Why I, a Swede, Believe in America and in Health Care Reform

ItPhoto 137‘s been a battle between two of the best things about America:  Individual liberty on the one hand and shared responsibility on the other.   In the debate on health care we can’t resort to Dubya-style prattle that framed political dramas as a battle between good and evil.  It’s just not that simple.  There are good ideas and good people on both sides of this debate.  I don’t often speak in the first person on CultureMutt but I have no problem making this exception because of the extreme importance of what is at stake here.  I want to address this on as personal a level as possible.

Health care in America is an embarrassment, it is woefully inadequate and completely unacceptable in the world’s richest and most powerful country.  How is it that in America, the world’s sole superpower, we have huge slabs of the population that are one illness away from bankruptcy and devastating, personal failure?  How is it that insurance companies are able to deny people coverage based on pre-existing conditions?  This is cruel, this is heartless, this is fundamentally un-American.

red, white, and blue capsules in pill bottlesI will admit that as a Swede, I often compare America to what I have in my country of birth.  Yes, Sweden has socialized medicine and yes, this does bias me in favor of providing health care as a right for all.  But I made a very conscious decision ten years ago to move to the United States.  The reason?  I still believe with all that is in me, that America is the land of opportunity.  I still believe that things – very good things – can be done in this country that cannot be done anywhere else.  I am proud of my adopted country and I defend it whenever I travel.  This is where I want to live and this is the country I am committed to on a level that makes me feel deeply invested in doing all I can to improve this country for all that live here.

What is special and what is unique in America is an unwavering belief in the possibilities of what we can achieve as individuals and what we can achieve together.  No other country on earth can claim the kind of environment that America offers to all that live here: superior opportunities to thrive and prosper.  I will admit that I came to America because I personally wanted to thrive and prosper and be supported in my drive to do so as an individual.  But having lived in America for 10 years now, I can say that the American promise has proved to be about more than just individual success: it is about our shared destiny as a people.  The good news about America is that this is a country where we give a damn.  This is a country of compassion.  This is a country where we care about other people; where we pick up our fallen in battle; where we work TOGETHER in the hope of improving our collective existence and that of future generations.  No matter how controversial, infuriating or deeply disappointing the path, we CANNOT allow the firestorm that is the health care debate to allow us to forget about this fundamental truth.  There is a better way than this.

Gavel, Stethoscope and Books on FlagLet’s not pretend that the health care reform bill that will be voted upon tomorrow in the House is without fault.  It certainly has weaknesses and compromises.  I am tempted to get on my soapbox as usual and pontificate on what the bill REALLY should look like but this time I won’t.  This moment is too important.  The bottom line is that our current health care has failed.  People are hurting, people are vulnerable and the time for change has come.  Just as it took courage and overlooking imperfections and potential political ramifications to vote in Medicare for seniors and Medicaid for the poor decades ago, it will take courage to bring health care reform today.  The time for stalling is over.  This country is better than this.  We are better than this.  And the America health care reform will bring is better than this. May the House prove it by voting for Health Care Reform tomorrow.  In the words of President Obama this afternoon, “Let’s get this done!”.

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Bjorn Karlman

36 thoughts on “Why I, a Swede, Believe in America and in Health Care Reform”

  1. thanks for making the choice to take a stand despite. it’s in adequate at best, but it seems like the only choice is to take the step, and hope in future generations we will continue to tweak it and make it better for all Americans in need of health care. Health care should not be a privilege, it should be a right for everyone that lives in this country.

  2. How anyone could trust the US government to come up with a good health care plan is beyond me. However, I am at the point where I really want it to pass.

    The sooner it passes, the sooner our government will go bankrupt and the sooner we can learn our lesson.

  3. Tania, I am with you. Nobody is saying that this is all we’ll do to reform health care. This is simply the first step. But if we don’t take it now we will surely be waiting a long time before anyone has the political guts for this fight again. The Republicans have shown us that they simply don’t see health care reform as enough of a priority to actually change. So we are right to focus on this while we have the chance.

  4. Astonishing! “Health care in America is an embarrassment, it is woefully inadequate and completely unacceptable in the world’s richest and most powerful country.” Yet the funny thing is that people from all over the world come to the USA whenever there is need for ground-breaking treatment, difficult procedures that require specialized knowledge and technology. How countries with socialized medicine often look to the USA for new technology, medicines and treatment methods. It is beyond me why there would be such demand for healthcare that is so embarrasing and woefully inadequate…. You’d think Americans would be lining up to go for treatment to Sweden or one of these other countries with much better healthcare. After all, a plane ticket would likely be much cheaper…

  5. I understand the cynicism David and I certainly think you have the right to question government action. But when we are faced with something as broken and as vital as our health care system, I would rather go with the government that, despite its flaws, has and continues to give people the most prosperous and charitable country on earth, than to wait for the private sector to allow greed to screw it up even more.

