The Nordic Theory of Everything: In Search of a Better Life

by Anu Partanen

But nine and a half thousand dollars a year sounded like an enormous sum, and there were copays on top of it. This was another of those moments when I felt I really wasn’t cut out for life in America.

Absurd as it might seem, in the United States it is nearly impossible for anyone—consumers and experts alike—to actually find out in advance what a medical test or procedure is going to cost.

With for-profit hospitals loading their bills with “all the usual and customary overcharges,” as Steven Brill put it, what for-profit insurance companies do is first deny every claim they can, and then wait to see whether, and how much, you’re going to fight back. Let’s be frank: This sort of behavior has no place in a modern civilized nation, not when we’re talking about providing citizens with a service as essential as health care.

Not considering costs, however, is causing Americans to get less value for their money, because expensive options are used even when cheaper ones would be just as effective. Some Americans have even started to plead with their doctors to take cost into account when making decisions about treatment, because more and more patients are realizing that they are likely to be the ones stuck with the impossibly high bill.

For individual Americans public health care would bring tremendous improvements in freedom, autonomy, and independence—freedom from employers, freedom from unhealthy dependencies within families, and freedom from countless hours spent arranging health care and figuring out how to pay for it.

If the government were to raise taxes significantly to pay for health-care costs without improving care, people would be up in arms. But if a private insurance company raises its prices dramatically every year, people grumble but mostly can do nothing about it. And in America it happens all the time.

In early 2012 the New York Times investigated a mysterious phenomenon. In U.S. states where citizens were clearly benefiting from government programs, voters supported Republican candidates who, for the most part, promised to reduce government spending. One might conclude that it was the wealthy residents of those states who were opposed to government spending, precisely because they didn’t want to support freeloaders. But in fact it was the very people whose lives were being improved by government spending who were voting to remove it.

From a Nordic point of view, it’s the current American approach that creates relationships of dependency. In Finland the goal is not to subsidize certain people or groups, but to equalize the basic support structure across the broad expanse of society.

After spending some time in America, I could well understand why many Americans hate anything to do with government. The post office is a disaster, the tax code is a mess, Amtrak trains rarely run on time, the roads are full of potholes, and the DMV is a nightmare. As Ronald Reagan famously quipped: “The nine most terrifying words in the English language are: ‘I’m from the government, and I’m here to help.’ ”

The trouble is, many Americans have come to believe there is no middle ground—no role for government services that might be “smart” rather than “big.” Government, in whatever form, has come to be seen as the enemy. In one recent poll a third of Americans even believed that an armed rebellion might be necessary to protect their liberties from government intrusion in the near future.

In 2014 Denmark had the third-highest average tax rate at 38.4 percent, but this was still lower than in Belgium and Germany. Finland came in ninth, at 30.7 percent, and—here’s a shocker—Sweden fell under the OECD average with a rate of 24.4 percent—less than the United States, which came in at 24.8 percent.

The issue here isn’t whether people should be allowed to get rich; of course they should. The issue, rather, is that in America people who have much more security than others are contributing proportionately much less of their income to the maintenance of the basic needs shared by everyone in society.

If you had to boil down the difference between the United States and the Nordic countries to a simple phrase, one way to say it might be: The United States has an unfair tax system and big government, while the Nordic countries have a fair tax system and smart government. Another way to describe the difference is that the United States is stuck in the past and the Nordic countries are already living in the future.

The Nordic countries have their psychiatric patients, alcoholics, drug addicts, and unemployed, but I couldn’t imagine a person in a similar state roaming the streets of Finland’s capital or any other Nordic city. Usually everyone has someplace to stay, if not in public housing, then in a decent shelter. And while you see the occasional person talking to themselves in public, the health-care systems reach more of the mentally ill than in the United States. Encountering the man on the New York subway was one of the moments that made it clear to me early on that in the United States you are really on your own.

It is certainly possible to start poor and end up rich in the United States, but research shows that doing so is much harder there than in other wealthy nations. America is no longer the land of opportunity—northern Europe is. This is the reality that led the British Labour Party leader Ed Miliband to make his surprising statement in 2012: “If you want the American dream, go to Finland.”

The means to restore the vitality of the American dream are well known and available. The OECD recommends three steps to counter the changes that have unsettled the labor market: investing in the workforce by offering easy access to education, health care, and day care; creating better jobs that pay more, especially on the lower rungs of the income ladder; and using a well-designed tax system to temper inequality and increase opportunity.

And yes, those who do very well by it are asked to pay quite a bit more. That’s because the lives of the very rich are already fantastically good, and there’s an acknowledgement that additional wealth beyond a certain point has diminishing returns for personal satisfaction—something that should be obvious, but that is also increasingly supported by research. Walk around the streets of Helsinki or Stockholm for a few days, and you’ll see rich people driving brand-new BMWs, Porsches, even the occasional Ferrari. What you won’t see so much of is rich people who own four or five Ferraris. Frankly, Nordics would rather have health care and good schools.

Nordic people know is that time off buys you a better quality of life than more cash. Those four or five glorious weeks of paid summer vacations that people in the Nordic countries enjoy really just mean that the employer is spreading eleven months of pay over twelve.

The reason for setting up such requirements is simple, and Massachusetts senator Elizabeth Warren put it eloquently: “There is nobody in this country who got rich on his own. Nobody. You built a factory out there, good for you. But, I want to be clear: you moved your goods to market on the roads the rest of us paid for. You hired workers the rest of us paid to educate. You were safe in your factory because of police forces and fire forces that the rest of us paid for. You didn’t have to worry that marauding bands would come and seize everything at your factory and hire someone to protect against this because of the work the rest of us did. Now look, you built a factory and it turned into something terrific or a great idea. God bless. Keep a big hunk of it. But part of the underlying social contract is you take a hunk of that and pay forward for the next kid who comes along.”

Americans toil away on an endless treadmill, virtually as servants of their employers, told that this is the only way to stay competitive. Yet their Nordic counterparts have the freedom to succeed professionally, contributing to the competitive advantage of their employers and their nation, while also enjoying life outside work.

But here’s the thing: What makes Nordic people uncomfortable is when “uniqueness” or “being special” includes the suggestion that certain people are more valuable than others.

Go to Italy or Spain, and the locals can’t stop telling you how great their own food, weather, scenery, or people are. Go to France, and you’ll hear all about its cuisine, history, and literary heritage. Come to America, and it’ll be made clear to you that the United States is the best country in the world. Go to Finland, and you’ll be asked why you bothered to come.

How have Finns managed to build such a great society, despite all their negativity? Perhaps the answer is that Finns have built a great society because of their pessimism, not in spite of it.

“Having a situation like we have in Sweden where you can be relaxed, things work well, it’s not wrought with class issues, you’re not paying lots of money and isolating yourself with your little group, and you don’t have to insert your children into this highly competitive system so early—once you have children, those things do matter. And there is a financial side to it as well. My friends who are academics in New York City are complaining about it. Even academics with fairly cushy salaries. They pay so much of their money for these things, and then they have to start saving for college too. So there is sort of a way in which you become really imprisoned.”