Why can European countries afford universal health care but not the U.S.?

Kent Kroeger
13 min readSep 26, 2018

By Kent R. Kroeger (September 26, 2018)

“It has been the goal of Democrats since Franklin D. Roosevelt to create a universal health care system guaranteeing health care to all people,” starts Vermont Senator Bernie Sanders’ stump speech as he promotes his Medicare-4-All (M4A) legislation. “Every other major industrialized nation has done so.”

He is correct. All major industrialized nations have either a straight single-payer system (Korea, Canada), a Beveridge Model single-payer system (UK, Sweden, Norway) or other type of universal coverage system (Germany, Australia, Spain). The U.S. stands along among industrialized countries in how it addresses health care.

But Sanders is wrong to suggest all Democrats share the goal of universal health care. In reality, the party has been, and remains, deeply divided on this issue. If the party were as united as Sanders suggests, they would have passed a single-payer system in 2008 instead of Obamacare which passed without any Republican support.

Why didn’t the Democrats pass a single-payer system? Because vested interests in the current private, employer-based health care system — physicians, pharmaceutical companies, and insurance companies — are too powerful within the Democratic Party to allow passage of a single-payer system that would dramatically reduce doctors’ incomes, virtually eliminate the private health insurance industry, and force U.S. pharmaceutical companies to face real price competition.

Americans pay more and get less

Any conversation about the U.S. health care system must start with this indisputable fact: Americans pay more and get less when compared to citizens in other industrialized countries.

According to the Organisation for Economic Co-operation and Development (OECD), health care expenditures account over 17 percent of the U.S. economy, compared to 10.1 percent for West European countries (see Figure 1).

Figure 1. Health Expenditures as a Percent of 2017 GDP

Kent Kroeger

I am a survey and statistical consultant with over 30 -years experience measuring and analyzing public opinion (You can contact me at: kroeger98@yahoo.com)