  6. Excellent point Dacha. I am certainly not denying (sorry fellow Euros!) that America allows access to the best technology/innovative procedures, most educated physicians, etc. I am proud of this, just as I am proud of America’s universities and its many other opportunities for success that I alluded to in the post. My hope is that this will never change, that America will only continue to get better. Scandinavian socialized medicine is certainly not the answer. Let’s be clear: what I am looking for is AMERICAN innovation – a fusion of our incredible ability to succeed/rise to the occasion and our commitment to living the American promise that says we work best when we work together and care for our neighbor. THAT is what I am in America for. I believe in this country. That is why I am not buying transatlantic tickets.

  7. I forgot to add that while America does allow “access to the best technology/innovative procedures, most educated physicians, etc.” to those that are insured with the correct coverage, this is care is no NEARLY available to millions of hard-working Americans that need it. This is the problem.

  8. England is a rich, powerful country with socialized medicine. What makes you think America will go bankrupt if other countries manage to have it with money left over?

  9. Bjorn, your vision for America is more American than most Americans would care to admit. I feel that we–the born and breds–have lost some of that old spirit of innovation and ingenuity to stagnancy, cynicism and contempt. Why is it that it’s always the foreigners who see in America what Americans can no longer see?

  10. Thanks Ehren, good to get the nod of approval from a born and bred:) We really do have something incredible in this country. Reminding ourselves of this from time to time and learning to build upon it is key to our success – both personally and as a forward-moving community. How is Gang Nam?

  11. The problem is that you can’t have it all. Basically what you seem to want is American opportunity and innovation coupled with Europe’s socialism. I am afraid that what makes America so great is our individual liberties. Socialism, or “spreading the wealth around” as Obama tactfully says, stifles innovation and opportunity by taking resources from the innovators and job-providers and putting it in the hands of government bureaucrats. Adopting a European style health care system is probably one of the surest and fastest ways to see America stop being America and become Europe. Why would we want to be like them, when as you pointed out, we have so much more to offer here?

    I love what you say about American innovation and how this is an opportunity to take the lead. You are right that our system is an embarrassment in it’s cost and inaccessibility, and I too believe that we can do better as Americans. I too believe that health care reform is long overdue, and you are right that Republicans made a huge mistake by not dealing with this when they were in power (among many mistakes they made, which is why they are in power no longer). However, the wrong kind of change could only make things work, we could lose the very thing that makes America great.

    You said we need American innovation to reform health care and I heartily agree. Instead of rehashing what has already been tried all over the world why don’t we do what we’ve always done as Americans and come up with something better? Healthcare reform that puts more choice and liberty in the hands of individuals instead of forcing them to rely on the government? There are numerous aspects of our healthcare system that could be changed in order to improve accessibility and drive down the cost of healthcare without taking creating huge new bureaucracies that will cost taxpayers countless billions and suck the incentive for innovation out of the healthcare industry. Like you I’ll refrain from going into the details of what I think health reform should looks like. If you want to know what kind of health care reform those of us who still place the highest value on traditional American liberty want to see you can easily find it all over the place. The other side is not without ideas, we just don’t have the bully pulpit right now.

    With all the negative potential of the current version of healthcare reform it is not a stretch of logic to say that we may be better off killing this bill and sending congress back to drawing board. I see we tell our government we as Americans can do better.

  12. I don’t know what the UK’s financial situation is, but I do know what America’s financial situation is, and our programs (specifically Medicare, Medicaid, Social Security, and this new Obama health care bill) are set up in a way that will bankrupt us or lead to Draconian health care rationing (death panels). Our government just does not have the money to pay for the benefits promised. We would be better off completely throwing out our current system and just exactly adopting another countries health care system. That never can and never will happen (but if it did, I would prefer Singapore’s system).

    Bjorn, I am sure you have seen the profit margins for the health insurance companies. They are non-existent. Couple that with the fact that most of American health care is not for profit, are it really throws the greed thing out the window in my opinion. Not to mention, how do you account for the government being the biggest denier of health care in the country? I am not talking raw numbers, I mean as a percentage of claims.

    http://biggovernment.com/ptuohe/2009/10/05/ama-endorses-largest-denier-of-health-care-claims/

    Insurance companies are a pain in the ass, but they exist today because of government legislation, not because of a free market. This new bill will create a bigger nightmare than most people realize. It does nothing to address costs and puts a huge financial burden on business, individuals, states, the federal government, health insurance companies, and health providers. If I end up being wrong I will eat my words…that I promise you. However, if it is the other way around, I doubt we will have a compliant Democratic Party ready to fix the big mistake.

    http://www.chicagobreakingbusiness.com/2010/03/caterpillar-health-care-bill-would-cost-it-100m.html

    If this assessment is even remotely close, the bill is a complete fiscal disaster.

