Craig Klugman, Ph.D.
This past month I was fortunate to spend several weeks touring northern Europe with my family. These are the lands of the midnight sun, where smoked salmon is more popular than hamburgers, and where a summer temperature of 75 is unseasonably warm. Besides meeting some wonderful people, absorbing fascinating history, and viewing beautiful scenery, I was amazed that most people I met wanted to talk about their health care system. In Denmark, Finland, Sweden, and Poland tour guides would regale us with tales of battles and churches, and talk about how much they loved their state-run health care system. Even sitting in a restaurant or on a boat when striking up a conversation with a stranger, invariably among the many wonderful things they had to say about their country, the topic of universal health care would arise.
What they perceive as making their health care system great was multifold. They would extoll the excellent quality of care, the empathy and respect they received from health care providers, and the low cost. Most mentioned having to make a modest co-payment for services, but would go on to say that they would always receive the care that they needed.
When I asked about people going into debt and losing all of their savings to pay for medical treatment, my hosts were aghast—such a thing is inconceivable in their systems. I asked about the waiting lists that those in the U.S. hear horror stories about. They expressed no problem with waiting a few weeks for a test or for a non-emergent surgery. In fact, when we compared how long it took to get an appointment at a general practitioners office, my wait times in the U.S. are often longer. And given that my insurance restricts which physicians I can see, freedom to choose your doctor is a not difference either.
Look at Sweden as an example. The system is taxpayer funded and available to anyone who lives or works in the country. Average life expectancy is 78.8 years for males/83.5 female compared to the U.S.’s 75.9 male/80.9 female. The system also provides excellent care for chronic disease; something U.S. medicine has not been very successful at. Annually, Sweden spends $3760 per capita (9% of GDP) on health care compared to the U.S.’s cost of $8233 (18% of GDP). Lower cost, better health outcomes. What’s not to like?
I had dinner with a relative in Scandinavia who moved there 3 years ago as a result of her chronic disease. She had married her college sweetheart who happened to be a citizen of the European Union. With her frequent hospitalizations and high medical bills, she lost not only her job (too many sick days, too much pressure on the cost of premiums paid by her employer) but also sold her house to pay for her medical bills. She also maxed out the lifetime coverage of her health insurance policy. Moving across the Pond did mean living with her in-laws (to save up enough to have an opportunity to start over). She also received her healthcare (with co-pays of $15-$30), a drug benefit, paid hospitalizations, and an assigned health care professional who helped manage her chronic illness. As a permanent resident, the government also provided her with a subsidy when she was no longer able to hold down a job. In the U.S., she believes, she would have had no alternative but to find a quiet place to go die and have declared bankruptcy more than once. With a Scandinavian health care system, she was not only alive, but was smiling and laughing at an amusement park with us.
Seeing all of the benefits of these systems, I was surprised when in a rare opportunity to catch up on the news back home, I learned that certain provisions of the Affordable Care Act were being postponed a year. Apparently it is not in our national interests to have insurance coverage for all citizens or residents or to make health care a priority. While no health care system is perfect, these other models seem to exist to help makes lives better, whereas the U.S. lacks a system at all.
I can’t imagine an American talking about the great health care that we provide our citizens when speaking with a visitor from another country. Some people argue that the Swedish model is expensive and not sustainable, others that it can only work in a small country but nowhere as large as the U.S. (most of these arguments are found on politically conservative websites). The pride that my hosts took in speaking about their health care was evident. What a nation values and where it places priority-whether that be happiness (Denmark), health, or profit—is manifested in the type of health care system that exists. The U.S. could learn much from these other models and I hope that someday I can speak to a foreign visitor about my pride in our great health care system. It’s good to have a dream.