Healthcare is the number one voting issue for the 2020

presidential elections.

And we've seen Elizabeth Warren come out recently and propose

something rather European.

A Medicare-for-all programme, which would essentially mimic

a European-style, nationalised healthcare programme in the US.

This may be a step too far for US voters.

But, economically, it makes a lot of sense.

America has the highest healthcare costs

and yet lower outcomes than many European nations,

or even OECD nations, as a whole.

It's clear that we need healthcare reform.

But Americans have always thought about healthcare

in a way that's very individualistic.

I had some personal experience with that when I was travelling

between London and New York a few years back and had my first

child.

I had a slightly higher than average

risk of certain kinds of foetal abnormalities.

In the US, my GYN recommended that I

do lots and lots of expensive tests for a very, very

tiny result of negative externalities.

In the UK, my British midwife told me, hey,

you have a 99.8 per cent chance of having a healthy baby.

I'd play those odds.

This really gets to the heart of the existential difference

in healthcare between Europe and the US.

In Europe, healthcare is a right.

It is a collective responsibility.

And the idea of not providing a basic safety net

would be pretty unthinkable.

In the US, healthcare has always been perceived as a privilege.

So you have some of the highest levels of concierge care.

You have high levels of healthcare innovation.

At the very low end of the spectrum,

you can get universal coverage through Medicaid.

But, in the middle, there are a lot

of people that aren't covered.

And that leads to healthcare being the number one

cause of personal bankruptcy in the US, one of the key

reasons that people cycle in and out of poverty,

and, some believe, a drag on our overall GDP growth.

Look for this to be a key issue in 2020.