Former Senator Jim DeMint, the new president of the conservative Heritage Foundation, has decried Obamacare as “a cancer” that is “is fundamentally inconsistent with liberty.” During the Senate Obamacare fight, DeMint famously declared “If we’re able to stop Obama on this, it will be his Waterloo. It will break him.”
But a new report from DeMint’s own organization suggests that, far from being incompatible with freedom, countries with health care systems with as much or significantly more government control over healthcare are the freest countries in the world.
The report in question is Heritage’s Economic Freedom Index, released annually since 1997. The report defines the concept of “economic freedom” in misleading right-wing terms, but even by those standards, it appears that universal health care systems far more expansive than Obamacare aren’t “fundamentally inconsistent with liberty.” In fact, the ten “freest” economies in 2013 by Heritage’s lights range from mandating individuals save a certain amount of money for health care to almost the entire health care system, including hospitals, being owned and operated by the government:
1. Hong Kong: The semi-autonomous city inside China has a universal, publicly run health care system: about 80 percent of Hong Kong hospitals are government owned and operated. While private supplemental insurance is available, it’s more expensive than public services.
2. Singapore: Singapore is often cited as a free-market health care system that works. But one of the centerpieces of the Singaporean model, as conservative David Frum notes, is a government mandate requiring citizens to place a certain percentage of their income in “medical savings accounts” to ensure they can pay for routine health care costs out of pocket (when their income is inadequate to pay, the government pays direct subsidies a la Obamacare’s Medicaid expansion). Hardly seems consistent with DeMint’s point that health care mandates are “slippery slopes” towards the death of freedom.
3. Australia: Australia has a single-payer system in which, like Canada, doctors are privately employed but all Australians are eligible for insurance coverage through a government-run provider called Medicare.
4. New Zealand: The Kiwi government has made most services free or nearly free to all residents; the government covers roughly 80 percent of national health care expenditures and directly owns and operates about half of all health care services in the country.
5. Switzerland: This Swiss system is closer to the American health plan post-Obamacare than most other national systems; Switzerland has both privately owned health care and privately-provided insurance together with an individual mandate to purchase health insurance. Interestingly, Swiss insurers are legally prohibited from profiting on the basic, mandatory insurance package.
6. Canada: Our northern neighbor is, of course, the most famous example of a single payer system in the United States.
7. Chile: Like Singapore, Chile mandates that individuals pay into health savings accounts to cover health care costs and supplements the accounts of poor Chileans. It also has both publicly and privately run health care services.
8. Mauritius: A tiny island nation in the Indian ocean, Mauritius has government-run health services that cover roughly 70 percent of the country’s health expenditures, with private supplemental practices making up the remainder. All government health services are provided free of charge to Mauritian citizens, which has helped the country improve quality of life for its citizens markedly in the past two decades.
9. Denmark: As in Mauritius or the United Kingdom, the Danish government owns and operates the vast majority of the health care system.
Number 10 on the list is, of course, the United States, which will finally join the rest of the top ten “most economically free nations” in providing universal or near-universal health care when Obamacare is fully implemented.