Archive, Zoe Hall
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Building Social Capital through Health Care

“How can social capital overcome divisive politics in order to achieve improved public health care?”

By Zoe Hall

Why you should care about Social Capital

     Did you know that every friendship you make is an investment (or in some horrible cases, a liability) for your future? What if I were to tell you that the success of recycling depends upon how much you trust your neighbor? This is all true, really, and it all has economic relevance.

     People seek intangible benefits in our daily lives known as ‘social capital.’ Social capital is defined by its experts as “the notion that networks and the associated norms of reciprocity — that you can do something kind and expect something kind in return — have value.” Essentially, there is a measured value to participation in communities.  Within communities, high amounts of social capital is based on “the ways in which people relate to each other and work together” to establish “shared norms, values and understandings that facilitate cooperation within or among groups.” Contributing to local social capital can be as simple as getting the vaccine for the flu shot knowing that this will contribute to ‘community immunity’ and prevent an outbreak in your neighborhood; likewise on a larger scale, a country with abundant social capital can expect a large voter turnout with its participants well-informed and voting for the good of the country.


What makes a country rich?

     It is fairly obvious that one of the highest indicators of a community’s social capital is its wealth. Impoverished communities struggle with cultivating social wealth; on the other hand affluent communities are in the position to constantly increase their abundance in this capital. Economists have yet to establish a universal equation to determine one’s level of social capital; much like other areas of the social sciences, this is a phenomena that is more qualitative than quantitative. So let’s look at quality of life factors. Countries with large amounts of social capital, like Finland and the Netherlands, can implement public programs like free education, extensive highways, and even universal health care with relative ease, because their constituents have already experienced the benefits of strong social initiatives and can trust in these programs with relative ease. In contrast, countries with low GDPs and essentially nonexistent social engagement, like the Democratic Republic of Congo or Myanmar, cultivate very little social capital and have virtually no public programs. In DR Congo, for example, only half of its population has consistent access to clean water, so how could they expect their government to provide them any form of health care? In a lot of ways, the United States belongs on the list of countries with high amounts of social capital and in a lot of ways we are able to provide for our constituents — numerous job opportunities, the best forms of higher education in the world, and ample opportunities that just aren’t available anywhere else. But in terms of health care, our capabilities don’t always seem very clear.


Impacting Societies

For one thing, Robert Putnam, who many consider the leader of thought on social capital, published a study in 2001 which shows a steady decline in America’s social capital over the last 30 years of the 20th century. Although we remain relatively high on the list of social capital-rich countries, one can’t help but think that our political climate these days makes it impossible to cultivate networks rich with reciprocity between the ideologies of the right and the left. Think about it; when is the last time you had a non-hostile conversation of depth with someone of opposing views to your own? More specifically, how did the conversation go when the topic was health care?

     The idea of universal health care in the United States is not always treated as a public good, but rather often public enemy number one. A recent New York Times’ article revealed a survey which found that one-third of Americans did not know the Affordable Care Act and Obamacare are the same thing. There’s much speculation over who first nicknamed the act, but one thing is for certain: giving it a polarizing tag provided a means for political destruction to a piece of legislation meant to provide healthcare for all. There are a lot of reasons why our one attempt at universal health care policy has failed miserably. On top of the polarizing rhetoric around the legislation, the health care system is a relatively hard thing to understand and most average Americans do not have the time or patience necessary to become fluent in healthcare language. It is also a hard thing to comprehend why insurance premiums keep going up (as seen on page three), and yet still tax dollars are used to provide someone else with a more affordable version of coverage.

     This does not mean that something like the ACA, or at least a public healthcare option, is not viable in the U.S. Actually, in 2015, in the small town of Unionville, Missouri a population of Amish and Mennonites decided to pool their money under the german philosophy “freundschaft“ which is their word for social capital. They would deal directly with the owners of their local hospital to negotiate and set prices to be paid up front from their community. This deal came in handy for both parties, as 90 percent of the hospital’s patients were receiving Medicare or Medicaid, and that couldn’t provide enough revenue to support the hospital’s overhead. Unfortunately this system couldn’t last forever, as hospital expenses amount to more than a rural population (1,820 people) can afford to support. The takeaway from this, however, is that American communities do have the ability to embrace something like public health care and should try to put our social capital to use to tackle this problem. The other takeaway is that American communities cannot do this all on their own.


Engaging in the Future

     A publicly funded healthcare system will only succeed if it is universal. In order to ensure that, we must begin to use our country’s abundance in social capital to see past our small, personal grievances against this policy for what it truly could be — an investment in the health of our generation now and future generations to come. This can only work if it stops being a partisan issue. As Obama’s tenure in the presidency proved, it will be impossible for this country to pass healthcare legislation, or any legislation that is a greater-good investment but maybe not a clear individual rewards system, if it is divided amongst party lines, with two separate networks of Democrats and Republicans. The strength in social capital comes from its ability to create empathy and compassion for those around us. Our countrymen must remain capable of expanding our networks of empathy and compassion to not just include, for example, members of our small, like-minded town of Unionville, Missouri, but to those who are different than us. In order to do this, divisive politics must stop when it comes to health care.

     We seem to be approaching the tipping point of this. During their February recess, members of Congress across the nation have been attending townhalls swamped with constituents concerned for the future of their healthcare. Although these events are overwhelmingly emotional and may seem unproductive, they could provide enough momentum to push elected officials to engage in a dialogue with their counterparts that is more than just heated debates. Hopefully, the time for real resolution has come.



Putnam, RD. (2000). Social Capital: Measurement and Consequences. Cambridge: Kennedy School of Government, Harvard University, 2000. Accessed 9 Feb. 2017.

Norrish, A., Biller-Andorno, N., Ryan, P., & Lee, T. H. (2013, November 20). Building Social Capital as a Strategy to Improve Healthcare Performance. Harvard Business Review.

OECD “The Well-Being of Nations: The Role of Human & Social Capital,” Organization for Economic Cooperation and Development, 2001. (2017, January 18). Retrieved February 14, 2017, from

Poverty & Healthcare. (n.d.). Retrieved February 14, 2017, from

Sable-Smith, B. (2015, December 5). Amish and Mennonite Patients Push An Experiment In Health Care Price Transparency. Retrieved February 15, 2017, from


1 Comment

  1. Pingback: What Labor Unions can Teach us About Social Capital – The Economics Review

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