clear-cut success.

Universal health-care works, it’s the best, and it works in many configurations across many economic and political systems. Medicare for all, private insurance with individual mandate, government supply of insurance to those without it, or government-owned insurance and hospitals–big populations, small populations–it all can be implemented in ways that work better than the US’s model.

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