Split off discussion of differences in healthcare systems

[taimen]

Just back in 2010, Finland and Iceland were the two Nordic countries with the lowest total tax revenues as % of GDP, and the tax level in a country goes up and down depending on whether the country has a conservative administration or a social democratic administration.

No it doesn't. Increase in tax revenue relative to gdp since 2010 is more likely due to post financial crisis recession and declining gdp in those countries. Finland has had a conservative administration since 2010, which is probably going to change after elections in April.
Exactly as you state, 5 percentage point difference is really significant between countries if both still cover most of the healthcare with tax money.
You have significantly lower taxes and fantastic public heathcare (other services too). But the reason for that is the economic prosperity itself, not the model of your healthcare system. Healthcare expediture per capita in Finland is 3013 EUR per annum, Norway 4653 (OECD Heath at a glance 2018). That is a significant difference, although large part of that money is paid as higher salaries to employees. Healthcare expenditure is between 9-10% of gdp in both countries, but Norway can do this with a lower tax rate. Finlands system is actually not a single payer system, but OECD statistics take this into account and are reliable afaik. Finland is by no means poor, but the service level is significantly lower despite higher taxes.

 

[Storker]

Healthcare expediture per capita in Finland is 3013 EUR per annum, Norway 4653 (OECD Heath at a glance 2018). That is a significant difference,

...which is in part caused by different definitions of what is included in "healthcare". Our system defines quite a bit of senior citizen care as healthcare, while other systems may put some of those costs under a different budget post.

Besides, using direct numbers for healtcare spending is disingenuous anyway. You have to normalize against the national cost level, so percentage of GDP is a much better metric than simple €/capita numbers. And if you divide heatlhcare spending by GDP, you get for 2017:
Sweden: 10.9%
Norway: 10.4%
Denmark: 10.2%
EU: 9.6%
Iceland: 9.4%
Finland: 9.2%

 

[taimen]

EDIT, previous stats I checked had spending under 10% for Norway, so that seems to be increasing.

 

[taimen]

But anyway, just tried to point out that Storkers ultra positive comments on universal healthcare with reasonable taxes come from an unusually prosperous country with high absolute and above average relative healthcare spending. That equation just isn't possible in more fragile economies, which end up taxing to starvation while still providing sub par healthcare service to taxpayers.

 

[Storker]

You have significantly lower taxes

Only for the last 5-8 years. And the 10 years before that, we had a slightly higher tax level than Finland.

You can't cherry-pick a few years; our petroleum-fueled prosperity started already in the early 70s.

 

[taimen]

Only for the last 5-8 years. And the 10 years before that, we had a slightly higher tax level than Finland.

You can't cherry-pick a few years; our petroleum-fueled prosperity started already in the early 70s.

And that has been very well played by the Norwegians. Taxes are not a bad thing when taxpayers are happy with the service they get. But with your prosperity I am sure you would have great, possibly even better, healthcare with a privately based model.
In Finland the public heatlhcare has not been able to cope with recent economic difficulties (and this is not cherry picking, it is the last 10 years that really are the issue), with constantly increasing costs and degrading services. I do believe that a private model with competition does better than universal public system when money is scarce.

 

[RayfromTX]

The private model doesn't mean competition. Is the US a private model? We spend twice what you do per person and there is no competition. The consumer has no advocate in the private model and no leverage. It's not like you can decide you want to shop pricing online and click on the provider of best value. We don't even have enough providers and the insurance companies are no help. They fight the consumer and do little to force lower prices from the pharmaceutical corps and the other providers. Inefficiency and waste are rampant because there is no way for the consumer to have a say and if they are covered they have little reason to argue cost. Private health care is a racket where sick people are extorted. If you have problems with public healthcare, just try having some health problems in the private system. I have lots of experience with healthcare in the US, almost all of it bad.

 

[Storker]

with your prosperity I am sure you would have great, possibly even better, healthcare with a privately based model.

You are? Despite the fact that every industrialized country with single-payer healthcare gets a lot more healthcare per € or $ or £ than is the case for private insurance-based healthcare?

You're of course free to be sure about something there is no data to support. Me, I prefer to look at the actual stats.

 

[taimen]

The private model doesn't mean competition. Is the US a private model? We spend twice what you do per person and there is no competition. The consumer has no advocate in the private model and no leverage. It's not like you can decide you want to shop pricing online and click on the provider of best value.

Having lived and worked in the US I have some experience in how the US model works from consumer viewpoint and I don't really advocate the US system. It actually seems to be very heavily regulated system with a lot of barriers for new competitors entering the market. And other peculiarities.
On the other hand, standard of care is extremely high.
Some European countries have great examples of private provider healthcare systems, either with universal coverage or with optional private insurances. This seems to work especially well in primary care leading to availability, good service and customer satisfaction.

 

[RayfromTX]

The standard of care is horrible. Almost all of our surgeries we were spit out on the street as soon as the anesthesia was worn off enough to make it to the car in a wheel chair. Then follow up care is left entirely to the patient with a phone number to a medical exchange where someone with no knowledge of you or your case tells you if you should go to the emergency room to address your problem. The decisions are made to maximize profits, not patient care. Let that sink in. All decisions about patient care are made based on profits as decided from the top down. Often your actual provider has their hands tied. It is not an industry that should be profit guided.