“Medicare For All” will never work: a Brazilian view

Even though I don’t follow the news, it’s somewhat impossible not to know that Bernie Sanders is making a lot of buzz as the possible Democrat candidate for the coming presidential elections. I know: he presents himself as a democratic socialist; he says that some European countries are good examples for the US. I believe that as a Brazilian I have something to say about that.

Bernie Sanders often compares the US with countries like Denmark or Sweeden. I believe there is a fundamental problem with that: the US is a gigantic country with a gigantic population. And a very diverse population at that! Nordic countries are tiny, with a tiny and homogenous population. How about comparing the US and Brazil? The two countries have about the same size and the population is not too different. Besides, Brazil is as culturally diverse as the US. Maybe more!

So here are some things about Brazil that I think people should know. Brazil is by definition a social democracy. That is not written anywhere, but one has only to read our constitution to be aware of that. Brazil’s constitution is very young: it was promulgated in 1988. As so, it reflects more recent political ideas. For example, it basically puts healthcare as a human right that the government has to provide for the population. So, Brazil has (in theory) a free universal healthcare system.

How is healthcare in Brazil in reality? Horrible. Inhumane. Media news are basically the same every week: long waiting lines for the most basic treatments. People dying without care. Few doctors. Overprice. Medication and equipment rooting without use. I don’t think that people in Brazil are different from people in the US. We have the same chromosomes. The difference is in how we deal with the issue. Brazil decided that healthcare is a right and that it should be provided by the government. The result is that we don’t have healthcare.

I believe I know why things are the way they are in Brazil: healthcare is a need. No doubt about that! But there is something really bad when a need is turned into a right. A right means that you have to get it, no matter what. But, really? No matter what? Second, there is something very deceiving when one talks about “free” healthcare. Really? Free?! Doctors have to get paid. Medicine costs money. One can’t possibly be serious when they say “free healthcare”. Finally, I suspect that the Austrian School of economics has something very important to say about the government running the healthcare system. More than anyone else, Friedrich Hayek pointed to how free prices are important for the economy. In a truly free economy, supply and demand interact with prices: high prices mean low supply; low prices mean high supply. This simple mechanism functions as a compass for everyone. However, when the government interferes, the result is inefficiency.  Too much medicine is bought and just rots. Or too little, and people die.

I’m not sure how many Bernie supporters read Notes on Liberty. But I really wish some of them would check what happens in Brazil. We tried to have a free universal healthcare system. We tried to have free college. We tried all these things. It didn’t work. I believe that the Austrian School can explain why. I know, it’s a bummer. There is nothing nice about people dying for lack of treatment. However, if you agree with me that this is a problem, I believe I’m in the right position to say that socialism – democratic or not – is not the solution.

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