Universal health care in a free market

The Nordic nations have interesting news for Anglo-Saxon economic thinkers regarding the nervous relationship between health care and the free market -- and it will come as a big surprise to many Americans struggling with their medical bills.

Coming on the heels of the marvelous international financial meltdown that we have provided for the world, the message is not only that these countries north of the Baltic Sea are the real “free marketeers” today, but also that it’s true because they have such good social programs.

The respected former Swedish finance minister Par Nuder explained these new “truths” in terms of a small story about his overseeing the closing of part of a company in northern Sweden. It was a situation not at all unlike what is happening across America, but it was the response of the workers at the plant that was so different.

Nuder was surprised, he said, when the workers did not seem abnormally upset when many of their colleagues, fellow workers and even relatives were pinpointed to be let go. Indeed, he was initially bewildered by their apparent acquiescence. Then they told him, “But it would be worse for the plant to close down because it wouldn’t be productive.”

You see, he went on, the Nordic model, with its universal health care and excellent social benefits, is more competitive because people have enough security to not fear change. And thus, “one of the conclusions of the financial crisis is to invest more in people.”

He paused to remark to me, as he left the annual meeting of the International Press Institute here, where he was a leading speaker, “People think it’s a question of equity versus security -- no, it’s both!”

This question of which economic, financial and social model works best for the men and women involved was a dominant theme in the meeting that brought together leading journalists, publishers, politicians and thinkers from across the world.

We Americans have been struggling with exactly these questions, especially in the most recent years. What kind of health care system do we want and/or can we afford? Will any new system inevitably lead to a state “one-server” method? How can we meet change with open arms and yet critical minds?

As of this writing, President Barack Obama is telling another big meeting, that of the American Medical Association in Chicago, that “health reform is the single most important thing we can do for our long-term fiscal health,” as he discussed the varied ways we Americans can transform that care in conformity with our own diverse traditions.

I don’t think most Americans have absorbed exactly WHY he is saying this, so perhaps we should listen to the Nordics, who are spelling out their ideas in such clear terms.

Their underlying contention is that when working men and women have reasonably secure pension programs, health insurance and educational benefits, they will not fear change as much as we seem to. Thus, in a globalized and ever-changing world, they accept change more easily, even with all the threats that accompany it.

Indeed, one model after the other came up here. For Asians, it would seem to be the Chinese authoritarian/capitalist model, which some call the “Beijing consensus,” with its emphasis on “good government” above liberal freedoms. For the Russians, only 50 miles away from Helsinki, after Soviet communism fell in 1991, their “answer” has become another authoritarianism, but one based almost exclusively upon the production of oil and gas.

But it was far and away the Nordic model -- with countries from Finland to Sweden to Norway to Denmark thriving under a comprehensive Social Democracy that is often made fun of in countries with the Anglo-Saxon free-market model -- that came out on top. (In fact, it was when one member, Iceland, switched over to the extreme Anglo-Saxon model in the last eight years that it, too, fell apart.)

Most literate people more or less know the major points of the Nordic Social Democratic model: from “investing more in people” through education and social benefits, to mobilizing everyone (especially women), to a “culture of cooperation,” to controlling traffic emissions, to “building social bridges for people to walk across on,” as Nuder put it.

Yes, this is a strange time, an unnerving time, a frightening time in many ways. Yet it is also a time when the options are suddenly open, and we must look carefully and choose wisely, for the future is being built anew even as we think.

As the Finnish journalist who opened the meeting said: “Things don’t happen by themselves. The impossible can be changed into the possible.”

* Georgie Anne Geyer has delivered distinctive foreign commentary from a variety of foreign fronts for more than 30 years.

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