  13. Ugghh.. I typed up a reply and then lost it when I tried to post because I realized too late that I didn’t have a connection. So here goes round 2. Thanks for the very thorough treatment of the subject. I think we agree on a lot. We both see the current greatness of this country and we are both motivated in making sure America fulfills its potential.

    I do not agree, however, that American health care with the reform will look just like Swedish health care (government run yet highly decentralized and frequently voted as one of the best in the world). I firmly believe that health care reform will make American health care BETTER than the models across the Atlantic. Reform won’t take away the competition and options that both of us capitalists prize, it will ADD to them. You will not be forced to switch insurance or doctors, you can keep them if you wish. The reforms will add to the options by offering insurance to 32,000,000 Americans that don’t have it now. This means that 95% of Americans will be paying into insurance plans and remember, the public option ISN”T EVEN ON THE TABLE (and yes, I am bummed about that but I understand if this is deemed as a bad fit for America)

    So this will offer millions of Americans the same types of private insurance choices that members of Congress will have — through a new competitive health insurance market that keeps costs down.
    It holds insurance companies accountable to keep premiums down and prevent denials of care and coverage, including for pre-existing conditions.

    And as for the “countless billions” you reference as the cost to the tax payer, reform will REDUCE the deficit by more than $100 billion over next ten years, and by more than one trillion dollars over the following decade. This is what the CBO says.

    So while the bill is not perfect, we have needed and talked about this for decades and the work and debate over the last year is unparalleled, it is time to do this.

  14. David, I liked the links.

    As for the first one addressing claims denied by Medicare, I work in healthcare and would the first to admit that it has flaws. I work for a hospital in a retirement community and it is frustrating to have claims denied or to have reimbursement cut. That said, we would be absolutely sunk without Medicare and seniors would be completely screwed. If someone proposed killing Medicare, even my most conservative colleagues would defend this government-run option. Americans rise to the occasion and I am convinced we can improve our health care. Currently the reform language does not have a public option so what will really happen is an expansion of insurance coverage by private insurers to cover over 30 million Americans. We both know that the nonpartisan CBO predicts this will SAVE money to the tune of a $100 plus billion deficit reduction over the next 10 years (hardly the “complete fiscal disaster” that you Rush Limbaughed.)

    You are correct in mentioning that health insurance companies do not have huge margins. This does not excuse massive premium hikes or the fact that they can deny coverage to patients with pre-existing conditions. We need insurance reform to address all of this.

    As for your second link RE the added costs to Caterpillar if health care reform passes, this may well be the case but the flip side is that reform will make insurance more affordable to the middle class and to SMALL BUSINESSES – without these two sectors thriving, we can’t have a fiscally thriving America.

  15. I will bet you $1000 that this bill will not decrease the deficit.

    http://news.yahoo.com/s/ap/20100319/ap_on_bi_ge/us_health_overhaul_deficit_1

    The whole thing is a budgetary scheme. Not only will it increase the deficit, it will increase the costs for every single business and person that buys health insurance.

    Medicare is a pyramid scheme ($75 trillion in debt pyramid scheme at that. Nothing else matters to me. It is not a sustainable program, so it doesn’t matter how effective or ineffective it is in my book. It is an unsustainable monstrosity…paying for the medical bills of old people today on the backs of tax payers of tomorrow.

    The point of the profit margins is that if you infringe on those margins, it will just force premiums up…which is exactly what this bill will do. And even if you took away the profit margins, it would have no real effect on the cost of health care.

  16. Your link is to a Medicare fix that looks like it is not in the language of the bill.

    And I think I’ll trust the CBO on their projections. The groups is non-partisan and therefore a lot more objective than you and I.

  17. I watched “Sicko” by Michael Moore just a few hours ago, as a requirement for a class, largely unaware of all the big discussions going on regarding today’s vote.

    I don’t care for Michael Moore’s tactics and journalistic style. Showing up in/near Guantanamo with a loudspeaker was downright ridiculous. But I simply could not argue with those being interviewed in Canada, the U.K., France and even Cuba.

