At the DNC riots in November some protesters brought signs claiming, “Health Care is a Human Right.” Senator Sanders and Congresswoman Jayapal proposed the “Medicare for All” (single-payer health care) bill in May of this year with the same slogan. Its support increases with every re-introduction; this time managing 112 co-sponsors.

Classic Liberalism enumerates inalienable rights and tradition has limited these to life, liberty, and the pursuit of happiness. Taken to its logical conclusion, a right to receive health care would mean that the state should force doctors to work. This is already happening in Scandinavia — “Medicare for All’s” North Star. This has led to an absurd state of affairs: Discussions around health care only ever consider patient outcomes and costs. The ability to keep doctors alive and willing, however, is taken for granted.(READ MORE from Hannah Spier: Unveiling Liberal Indoctrination in Therapy Rooms: The Four Toxic Ideas Crippling Mental Health)  

A case in point: This June, a young Norwegian Doctor called Maiken Schultz committed suicide. She was a mother of two who was planning her wedding. This sparked a national social media campaign with the hashtag “doctors must live.” It brought countless stories of doctor’s work conditions and poor mental health out of the woodwork and got national media attention.

What is noteworthy about this suicide was the young age and lack of preexisting mental health disorder. She had even solved the problem of her working conditions by taking a job in one of the few private clinics. Her husband wrote a chilling post on Facebook describing how Maiken felt she was abandoning her colleagues in the public hospital to deal with inhumane workloads. So strong is the pressure Norwegian doctors are under that the guilt of leaving others to drown in work appears to have driven her to suicide, despite having everything to live for. This case is far from an exception; the suicide rate of female Norwegian doctors is double that of Norwegian women in general.

An international study surveying the work life balance and job satisfaction of primary care doctors underscores all of this. The scores of the Swiss and Dutch doctors (both countries with competing payer systems, significant emphasis on private healthcare, and very limited or no public healthcare) soar above those who have in common that they work in universal single-payer health care systems. 

Looking closer at the countries with single-payer health care, young physicians are buckling under the demands of their failing hospitals. In Germany 70 percent of young physicians exhibit symptoms of “Burn-Out.” In Finland that number is 60 percent. The alarm is also sounding in Sweden, Britain, New Zealand, and Australia, countries in the West with universal private healthcare, all begging for change. 

Although young American resident physicians also struggle with their demanding schedules, they have a lower suicide rate than their general population peers. Compare that to the aforementioned countries where young physicians are dropping like flies. 

Medical students everywhere expect long shifts, weekend work, and overtime outside of the legal framework. The hope is, however, to eventually have a pathway for a family friendly work model. Hope is a strong protective factor against depression and Burn-Out, as is being reimbursed instead of coerced. In Switzerland, residents report working 56 hours a week on average with 140 hours overtime per year, and yet no one is talking about a suicide culture among Swiss doctors. (READ MORE: The Paradoxical Decline of Female Happiness in Egalitarian Norway)

Sanders and Jayapal drag the American health care system through the dirt, flagging high infant and maternal mortality rates (both of which become significantly less acute when adjusting for the high obesity and drug-use in the U.S). Cancer survival rates are a better indicator for treatment quality: the U.S. ranks first. Another is “Intensive Care Beds per Capita,” which is linked to lower mortality rates. The U.S can brag of 31 beds per 100.000, again top in the world, whereas Sweden offers a mere 4.8, only just edging out China and India for the bottom spot. 

The recruitment problem and consequent work overload in hospitals occur in all the Single-Payer countries and waiting time is the main reason given for unmet care needs. Who cares about your health care systems’ high ranking if you die waiting? 

Norway’s supposed to have universal health care, yet 3.9 percent of patients are left without a GP, a number that’s steadily growing. There’s no way of accessing hospital treatments without a GP referral, and even with one, the average waiting time in Norway is 75 days. Perhaps Sweden is faring better? They are bussing their patients to Norway for treatment. In Britain (NHS) the average waiting time is 13.6 weeks. More than 18,000 Scots died while waiting for treatment from the NHS. Healthcare is recognized in Britain as a basic right. 

Switzerland has the lowest waiting time in the world, rivaled only by the Netherlands and the U.S. 

Another consequence of staffing shortages was seen when Norway, for the fifth year in a row, paid out over one billion NOK (over 100 million dollars) in damages to malpractice claims. That is 20 times higher per capita than the amount paid out in Switzerland. No wonder private health in Norway is booming; it has seen drastic growth over the last 15 years and is now a billion dollar industry. The newest survey showed that 67 percent of the population is willing to pay for private health care clinics, if they can afford it — creating precisely the class society that terrify social democrats.   

In Norwegian media, budgeting failures or spending cuts are always to blame, giving the impression that throwing good money after bad would improve affairs. The problem is, Norway is already among the world’s top five healthcare spenders. This problem didn’t arise with the latest coalition. The recruitment problem has been worsening for 80 years, regardless of right- or left-wing politicians pulling the levers. The right-wing parties, essentially social democrats as well, also support universal single payer health, but allow for private enterprise.  

Physicians are the only profession requiring a minimum of 10 years of higher education, have limited labor law protection, and are thus forced into sky-high overtime with tremendous responsibility and severe consequences upon failure to perform. Incentive is obviously key. Switzerland and the U.S. can boast high salaries and family friendly jobs in private practice once board-certified. The countries with single-payer health care on the other hand, tempt physicians with idealism. In egalitarian Norway and Sweden, even the social status is of days bygone. Doctors are addressed by first name at the first appointment. If you’re not fulfilled and motivated by the knowledge of doing meaningful work alone, then shame on you. (READ MORE: The Dark Side of Norway’s Social Democracy: The Alarming Rise of Disability Claims and Entitlement Culture)

One young radiologist has spoken out about being made to share with one other doctor the shift schedule meant to be shared by five. She talks about the shame she feels should she admit not managing the load. The threshold for admitting the work is making her sick is so high because the work defines her identity. This is the definition of being an ideologue. Basing recruitment and maintenance of doctors on the continued existence of such ideologues is ensuring the slow death of these universal health care systems and those trapped within them.