By Charalampos Karouzos,
I recently happened to stand upon an article by the New York Times which struck me by highlighting one ironic but troubling trend; in a highly developed, in theory-rich society, young people are willingly taking health risks to protect their financial futures at the start of their professioanl careers. It seems counterintuitive, yet it’s happening. The NYT piece “Why Young Americans Dread Turning 26: Health-Insurance Chaos” explores how young adults in the United States, upon losing coverage through their parents’ plans, suddenly find themselves exposed to the full financial weight of the private healthcare system. The result is a widespread tendency to delay or avoid medical care altogether, not because health is unimportant, but because premiums, deductibles, and co-pays threaten to derail early career and financial stability. In one of the wealthiest countries on earth, people are gambling with their health so they can afford to chase their ambitions. My European mind can comprehend that policy.
Surprisingly in our ever more interconnected world, this problem is uniquely American. If such a scenario unfolded in Europe, where most countries operate under public or heavily regulated healthcare systems, it would be almost unimaginable. In the European context, there is no cliff at age 26, no sudden cutoff where someone must choose between a doctor’s visit and their rent. Universal or near-universal access to care is the norm, and it reflects a collective decision that health should not be contingent on employment, age, or income.
The benefits of such, humans-first, systems are profound. Universal access ensures that individuals do not postpone preventive care or necessary treatments because of costs, and do not need to gamble their health using as a leverage their youth. A young professional in Paris or Vienna can focus on building their future without fearing that a sudden illness or an injury will bankrupt them. This not only improves individual lives but contributes to a more stable and resilient society. Economically, public systems can also pool risks, negotiate prices more effectively, and cut down on administrative costs that often plague private insurance models. By removing the profit-driven middlemen, called for-profit insurnace companies, countries can ensure that more money is spent on actual care rather than bureaucracy; which at a theoretical level translates to both healthier citizens and a healthier economy.
Hard data speak loudly for themselves. In countries like Austria and France, coverage rates are essentially universal, reaching 99 percent of the population, in Germany, the figure is about 92 percent. Even in the Netherlands, where private insurance plays a large role, mandatory insurance combined with subsidies ensures nearly complete inclusion. Compare that with the global powerhouse called the United States, where millions remain uninsured and medical debt is the leading cause of personal bankruptcy, even after the actions Obama took during his term. It is not simply a question of fairness, which can’t be held into conversation; but of efficiency, as public systems consistently achieve better health outcomes at lower costs per capita.
The models of public healthcare by themselves vary. Some countries use the Beveridge model, such as the United Kingdom, Italy, Greece, and Denmark, where healthcare is funded through taxation and services are free at the point of use. Others follow the Bismarck model, as in Germany, where employers and employees contribute to nonprofit funds that guarantee universal coverage. Both models, although different, succeed in making healthcare a public good rather than a private commodity, a stark contrast to the private healthcare approach. While critics in Europe sometimes complain about wait times or underfunding, the principle that access to healthcare is a fundomental right remains intact. Even where supplemental private insurance exists, as in Germany or Belgium, it is an add-on to a solid universal foundation, not a substitute for it.
In the U.S., by contrast, healthcare is too often treated as a privilege tied to employment, which as a general idea it’s reasonable. This system however often produces bizarre outcomes, such as the 26-year-old facing a loss of coverage, or patients with chronic illnesses forced into financial ruin simply to afford treatment. These are failures not of medicine but of public policy. The U.S.A. spends far more on healthcare per capita than any European nation, yet its life expectancy lags behind, and access to preventive care remains uneven. By framing healthcare as a consumer good, society risks undermining the very notion of health as a shared right.
The broader implications of these policies are significant. Public systems strengthen social cohesion and trust, and when people know that their health needs will be met regardless of their financial situation, they are more likely to contribute positively to society. In the United Kingdom, despite well-publicized struggles, the National Health Service remains one of the most trusted institutions, precisely because it represents a shared commitment to the wellbeing of all. In Italy or Denmark, where taxation supports national healthcare systems, the same principle applies; collective responsibility fosters collective resilience.
None of this is to claim that public systems are perfect, indeed they are not. They face challenges of underfunding, political interference, and rising demand from aging populations. But the core principle of health equity, remains one of the great achievements of modern democratic societies. Even when debates arise, they focus on how to strengthen these systems, not dismantle them. Citizens understand that their health is more secure in a public framework, even with its imperfections, than in a market-driven system where coverage is conditional and precarious.
Returning to that young American who hesitates to see a doctor for fear of financial collapse, the contrast could not be clearer. In Europe, health is not viewed as a trade-off against financial success, but as a prerequisite for it. A healthy population is a productive population, one that drives innovation, sustains families, and contributes to the economy in lasting ways. To risk that for short-term financial policies is to erode the very foundation of society.
The lesson, then, is not limited to one nation’s policies. It is a reminder we should structure society and in this case healthcare to reflect our values. Choosing to make health contingent on wealth, we create societies where inequality deepens and opportunities shrink. If we choose universality, we affirm that health is both a right and a shared investment in our collective future and despite their flaws, they remain one of the most powerful tools for fairness, resilience, and human dignity.
References
- Why Young Americans Dread Turning 26: Health-Insurance Chaos. The New York Times. Available here
- Parents’ Health Insurance and the Age 26 Cutoff. Statesman. Available here
- Why Young Americans Dread Turning 26: Health Insurance Chaos. Health Leaders Media. Available here
- Healthcare Systems in the EU: Coverage and Models. European Parliament. Available here
- Public and Private Healthcare System in Terms of both Quality and Cost: A Review. ResearchGate. Available here
- International Comparison of Health Systems. KFF. Available here
- European Expat Healthcare: Public vs Private. BrightTax. Available here
- The Future of the NHS. Financial Times. Available here
