Putting the Health and Care in Healthcare

Red, white, and blue. The blue represents Americans’ collective mood.

Is it our work-centric culture? Our reticence to discuss mental health? Our collective independence?

Regardless the U.S. stands for Under Stress. But why are we so unhappy — at least compared to our Scandinavian brethren? Denmark and Norway top Forbes’ list of the world’s 10 happiest countries. The two countries pace CNBC’s list as well. By comparison, the stars and stripes check in at #15, lagging behind, umm, Costa Rica.

The U.S. is an economic powerhouse; our personal incomes are steadily increasing too. But we are running, not walking, to the psychiatrist office for our monthly supply of happiness pills.

What gives? And what differentiates ourselves from our smiling Scandinavian peers?

Social support. And this theme manifests itself in our dueling health care systems.

In the United States, our health care model is predicated on profit. Stratifying risk, insurance companies profiteer from an individual person’s sickness(es). The quality of your insurance fluctuates based on age, income, geography. While progressives call for a comprehensive health care system, universal health insurance remains deeply controversial among the public. Detractors disparage universal health care as “socialist” or “European.”

We should be so lucky.

According to The Commonwealth Fund, the United States spends more than its Western peers (including Denmark and Norway) on health insurance. The result: the lowest life expectancy and health outcomes among its Western peers.

But more than our wheezing health numbers, our restrictive health care model has social implications. As Americans, we are casually dropped from one insurance plan to another.  Continuity of care is sacrificed for profit margins. Your long-term physician? He just received the dreaded out of network tag from your unsympathetic insurance company. Even during cancer treatment. Yes, some 2,500 cancer patients — in the throes of treatment — were unceremoniously dropped by their insurance company.

The Scandinavian approach is — dare I say it — more humanistic. And this is best represented in its cohesive structure. In Scandinavia, social support means more than a cheerful insurance receptionist.

Because health care is a fundamental right, Scandinavians are not scurrying from one health care provider to another. In fact, Danes are in touch with their primary care physician an average of nearly seven times per year, according to a 2012 PubMed article. Under this paradigm, Danes enjoy a professional advocate to navigate their health care system.

Furthermore, Danes’ comprehensive care has social implications. Unlike our profit-minded system, there is a social safety net for the mentally or the chronically ill. Every citizen receives health care — regardless of affluence or connections (or lack thereof). With more than 90% of Danes satisfied with their health care, the social safety net is both stabilizing and successful. By comparison, our social safety net is fragmented and inconsistent. While some states may provide unlimited mental health coverage, other states’ mental health services may be barebones — at best.

SOCIALized medicine?

Yes we can. And should.

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