    Americans are scared of the word “socialized,” tying it to communism and visions of unrestricted & unreasonable government control. That’s not what it looked like in all those other countries (with the exception, perhaps, of Cuba, where we know medical supplies and even basic foods tend to be low). In the other countries, they get taxed a lot, the taxes fund the health care, and the average citizen gets care at no cost, or very small cost (i.e., $10 prescriptions in Great Britain).

    Doctors still make good money, and people don’t worry about getting sick, getting old or losing their job and being unable to afford health care. As someone who had to fork out several thousand dollars for an E.R. visit for a broken ankle and subsequent orthopedist and physical therapy sessions, I can see how a single event could leave you on the brink of bankruptcy. I was lucky enough not to require surgery.

    Moore seems to put the blame on HMO’s and pharmaceutical companies, which continue to make huge profits. If this bill will take a good stab at the insurance companies, then by all means, I hope it passes. I just hope it’s not too little, too late.

  18. Licia, I am with you on the mixed feelings on Michael Moore. I do agree that the Republican tendency to jump up and down and yell “Socialism!!!” every time Democrats try to do what they were voted in to do, is getting about as tired as Bush’s “war on terror” lingo. Socialists would NEVER agree with the health reform that is being voted on in the House today. And that makes me happy. I am not for socialism. That’s why I moved here. I AM for compassion however, this, in my view is truly American.

  19. Those are CBO numbers. That’s the point, they are leaving huge costs out of this bill. If Republicans were passing a war bill and said this bill will actually reduce the deficit, but excluded the costs of the weapons that would be needed to fight the war, people would laugh.

  20. OK, that comment thread got cut off so I’m back on down here…David, that WOULD be laughable (the scenario with Republicans leaving the cost of weapons out of the cost for war). Hardly apples to apples though.. My point right now is that quite apart from our points back and forth, the CBO, as a nonpartisan entity should be listened to. Of COURSE Republicans are going to say that all kinds of costs are being left out. They have clearly pledged to do whatever it takes to block this legislation and they are doing an increasingly hysterical job at it right here: http://www.cnn.com/video/flashLive/live.html?stream=stream/2&hpt=T1 Let’s forget what Democrats or Republicans say about the finances of this thing and actually listen to some objective analysis… seriously, this is not your strongest argument David,

  21. Bjorn I don’t know how I feel about healthcare reform yet. It both scares and excites me. Regardless I enjoyed this posting written in the first person, even though that is not your usual style. Also I love the passion and knowledge that you have put into American politics. Perhaps that is something that I, as American, take for granted and should take as an example. Thank you.

  22. You can repeat the contents of the bill over and over again, but people will hear only what they want to hear. The CBOs projections are the best, most accurate and ONLY non-partisan findings we have to date. Yet somehow this is not enough to convince people of the bill’s merits. The problem is that the passage of the bill signals both a significant political coup for the Obama administration ( as opposed to the political Titanic Republicans had predicted) and yet another logically unavoidable shift in philosophy about how America takes care of her own. These latter two points are what get critics all hot and bothered, not the content of the bill.

  23. The truth of what you say was made abundantly clear in the final hours of the House debate. I literally could not believe the gibberish coming from some of the speakers. Soviet-style takeover? READ SOME HISTORY and before that READ THE BILL. Compassion is possible in America, and it is LESS COSTLY.

  24. Hmm, the last numbers I heard from the CBO were about how much Health care reform would increase government spending (and therefore the deficit). But then again, that was awhile back, and they have made some changes since then. Still I wonder how they figure that by spending so much more they will reduce the deficit. I understand that the bill involves a lot of new taxes and fines, but last I heard these things were not going to pay for it. Maybe they have very optimistic views on how this bill will impact that economy, but that’s kind of iffy.

  25. You are so lucky you can live there. I believe the USA is almost the greatest place to live, work, praise and raise a family. Many of us just don’t have that opportunity and have to look at it from outside.

  26. Are you refering to the same England whose National Health Service (NHS) is expected to go bankrupt in 2 years despite the huge increases in funding it got every year since Labour took over in 1997?! Look into it, all the developed countries with socialized health care are having serious issues with solvency and funding for these programs, and this includes Americas own Medicare! It is a mill-stone tied around the neck, and America is about to vote to sizeably enlarge theirs.

  27. So do you feel that the budget of a government-run healthcare will allow for this research and innovation to continue? Because if there is no incentive of selling the new medicine/technology in the free market, the only alternative way research will continue is for the government to fund it. And as I see it, the government will be lucky to provide the promised coverage for the $940 billion price tag, let alone fund any research.

