DANISH HEALTHCARE

Denmark has an admirable public health system. Pretty much everything is free (even dentistry is subsidised), and you have the right to have an operation in the private sector, at the state's expense, if the state can't deal with you within one month. That's probably about as good a deal as you can get in this world.

Yet the inexorable demographic trends of longer life, fewer babies and consequential increased dependency ratios affect this small, northern European country just like anywhere else. And that in turn has led to the beginnings, faint though noticeable because of their novelty, of a debate about priorities. Is it really such a good idea to carry out so many fat removal operations, for instance, particularly on young people, shouldn't they simply be told to cut out the sugar? Is it really such a good idea to provide respirators + care at home, when it would be much, much cheaper to look after such people in care homes? And so on and so forth.

In my view, the debate about the quality of old age is going to be one of the biggest, if not the biggest, issue in western politics during the next twenty years. Living to 90 is fine, if your physical and mental faculties are OK, you have a modest amount of money to pay your bills, and you have some form of social network. If these things are not around, then living to 90 is probably pretty miserable. What the Danish debate about healthcare (and its sister debate about old people's homes, also mainly stated funded) ultimately shows is that a large part of the current infrastructure needed to support old people may not be there in the future. Forging a consensus about what should or should not be part of the state-provided package will be the great challenge for politicians, mindful of the fact that pensioners are the most assiduous voter group of all.

Walter Blotscher