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Op-Ed Columnist

Why Nations Fail

Washington, DC

Josh Haner/The New York Times

Thomas L. Friedman

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Imagine if academics sat down with ordinary people like you and me and ironed out some real solutions to our health insurance crisis.

With the election season over, maybe you’ve forgotten about health insurance, but I certainly haven’t. It would be easy to forget that the problem even exists, when our headlines are constantly splashed with the violence in Greece, the authoritarian crackdown in Madagascar and the still-unstable democratic transition in Guatemala. But the health insurance problem is growing, and politicians are more divided than ever. Democrats seem to think that health insurance can just be ignored. Republican politicians like Rand Paul, on the other hand, seem to think that unscientific rhetoric will substitute for a compromise.

But the Republican party of Rand Paul is not the Republican party of Ronald Reagan. Reagan wouldn’t just filibuster, he'd break ranks with members of his own party because he'd understand that the fate of the country, and his own political career, depended on a lasting solution to the problem of health insurance.

It's good to see the talks between the president and congress getting off to a solid start, but we know there will be plenty of partisan fireworks before any deal is cut. If I had fifteen minutes to pitch my idea to politicians, I'd tell them two things about health insurance. First, there's no way around the issue unless we're prepared to spend more: and not just spend more, but spend smarter by investing in the kind of human capital that makes countries succeed. That's going to require some tax increases as well, but as they say, "Ain't nothing to it but to do it."

Second, I'd tell them to look at Denmark, which all but solved its health insurance crisis over the past decade. When I visited Denmark in 2004, Mwambe, the cabbie who drove me from the airport, couldn't stop telling me about how he had to take a fourth job because of the high cost of health insurance. I caught up with Mwambe in Copenhagen last year. Thanks to Denmark's reformed approach toward health insurance, Mwambe has enough money in his pocket to finally be able to afford a smartphone for his kids.

That's all it takes. Don't expect to see any solutions as long as politicians insist on playing a high-stakes game of ping pong with one another. America has to become a first world country again.