Why does the U.S. not have universal health insurance, unlike almost all other rich democracies?

The fact that the United States does not have a universal health insurance system is undoubtedly bad for its citizens.  Despite being the most advanced nation in the world economy-wise, the United States holds the notorious distinction of having a highly-under-functioning health-care system. This fact is proven by the high rates of negative outcomes for patients as well as the percentage of the population that could not afford to purchase insurance plans.

Several public opinion polls have indicated that the general public is overwhelmingly in support of a nationalized health-care system, meaning that healthcare should come under the domain of the government, away from private corporations.  But, in spite of this unanimous support for a universal healthcare system (that includes universal insurance), the issue never crops up during presidential debates.  The limitations of the two-party democratic system are also being exposed as a result.  Both the Democratic Party and the Republican Party are funded by private corporations during election campaigns, the health-insurance lobby being one of the major contributors to campaign funds.  Given such a setup, it is only natural that the public opinion is suppressed or ignored in favor of the vested private interests.  Some intellectuals argue that the United States lags behind other industrialized nations in its health-care system, due to its Capitalist economy, which puts corporate profits ahead of public interest.

The Scandinavian countries of Sweden, Norway and Denmark are recognized to have the best universal healthcare systems in place.  Although the GDP and per capita incomes of these nations are relatively small, the “socialist” basis of their political systems has ensured this favorable condition.  Also, in these countries the mainstream media is not heavily concentrated in the hands of a few giant corporations, which is the case in America.  This makes it easy for the real public opinion to be openly discussed and debated.  More importantly, it is in the democratic tradition of these nations to include public sentiments and opinions in the debates leading up to elections.  But unfortunately, such open expression of public sentiment is not possible in the American mainstream media, which is again in the hands of private capitalists.

Some cultural factors are at play too.  The most successful public support system in the history of the United States is Social Security, introduced by President Franklin Roosevelt.  It is successful only because it is run by the government and is based on the principles of empathy for disadvantaged compatriots.  But any privately run system cannot instill and run on this altruistic spirit, which was the key to the success of Social Security.  In American mainstream culture, “individuality” is portrayed as superior to “collectivism”.  But, the most successful healthcare systems in the world are based on the latter concept, including the much criticized China.  It is interesting to note that China has had a commendable healthcare record for much of the twentieth century; and this was made possible due to the “collectivist” culture adopted by its people.  So, here is a lesson or two for American policy makers to raise the standards of the existing and much maligned healthcare system.