Nordic Welfare State being cut down to size

This according to this official Swedish website:
http://sweden.se/society/healthcare-in-sweden/

Waiting times for preplanned care, such as cataract or hip-replacement surgery, have long been a cause of dissatisfaction. As a result, Sweden introduced a health care guarantee in 2005.

This means no patient should have to wait more than seven days for an appointment at a community health care center, 90 days for an appointment with a specialist and 90 days for an operation or treatment, once it has been determined what care is needed. If the waiting time is exceeded, patients are offered care elsewhere; the cost, including any travel costs, is then paid by their county council.

Statistics from December 2010 indicate that about nine out of ten patients see a specialist within 90 days and receive treatment or are operated on within a further 90 days [a total wait of 6 months]. Roughly 80 per cent today feel they receive the care they need. In 2006, the figure was 74 per cent.

Also emergencies are seen immediately and urgent care cases are given an appointment date in under a week.
From Wikipedia:

Waiting times

Urgent cases are always prioritized and emergency cases are treated immediately. In urgent cases, the national guarantee of care states that a patient should be able to get an appointment with a primary care physician within 3 days of contacting the clinic.


Sweden also has private medical insurance a person can buy themselves and use just like we do in the US.

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Originally Posted by Alan

In all sincerity, those metrics mean nothing to a person who dies while waiting.

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Your personal experience also does nothing for the 49 million uninsured plus all the underinsured in the U.S., unless their suffering is not important to you. Except for possibly some ER care, their wait times are basically forever.

I'd be happy with the Swedish wait times Spartana posted, if it meant affordable coverage for all.

From an article in the New England Journal of Medicine -

"It is hard to ignore that in 2006, the United States was number 1 in terms of health care spending per capita but ranked 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy.3 These facts have fueled a question now being discussed in academic circles, as well as by government and the public: Why do we spend so much to get so little?"

http://www.nejm.org/doi/full/10.1056/NEJMp0910064F

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Originally Posted by try2bfrugal

Your personal experience also does nothing for the 49 million uninsured plus all the underinsured in the U.S., unless their suffering is not important to you.

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All suffering is important to me, but survival ranks up there pretty high too. I'm glad we had a free market system which enabled me to do so. Those strangely familiar wait times Spartana posted probably wouldn't have done the trick for me.

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Originally Posted by Alan

All suffering is important to me, but survival ranks up there pretty high too. I'm glad we had a free market system which enabled me to do so. Those strangely familiar wait times Spartana posted probably wouldn't have done the trick for me.

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It sound like you had an emergency - "Also emergencies are seen immediately and urgent care cases are given an appointment date in under a week."

and Spartana wrote "Sweden also has private medical insurance a person can buy themselves and use just like we do in the US."

Free market and government care for those that cannot afford private insurance? Sounds like a winning system.

In the U.S., "For three decades, Americans, particularly men, have had either the lowest or near the lowest likelihood of surviving to age 50. The most powerful reasons found for that were homicide, car accidents, other kinds of accidents, non-communicable diseases, and perinatal problems like low birth weight and premature birth, which contribute to high infant mortality."

New Health Rankings: Of 17 Nations, U.S. is Dead Last

http://www.theatlantic.com/health/ar...d-last/267045/

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Originally Posted by try2bfrugal

Your personal experience also does nothing for the 49 million uninsured plus all the underinsured in the U.S., unless their suffering is not important to you. Except for possibly some ER care, their wait times are basically forever.

I'd be happy with the Swedish wait times Spartana posted, if it meant affordable coverage for all.

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While I agree that the Swedish system is far better than no medical care options at all - like we have for those low income and unemployed people who are uninsured in the US and can't afford the costs to buy insurance - but I think that the Swedish model of a 3 month wait to be seen by a specialist and 6 month wait for treatment or surgery is not something I'd be happy with at all. Especially if I was paying 50% or more of my income in taxes to support that care level. That small lump on your breast can metastasize to untreatable deadly cancer in much less time than that. So it's not a healthcare model I would cheer for. It seem Sweden could easily remedy those long waits by de-funding many of it's other very generous, but certainly not life or death situations, social programs to offer better and speedier medical care for it's citizens.

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Originally Posted by Spartana

While I agree that the Swedish system is far better than no medical care options at all - like we have for those low income and unemployed people who are uninsured in the US and can't afford the costs to buy insurance - but I think that the Swedish model of a 3 month wait to be seen by a specialist and 6 month wait for treatment or surgery is not something I'd be happy with at all. Especially if I was paying 50% or more of my income in taxes to support that care level. That small lump on your breast can metastasize to untreatable deadly cancer in much less time than that. So it's not a healthcare model I would cheer for. It seem Sweden could easily remedy those long waits by de-funding many of it's other very generous, but certainly not life or death situations, social programs to offer better and speedier medical care for it's citizens.

