One of the things that people who live in countries with universal, taxpayer-funded health care coverage (all of the developed countries in the world except the United States) know, is that anything that increases sickness or death among the general population also increases their taxes. Conversely, as health care expenses go down, so do taxes.
“Can you imagine waking up every morning knowing that if you or your spouse or child was diagnosed that day with cancer or got in a car accident or had some other major injury, it could lead to your being bankrupt, homeless, and a pauper for the rest of your life?”
Danes, for example, know this well.
A decade or so ago, I was doing my radio show from Copenhagen and interviewing various Danish politicians and public figures—most of them calling themselves “conservatives.” There I met Peter Mogensen, an economist by training and chief political editor of Denmark’s second-largest national newspaper, Politiken, who for four years (1997–2000) was the head political adviser to Denmark’s then-prime minister, Poul Nyrup Rasmussen.
A handsome man of young middle years, he also plays in a Bruce Springsteen lookalike rock band and cuts a wide swath through Danish popular society. So it was particularly interesting to see this normally unflappable man with a slightly confused look on his face.
We were in the studios of Danish Radio (their equivalent of BBC or NPR) in downtown Copenhagen, where I was broadcasting for a week in June 2008. I’d just asked him how many Danes experienced financial distress, lost their homes, or even had to declare bankruptcy because of a major illness in the family.
“Why, of course,” he blinked a few times, “none.”
I explained how every year in the United States, large numbers of families lose their jobs and their homes, and most of their most precious possessions are sold to satisfy the demands of creditors because they can’t afford to pay the copays, deductibles, and expenses associated with having cancer, heart disease, auto accident injuries, or other serious conditions.
“Over half of all the bankruptcies in America,” I told him on the air, “are because people can’t afford these expenses, and their insurance companies don’t cover all their expenses or they don’t have health insurance.”
"The Hidden History of American Healthcare: Why Sickness Bankrupts You and Makes Others Insanely Rich" by Thom Hartmann
He shook his head sadly. “Here in Denmark, we could not imagine living like that,” he said.
Danish Radio later sponsored an online Q&A chat with me and their listeners.
“Why aren’t Americans just as happy as I am?” one woman asked, referencing Denmark having been credited for having the “happiest people in the world” that year. I replied, “Can you imagine waking up every morning knowing that if you or your spouse or child was diagnosed that day with cancer or got in a car accident or had some other major injury, it could lead to your being bankrupt, homeless, and a pauper for the rest of your life?”
“Of course not. That’s stupid,” she replied dismissively.
“No,” I said. “That’s the reality for Americans.”
“Impossible!” she said. “There would be a revolution! People in America would not stand for such a thing!”
After several similar, disbelieving callers, a young man called in to say that he’d been an exchange student who spent half a year in the United States and that, in fact, the situation I described was accurate. The Danes were astounded.
A day or two later, I had one of the city officials from Copenhagen on the show and asked about the recent program to convert a large number of the city’s streets into wide bike lanes. He pointed out that the healthier people became because they biked to work every day, the less their health care would cost the city or the nation.
Another politician told me how Denmark had launched a national anti-smoking program, something he observed was common across European countries. The program’s cost, he said, would be recovered in less than two or three years because of the reduced health care costs due to fewer people smoking.
This ties together health care reform with Green New Deal-type reforms that decrease air pollution and the use of the fossil fuels that cause so much of it.
In 2020, testimony before the House Committee on Oversight and Reform, Michael Greenstone of the University of Chicago explained recent improvements in the ability to measure the health impacts of air pollution.
“The economic costs of climate-induced health risks,” Greenstone testified, “are at least an order of magnitude larger than has previously been understood.”
The costs to America—both from air pollution associated with fossil fuels and from the damage being done to our nation by climate change—are so great that they’ll burden our overall economy and also raise our health care expenses on an ongoing basis.
He said that, with emissions at their current rate, the number of people dying from air pollution and climate-related causes (from diseases caused by inhaling air pollution to deaths from
wildfires and extreme weather events) is “almost as large as the current fatality rate from cancers.”
Drew Shindell, distinguished professor of Earth Sciences at Duke University, testified at the same hearing that, following a Green New Deal–like plan, “[o]ver the next fifty years, keeping to the 2°C pathway would prevent roughly 4.5 million premature deaths, about 3.5 million hospitalizations and emergency room visits, and approximately 300 million lost workdays in the United States.”
To put that in context, Representative Robin Kelly responded, “That’s a huge number. That’s nearly three times the number of lives we lose in car accidents every year. It’s twice the number of deaths caused by opioids in the past few years.”
Shindell agreed and added, “The avoided deaths are valued at more than $37 trillion. The avoided health care spending due to reduced hospitalizations and emergency room visits exceeds $37 billion, and the increased labor productivity is valued at more than $75 billion.”
Thus, he said, “[o]n average, this amounts to over $700 billion per year in benefits to the United States from improved health and labor alone, far more than the cost of the energy transition.”
In other words, the costs to America—both from air pollution associated with fossil fuels and from the damage being done to our nation by climate change—are so great that they’ll burden our overall economy and also raise our health care expenses on an ongoing basis.
Right now, Americans don’t see or understand any relationship between carbon pollution and the cost of their health care or their taxes. But if there were a single-payer type of system in the United States, where we all knew what we were spending every year, the costs of fossil fuel pollution would show up as an identifiable number as part of our annual health care expenses.
So would obesity and food deserts; poisonous fly ash and other waste from coal-fired power plants; crises like the water system in Flint, Michigan; and the high rates of disease experienced
by people who live in “sacrifice zones” like the “cancer alley” 200-mile corridor downwind from Texas’s and Louisiana’s refineries.
The experience of other nations with single-payer systems shows that just instituting such a program alone becomes a big motivator for fossil fuel mitigation strategies, from carbon taxes to a Green New Deal.
Reprinted from The Hidden History of American Healthcare: Why Sickness Bankrupts You and Makes Others Insanely Rich, with the permission of Berrett-Koehler Publishers. Copyright © 2021 by Thom Hartmann. Publication date: September 7, 2021.