  28. “And as for the “countless billions” you reference as the cost to the tax payer, reform will REDUCE the deficit by more than $100 billion over next ten years, and by more than one trillion dollars over the following decade. This is what the CBO says.”
    OK, reality check! CBO says the bill will cost $940 billion, but will not add to the deficit, in fact it will reduce it. What this means is that there is a provision within the bill to cover this cost, and apparantly even a little bit of extra. The only way it will not add to the deficit (debt) is if this bill raises additional revenue to cover the cost of the bill, or in simple English – you and I, the tax payer, will foot the bill by paying higher taxes and higher health-care premiums so that there is cash in the bank to cover this adventure, instead of just adding more debt to our country’s ledger. Nothing in this life is free, and neither is this bill. We will pay for it, just not POS like now.

  29. Actually yes, I do. Research and innovation are a huge priority for the Obama administration. http://www.cnn.com/2009/POLITICS/09/30/obama.health.grants/index.html
    He has already invested heavily in both. And where are you getting your doomsday scenario of the free market disappearing? If anything, health care reform HELPS people take risk because they have a safety net that will allow them to take creative risks without having to stay put because of fear of failure.

  30. Dacha, there is more than your one way to skin a cat. Reducing the deficit isn’t done simply by raising additional revenue through taxes. There are several cost-saving measures and pro-competition measures that will drive down costs. Here’s an article I found helpful on the topic – I feel like it is clear without being too simplistic…:
    http://www.newsweek.com/id/235246/page/1

  31. Thanks for the reminder Valeria… sometimes we just get caught up in the whirlwind of the moment and forget gratitude! I for one, am certainly guilty.

  32. It COSTS $940 billion and doesn’t increase deficit (debt), which means it HAS to be covered by additional revenue. Cost cutting comes into the picture only to the effect of having it cost $940 billion as opposed to say… $1.3 trillion.
    The worrying part is this: with no exclusions allowed, and insurance mandatory, the cost of health insurance is bound to increase to cover the costs for the treatment of these individuals. Yet, the insurance companies are not allowed to go over certain thresholds, and so will soon not be able to break even. This will eventually eliminate the private sector, competition etc. and lands the government with both the tab but also the control of the whole thing. Of course, this then leaves the “public option” as the only option, something many have been very keen on – fully nationalized health service.
    The other cost cutting measures seem to be essentially rationing, in other words you are given a budget for treatment of a patient. This already exists within Medicare. For e.g. Medicare gives you a budget of approx $1500 for physiotherapy for a calendar year. You fall and break your hip, you can pretty much count on that burning up your $1500. What happens when 6 months later you sprain your wrist? You’re SOL until the next year rolls around! Look into it – this is how Medicare operates right now, and from the sounds of it, this is set to be extended across the board with this bill. So you have a situation like in England – you can only afford to operate so many staffed beds with your budget, so people can get in line and start waiting for their procedures, sometimes for months. It also means that where as a doctor now would happily order an MRI to see why my wife’s leg is going numb and in doing so would discover a buldging disc in her back, easily corrected by a bit of physio; they will do what they did to her in England and simply tell her to walk it off, because hey, it’s a heck of a lot cheaper than an MRI! 3 months later the disc in her back ruptured, and she is now stuck with a lifelong back problem which, thanks to Obama & co., you the taxpayer will now pay for for a very long time. This is the crucial difference with this bill – up until now service was rendered to a paying customer. From now on you will be a budget expense and treated as such. Do NOT underestimate this difference!
    The one overdue cost-cutting measure which I don’t see in the bill is a change in tort-laws, which are currently driving astronomical increases in liability insurance costs for doctors, hospitals and pharmaceuticals, and consequently the cost of providing care. But of course, that would essentially pull the plug on lucrative business for the likes of John Edwards and other influential/rich democrats who are needed to fund what will have to be the mother of all campaigns to get this looney bunch re-elected later this year and in 2012. I guess the tax-payer is now also expected to cough up for the costs of all the malpractice suits…..
    Or how about this for encouraging competition: allow health insurance companies to operate across state lines, which the government is currently forbidding them to do.
    I will say this – the system as it is now does need help, and a lot of it. But the way I see it, this will make a bad situation worse, not better.

  33. Cool! I just hope that the government will then approve the treatments that this research comes up with. Because in budget-driven health care, where things are bought in bulk and expected costs of treatment for a particular diagnosis are set by the government, new treatments resulting from this research may not be approved in treatment of a patient. And that’s how I see the free market disappearing. If the government doesn’t bulk buy what you’ve come up with, there was little point in you doing the research and development, even if R&D itself was funded by the government. Who else is out there to buy your product? The insurance companies can’t approve it, because the government is capping how much they can spend for a particular diagnosis….

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