By Avik Roy
Forbes, January 27, 2015
Many American conservatives oppose universal health insurance because they see it as fundamentally antithetical to a free society. “If we persevere in our quixotic quest for a fetishized medical equality we will sacrifice personal freedom as its price,” wrote a guest editorialist in the ]Wall Street Journal in 2009. But according to the Heritage Foundation, a leading conservative think tank, ten nations freer than the United States have achieved universal health coverage. It turns out that the right kind of health reform could cover more Americans while increasing economic freedom.
Today, Heritage published its 2015 Index of Economic Freedom, an annual look at economic liberty around the world. The United States stayed put at #12, just below Ireland, Mauritius, and Denmark.
What’s striking about the list is that of the eleven countries ahead of the U.S. in economic freedom, ten have achieved universal coverage. Many Americans on both the right on the left subscribe to the myth that the U.S. has a free-market health care system. It doesn’t. U.S. government entities spend more per-capita on health care than all but two other countries in the world.
The Swiss and Singaporean models
The two advanced economies with the most economically free health care systems—Switzerland and Singapore—have achieved universal health insurance while spending a fraction of what the U.S. spends. Switzerland’s public spending on health care is about half of America’s, and Singapore’s is about a fifth of ours. If we had either of those systems, we wouldn’t have a federal budget deficit.
Tellingly, on the Heritage Index of Economic Freedom, both Switzerland (#5) and Singapore (#2) rank far higher than the U.S. on overall economic freedom. Both countries serve as models for my health reform plan, Transcending Obamacare, which would adapt features of the Swiss and Singaporean health care systems to liberate U.S. health care from onerous regulations and wasteful spending. We’ve modeled the plan as reducing federal spending by $10.5 trillion over 30 years, while increasing the number of people with health insurance by 12 million.