Universal Healthcare: Not the Solution to Improve Overall Health

This is the first part of a two-part series on healthcare.

Universal healthcare has been highly regarded as the savior of healthcare. Taking a closer look at these systems in places like Denmark, Japan, and Canada paints a different picture of what actually improves overall health of a nation. And a single payer Medicare For All plan would surely spell disaster for all.

 Denmark

If you asked which country had the best healthcare system, Denmark is typically the answer you would get if you asked most Bernie Sanders supporters and Senator Sanders himself. In the 18th and 19th centuries, as old feudal social relations broke down, healthcare in Denmark was passed down to the towns and counties under central state guidance. Denmark’s healthcare system has always been subsidized by taxes collected from the parish, town, and county levels. The roots of their welfare state can be traced back to the 18th century, “long before the emergence of social democratic parties and organized philanthropy.”

In Denmark, mortality rates from cancer totaled close to 17,000 in 2013. However, while that number seems comparatively small to the U.S.’s approximate 592,000 cancer deaths, Denmark had a significantly smaller total population than the U.S. at 5.6 million in 2013 versus the U.S. population at 316.5 million in 2013. For Denmark, that is still a significant portion of cancer deaths that can be prevented from healthy diet, exercise, and healthy lifestyles. And this is just one disease.

To Denmark’s credit, they are among some of the lowest ranked for cardiovascular disease (CVD) out of 28 European Union (EU) member states. Taking a closer look at Denmark’s great results with lowering their risk of CVD reveals that perhaps it’s not their universal healthcare system that is the reason for having low rates of CVD but something else.

In 2004, Denmark imposed a ban on trans fats. Studies have shown an association between consuming trans fats and increased risk to CVD. Trans fats can naturally occur in dairy or meat but the type that is mostly consumed by humans are the trans fats that can be artificially manufactured and show up in fried foods in hydrogenated oil. A study published by the American Journal of Preventative Medicine regarding the trans fat ban in Denmark found that a decade after its 2004 implementation, the trans fat ban significantly reduced CVD rates tremendously.

Perhaps hidden beneath the veil of universal healthcare lies another explanation why Denmark exhibits lower disease rates. A 2004 study found that Danes with higher education levels have better health and have longer life expectancy. Lower education levels and poor health can be attributed to unfavorable living conditions, unhealthy work environments, and certainly higher mortality rates for uneducated people on permanent unemployment.

Of course, the U.S. could specifically benefit from Denmark’s system by eliminating medical insurance companies or other insurance entities operating for profit. This would reduce huge amounts of paperwork and time spent dealing with multiple insurance companies and billing. However, while eliminating medical insurance companies is certainly the right course of action, handing control over to the government to insure the health of its citizens may be a slippery slope due to the sheer amount of lobbying and corruption that plagues our government. The best option is to empower citizens and allow the free market to operate, while government’s only role should be to simply promote voluntary cooperation and prevent coercion.

Japan

Japan is the revered as the paragon of health and also has a universal healthcare system. The country is ranked first in “health life expectancy,” which considers mortality and the effect of chronic diseases such as heart and lung diseases, diabetes and serious injuries. Health life expectancy is life expectancy minus the years a person would be enduring years afflicted by disease. According to Professor of Global Health Policy at the University of Tokyo, Kenji Shibuya, it is “more telling that Japanese women enjoy healthy lives for only 71.7 years, and men for only 68.8 years,” as opposed how life expectancy measures, which increase those total years. “In other words, one can say that most middle aged and elderly Japanese are living with some kind of disease,” states Shibuya.

The traditional Japanese diet mainly consists of less fatty foods such as fish and vegetables. However, their food lacks vital nutrients from fruits, nuts, and whole grains and usually contains high amounts of sodium that can contribute to high blood pressure. High blood pressure can lead to heart attack, heart failure, stroke, kidney disease, osteoporosis, and stomach cancer. This high sodium diet could even be linked to two of Japan’s top leading causes of death: stroke and heart disease, which are still at high levels for a country with the best health life expectancy.

