Port: What if universal, government-backed health care doesn't actually make poor people healthier?

Ambulance isolated on white
Ambulance isolated on white

MINOT, N.D. — Every single Democratic candidate for president in 2020 backs expanding access to health care through some form of a government program.

Per the Washington Post , some of the candidates want everyone in the Medicare program. Others want a sort of public option for health coverage.

The basis of these policy positions is the assumption that expanded health insurance coverage will make Americans, and particularly Americans at the lower ends of the income spectrum, healthier.

Is this true?

A new study, conducted by a team of researchers from institutions across Europe and the U.S. looking at the lifespans of more than 25,000 Americans and U.K. citizens, suggests it may not be.


CNN reports on this study , and their headline focuses on the differences in life expectancy found between the poorer and richer participants: " Rich people are staying healthy for almost a decade longer than poor people"

But what about the differences between people living in America versus people living in the United Kingdom? After all, the health care systems in these places are dramatically different.

America has mostly private insurance and health care system (though most Americans get their insurance through a third party, like an employer or a government program, which is problematic in its own right but also a topic for another column).

The U.K. has a nationalized health care system . The sort of model Democrats would like to emulate here in the U.S.

If Democrats are right, that expanded government-backed coverage can help poorer Americans get access to health care and thus live longer and healthier lives, we should see a difference between the life expectancies of Americans and U.K. citizens in this study, right?

We don't.

"There was no significant difference between the two countries in relation to the study's key findings," CNN reports in a paragraph buried near the end of their article (class war makes for better headlines, I guess).

"Inequalities in healthy life expectancy exist in both countries and are of similar magnitude," the researchers wrote in their conclusion.


Most reading CNN's headline will probably assume that rich people are living longer because they can afford to access health care that poorer people cannot. But in the United Kingdom, all citizens have the same government-backed access to health care, but that access doesn't seem to move the needle when it comes to life expectancy.

The access to health care wealth can buy is still a factor. Medical tourism , people traveling to find the health care they cannot access in their home countries, is a very real phenomenon, though not likely something to be practiced by the lower strata of the economic scale.

Yet that aside, maybe the differences have less to do with government policy than they do with individual lifestyle choices.

Another, less pejorative term for a rich person is a successful person.

Successful people tend to find success by making responsible lifestyle choices. Including, one would presume, the choice to live a healthier life.

Many assume that rich people are healthier because they're rich and can afford more health care.

But what if they're rich and healthier because they just make better choices?

In our political debates, we spend a lot of time talking about why certain people get certain outcomes, be they economic or in education or in terms of our health. We try to tie those outcomes to specific policy positions, and sometimes that's appropriate. The tax code, for instance, can absolutely influence our economic wellbeing.


What we often forget is the influence individual decision-making has on our lives.

Problem is, talking about that sort of thing isn't good politics. Voters don't typically like to hear that many of the problems in their lives are a product of the choices they've made.

A much more palatable political message is one that blames other people for your problems and offers fixes that include sticking it to those baddies.

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Rob Port, founder of, a North Dakota political blog, is a Forum Communications commentator. Listen to his Plain Talk Podcast and follow him on Twitter at @RobPort.

Opinion by Rob Port
Rob Port is a news reporter, columnist, and podcast host for the Forum News Service. He has an extensive background in investigations and public records. He has covered political events in North Dakota and the upper Midwest for two decades. Reach him at Click here to subscribe to his Plain Talk podcast.
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