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Exactly why I find the claims of such waits for treatment of a serious medical issue & medical emergencies, which is what cancer & cardiac symptoms often are, to be non-credible. Some cancers are slow growing and can wait for treatment. Some are not, and cannot wait. Where are the facts?

Of course, we too have a lengthy waiting system in the US. Those who are uninsured do not seek attention until they are in a medical emergency, then access the ER, to great expense. Waiting periods are enforced socially through shame, and economically, via the reality of financial disasters if one is not adequately covered. Let us not presume that our system of punishing the poor by denying access to timely and effective care at an affordable price doesn't not exist. This very underbelly makes our class stratified system wholly unethical.

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Originally Posted by redfox

Exactly why I find the claims of such waits for treatment of a serious medical issue & medical emergencies, which is what cancer & cardiac symptoms often are, to be non-credible.

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When I have a patient with a serious cardiac issue, once we have stabilized them, we have them in the cath lab, or wherever else they need to be, from here, in minutes. We keep a helicopter and some fixed-wing aircraft on-deck on the mainland to evac them, generally it is at the LZ here by the time we transport the patient to the site. Weather is bad, they may get stuck on a boat, which can be problematic.

We never ask about their insurance situation or paw through their wallet looking for $20 bills, we just get them to treatment.

Sometimes there *is* a delay, if all the aircraft are committed, or the patient is too sick to be airlifted.

We have a >80% rate of spontaneous return to circulation here, which I suspect beats Rob's Mexican paradise. And we have great post-treatment outcomes.

If Alan had been vacationing here and complaining of the same symptoms, we would have probably had him in surgery earlier than he experienced in his run-through.

Cannot speak for the Swedish system but the Canadian system had my DH in full care for lung cancer in no time flat, tested for all the possibilities that might also be present and was fully insured under universal care.
A close relative had a stroke and was treated immediately with good follow-up therapy as well under universal coverage.
One can make an argument for both but the fact remains that the expectations are simply not sustainable indefinitely. I don't have a solution but do find that universal care does give peace of mind when it is critical.

So I guess the question is how would Americans feel about having a substantial raise in taxes to fund a system like this? From the link spartana provided there also is an amount you pay each year when you access care. So it sounds like we are talking close to a 50% tax rate! give or take. So emergency care is assumed to be covered. Then people that want it pay for private insurance. This is a very different system than what we are used to.

Of course, with the ACA I would be very surprised if our taxes don't rise. Expanded medicaid and subsidies have to come from somewhere. It is just a big shift in thinking. I have a hard time believing Americans would swallow a 40 or 50 % tax rate. What do you think?

Quote:

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Originally Posted by redfox

Exactly why I find the claims of such waits for treatment of a serious medical issue & medical emergencies, which is what cancer & cardiac symptoms often are, to be non-credible. Some cancers are slow growing and can wait for treatment. Some are not, and cannot wait. Where are the facts?

Of course, we too have a lengthy waiting system in the US. Those who are uninsured do not seek attention until they are in a medical emergency, then access the ER, to great expense. Waiting periods are enforced socially through shame, and economically, via the reality of financial disasters if one is not adequately covered. Let us not presume that our system of punishing the poor by denying access to timely and effective care at an affordable price doesn't not exist. This very underbelly makes our class stratified system wholly unethical.

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I think part of the problem is in defining what "emergency" means in Sweden. Say I have a wacked out lab test at my annual physical and my primary care person wants to send me to a specialist. That wait may take 3 months because the wacked out lab test really isn't considered an emergency or even urgent. Same with that strange lump or rash. So by the time I actually do see someone, my wacked out lab test or lump or rash is now something that is untreatable. Or, if it's treatable but not considered an emergency, then I may have to wait another 3 months to have a needed surgery (although not an emergency surgery). That wait can mean a lot of changes happen that can potentially be deadly. I'm dealing with this situation at the VA hospital now (wacked out lab tests and looonnnngggg waits for specialists and between further testing) and I imagine the experience is the same with any other public health system. I have opted to buy n expensive (to me) private insurance policy because the wait times are just too long if it is something serious. I have no way to make it go faster so going to a private doctor is the only option if I want speedier care. Or at least speedier diagnosis of what could potentially be something bad.