In 2012, a report from The Japan Times reveals that cancer, heart disease, and cerebrovascular diseases that lead to strokes are at their lowest levels in half a century but yet still confirms that high sodium diets are the culprit for high mortality rates in some areas.  The report also confirms that a “variety of factors are believed to contribute to the lower mortality rates, including a change in lifestyles, a drop in the number of smokers, advanced public health policies and more information about health issues,” a woman from the Health, Labor and Welfare Ministry told reporters at The Japan Times.

Japan was able to reduce their obesity rates to 3.5% and they didn’t need a universal healthcare system to do it. While contributing to the low mortality rates from disease, something other than lifestyle changes contributed to these better health outcomes, which is a specific kind of policy that has nothing to do with a universal healthcare system—a mandated “metabo law” that requires citizens to comply with a government-mandated waistline limit or face consequences and financial penalties.

Under this law, companies and local governments that do not meet the required waistline threshold for men and women will be subject to “financial penalties.” While this law would not work in the U.S., it demonstrates that the reason for Japan’s health was due to healthier lifestyles and polices that mandate them to be thin, not a universal healthcare system. 

Canada

Canada is another country that has a universal healthcare system, except the actual health of their nation is not much better off than the citizens in the U.S. The top leading causes of death in Canada are cancer and heart disease, just as they are here in the U.S. Canada suffers from the same preventable disease epidemic as the U.S. almost in the same descending order from biggest killer to least. Even the mortality rates from cancer in Canada are very similar to morality rates from cancer in the U.S. relative to population size.

Canada had a total population of approximately 35 million people in 2013. Canadian mortality rates from cancer totaled 75,112 and mortality rates from heart disease totaled 49,891. The U.S. had a total population of approximately 315 million in 2013. U.S. morality rates for cancer were 591,699 and mortality rates from heart disease were 614,348. Relative to population size, cancer mortality rates in the U.S. are only 14% higher than Canada. However, the difference between mortality rates from heart disease relative to population size between both countries show an increase of almost 18.8% in Canada’s mortality rates. This means Canadians are actually dying from heart disease at a higher rate than their American counterparts. It’s evident that Canada’s universal healthcare system is not the best example for the U.S. to model after. This disease epidemic is not just exclusive to the U.S., but Canada as well.

In 2014, the obesity rates in Canada are not very comforting when 20.2% of adults have obesity, which averages out to 5.3 million people. Also, in 2015, the frequency of childhood obesity from age three to 10 was at 13%, compared to 17.5% in the U.S. Again, all this in total alludes to millions of people that either died from a preventable disease, or were diagnosed or were undiagnosed from a preventable disease, or are suffering from obesity. Finally, the “free” healthcare in Canada is not free. In 2015, healthcare costs for an average family (2 parents, 2 children) are $11,735 annually.

If the overall health of Canada was not poor enough, the wait times for emergency room visits are simply egregious. The overall wait time in Canada is significantly longer than other countries with publicly funded healthcare systems. In fact, 27% of Canadians reported “waiting more than four hours in the emergency department compared with one per cent in the Netherlands and five per cent in the United Kingdom,” according to the “The Wait Times Alliance’s” annual report card. Worse yet, according to a report from a health watchdog, 35% of the patients (one in three) in Quebec had to wait a staggering five hours or more just to be seen in an emergency room visit.

Conclusion

The best aspect of a universal healthcare system in all of these countries is the idea of eliminating the for-profit insurance companies. However, as detailed in the aforementioned, this will not always produce a healthier nation.

The recurring intuitive theme that keeps persistently surfacing here is that proper diet, exercise, and healthy lifestyles are the best prescription to increase health in people. It should be glaringly obvious that universal healthcare will not ensure a healthy nation. Universal healthcare will not solve the issue because it will not solve the quality of life, which should be the objective of healthcare.

After examining other countries’ universal healthcare systems and comparing mortality rates from preventable diseases, it’s clear to assert that these countries are no better off with a universal healthcare system than publicly funded systems in terms of what actually improves overall health. The evidence demonstrates that healthy diet, nutrition, exercise, and healthy lifestyles are all that’s required, and not how many people are insured under a universal healthcare system.