I’ve spent a lot of time in the US and North America, and I’ve had loads of political discussions with smart, well-educated Americans, who, when discussing what is known as «the Nordic model», have dismissed it as an option for the US under the guise that the reason it works in the Nordics is because of its size, and an underlying fear of what they have been taught about what they think is socialism, by media and political leadership through generations.

Social democracies are often mistaken in America for socialism, Marxism, and communism. This uninformed fear has been a scare tactic sold by US politicians for decades. To quote one of my heroes, the English comedian Jimmy Carr, when asked by a heckler to “define communism”:

“From each according to their abilities, to each according to their needs.”

*> Yeah — it just doesn’t scale. Everyone is a communist. All of you are communists with your families. If you’ve got kids, you’re a f****ing communist at home. Each according to their needs. You take care of them. Of course you do. And as things get wider, in your local community, you might be a socialist — try and help everyone out. And then you get up to the nation-state level, and you go, ‘yeah, f*** those guys.’

— Jimmy Carr

Social democracy, for those who didn’t know, is actually capitalism, but with guardrails. And like in the US, production stays in private hands, the market sets the prices. And like any other capitalist country, companies compete, make profits, and of course, fail.

When we look at child mortality rates, we see that the US have nearly 7 infant deaths per 1000 live births, roughly twice as many as the Nordics. If we matched the numbers from the Nordic countries, a Nordic-style system in the US would save over 7,300 lives. That’s a 9/11 of dead infants every year, by policy choice.

Since we are talking about health, let’s just have a look at some numbers on healthcare in general. In 2024, the US Health expenditure reached almost $13,500 per person. The EU spent roughly half as much and delivers better outcomes. US life expectancy is 79 years, well below the OECD average of 81 and lower than most Western countries. And one would think that, because America pays twice as much for healthcare as other Western countries, it gets more. But the sad fact is that they don’t; they pay more because the system is designed to extract.

There is also a unique American medical disease, it’s called Medical bankruptcy. The majority of all US insolvencies resulted from medical costs. That adds up to more than half a million Americans. In comparison, France has none. Medical bankruptcy is a category that essentially does not exist in the Nordics or any social democracies. It’s a structural feature of the US economy.

The difference in Nordic social democracies is that the state taxes the resulting wealth progressively and uses that revenue to guarantee universal public goods such as healthcare, education, pensions, parental leave and unemployment insurance.

They empower labour through strong unions and collective bargaining, and they regulate markets to prevent the worst externalities.

I want to dismantle this argument once and for all, and I would like to help those of you who fear social democracy to understand that the reason it won’t work in the US isn’t that it doesn’t scale.

First, the “you’re small, that’s why it works” argument is intellectually lazy. You already have 50 «small countries» through the 50-state experiment you call the United States.

The state of Wyoming has roughly 580,000 people. Vermont around 650,000. North Dakota has approximately 780,000. Several U.S. states have roughly the population of Iceland. About a dozen have populations comparable to Norway, Denmark, or Finland. If “small” were the explanation, the smallest states should outperform Norway on health, education, and crime. They don’t. Mississippi and West Virginia have populations close to Norway’s and produce some of the worst outcomes in the developed world, in terms of infant mortality, life expectancy, and incarceration. Massachusetts, the state with the lowest incarceration rate in the nation, would still rank 17th in the world, higher than Iran, Colombia, and all founding NATO nations. So stop using scale as the variable when policy is.

Another argument I’ve heard often is that the Nordics are homogeneous. Which is empirically dead wrong, both Norway and Sweden have proportionally larger foreign-born populations than the US. The diversity argument has been factually inverted for at least a decade.

Let’s look at scale for a moment. What do companies do before advocating widespread adoption of a new product or a service? In medicine, they conduct smaller clinical trials; in consumer products, they choose smaller trial markets comparable to their own. Actually, it’s common practice in the US that state and local governments experiment with policy ideas before they are adopted by the federal government.

This is, in effect, what has happened with social democratic capitalism over the past several decades. The Nordic countries have been chief practitioners and have served as trial subjects.

The Nordic nations’ coupling of democracy, capitalism, and education together with expansive public insurance, employment-friendly public services, and moderate product and labour market regulations has produced a better standard of living for their least well-off members, greater economic security, and very likely more equality of opportunity than in other rich democratic nations. And the Nordics have gotten these results without sacrificing economic growth, freedom, community, or any of a large number of other outcomes we want in a good society.

You don’t need one huge centralised welfare state of 330 million people. Germany (84 million), the UK (67 million), and France (68 million) all provide universal healthcare on a scale far larger than that of any Nordic country. Germany alone is bigger than all five Nordic countries combined and has had universal healthcare since Bismarck in 1883. The US is the only wealthy democracy without it. Again, it isn’t a scale problem. It’s a choice.

“It’s the same price, better distributed, with better outcomes.”

The last argument I hear is that Nordic taxes are just too high. They are high. The Nordic model isn’t funded by soaking billionaires; it’s funded by a 25% VAT and income tax that hits modest salaries. But here’s an under-acknowledged fact for you: you already pay Nordic-level amounts for welfare provision. You just pay it to insurers, landlords, universities, and care homes instead of to the Treasury. The Nordic model isn’t more expensive. It’s the same price, better distributed, with better outcomes.

We’ve now established that the US isn’t failing at this because of its size, either geographically or population-wise. So why does it fail? The answer is simpler than ideology, culture, or medical knowledge. For two generations, the US has made the political choice to prioritise private extraction over public outcomes. Treating citizens in need of healthcare as customers, not patients. That’s the whole difference.

So, let’s get back to Greenland, an ice sheet the size of Mexico, inhabited by 57,000 people. They have universal healthcare, which is publicly funded, no insurance needed. Each district has its own small hospital, and there are health clinics in every village, which are spread across the most logistically punishing geography on the planet. The US can’t manage it in Manhattan. If “scale” were the problem, Greenland should be impossible. It isn’t. It just requires the political choice to do it.

Sources

  • Trump’s TruthSocial post, 9 April 2026 — reported by Al Jazeera.
  • US infant mortality: CDC, National Vital Statistics Reports, June 2025.
  • Nordic infant mortality rates: Nordic Perinatal Statistics 2022, THL; OECD Health at a Glance 2025.
  • US life expectancy and health spending: CDC; Centers for Medicare & Medicaid Services, National Health Expenditure Accounts 2023.
  • Medical debt: Kaiser Family Foundation, The Burden of Medical Debt in the United States, 2022.
  • Foreign-born population shares: OECD International Migration Outlook 2024.
  • Nordic model analysis: Mogstad, Salvanes & Torsvik, Income Equality in the Nordic Countries, Becker Friedman Institute, University of Chicago, 2025.
  • US incarceration rankings: Widra, E. States of Incarceration: The Global Context 2024. Prison Policy Initiative, June 2024. prisonpolicy.org/global/2024.html