US and Scandinavian Healthcare System: A Comparison

The article puts it in very simple terms that Scandinavian countries’ healthcare system is for social good, and that of US is like a business (Bradley & Taylor, 2013).  Both the authors are quite accomplished.  Elizabeth Bradley is is a professor of public health at Yale University and the director of the Yale Global Health Leadership Institute.  Lauren Taylor is a Presidential Scholar at Harvard Divinity School where she teaches Health Ethics.  Together they have co-authored The American Healthcare Paradox, on which this essay is based. 

It is a know fact that United States spends most per capital on healthcare.  Against this backdrop, the authors have tried to analyze the reasons why it resists switching to publicly funded/delivered healthcare system.  It is something that has increased efficiency and coverage in other countries. 

It states that the United States in its belief to be different from other countries has consistently ignored their outcomes.  There is clear evidence that the “Scandinavian model”, when compared to US’s, outperforms in delivering better outcomes at reduced costs.  These countries spend a little more that half of what US spends on healthcare, cover 100% of their citizen, and have more physicians and acute care beds the latter.  This bring into front what we can learn from their model.  That is not to discount that they too must be having problems of their own.  Their research involving in-depth interviews and surveys with policy makers and practitioners found that both countries shared a common values, which is personal freedom.  To be more specific people of both countries value their personal freedom and their ability to control theirs as something paramount.  Also, one needs to take into account that the need for freedom and love for competition does not mean that quality and efficient care cannot be provided to the population.  Also, it does not hold true that the need for scientific innovation cannot find common ground with the belief in having humanistic approach to healthcare. 

The big question then is why is the there so much resistance to change? This is where the differences start.  Americans are less amenable to taxing the rich so as to cross-subsidize services to the poor.  This has to do with their psyche that social assistance in any form is likely to weaken the resolve of the people to exert and excel.  In contrast, the Scandinavians consider dependence on government as an assurance against their own insecurities.  These differences are prominently reflected across their respective healthcare system. 

The take away form this article is that its not the narrow comparison between the system of both the countries, but a broader view how these system evolved in the first place that is the key.  Further, it needs to be determined what is to be done in light of how the Americans view their system.  Up till now the debate on healthcare has always been restricted to ways to cut costs, increase access and improve outcomes.  And most would agree that the reforms so far have not been sufficient enough to curtail long-term costs or attain universal access.  In light of the prevailing view in US regarding government’s involvement in their daily life, a boarder debate on this required before any substantial progress can be made on healthcare.  It is only then that any comparison with Scandinavian model can have meaningful impact. 

The article is well structured, as sets the tone with usual WHO/OECD data.  Then builds upon a bit by describing the Scandinavian model.  It then tries to find a common ground between the US and Scandinavian values.  Then it moves on to more of analytical side by describing its survey and interview, which tries to go deeper into the problem.  Against this background, it tries to evaluate the reasons behind the difference in the system.  It concludes logically by bringing to front the psyche of people of respective countries, especially how they perceive the role of government in their daily lives.  Finally, how that reflects in their respective healthcare system.

After going through this article, I believe, before any further debate on healthcare, it is essential of have a broader debate about the role of government in the lives of average Americans.  It will be even tougher debate, and individual steps would be even harder to push.  Without broadening too much, they should limit the debate to health and social issues.  They should bring into forefront the need to take care of have-nots.  They should also consider promoting institutions, such as those that are typically people focused. 


Bradley, E. & Taylor, L. (2013). US Health Care Reform Is Only Getting Started. [online] Retrieved from: http://yaleglobal.yale.edu/content/us-heath-care-reform-only-getting-started [Accessed: 11 Dec 2013].

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