Unbiased Analysis of Today's Healthcare Issues

Health Care Around the World: Norway

Written By: Jason Shafrin - Apr• 18•08

All Norwegians are insured by the National Insurance Scheme. This is a universal, tax-funded, single-payer health system. Compared to France, Italy, Spain and Japan, Norway has the most centralized system.

Percent Insured. 100%. All Norwegian citizens and residents are covered.

Funding. The National Insurance Scheme is funded by general tax revenues. There is no earmarked tax for health care. The Norwegian tax burden is 45% of GDP. The government sets a global budget limiting overall health expenditures and capital investment.

Private Insurance. Norwegians can opt out of the the government system and pay out-of-pocket. Many pay out-of-pocket and travel to a foreign country for medical care when waiting lists are long.

Physician Compensation. Hospital and nonhospital physicians generally are paid on a salaried basis. Some specialists can receive an annual grant and fee-for-service payments. Reimbursement rates, however, are set by the government and, unlike in France, the physician can not charge higher rates than the centrally-set reimbursement rate.

Physician Choice. Patients choose general practitioners (GPs) from a government list. These GPs then act as gatekeepers for specialist services. Patients can only switch GPs twice per year and only if there is no waiting list for the requested GP.

Copayment/Deductibles. There are no copayments for hospitals stays or drugs. There are small copayments for outpatient treatment.

Waiting Times. There are significant waiting times for many procedures. Many Norwegians go abroad for medical treatments. The average weight for a hip replacement is more than 4 months. “Approximately 23 percent of all patients referred for hospital admission have to wait longer than three months for admission.” Also, care can be denied if it is not deemed to be cost-effective.

Benefits. Very generous. The program also provides sick pay.”  As Michael Moore has noted, the Norwegian system will even pay for ‘spa treatments’ in some cases.”

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42 Comments

  1. […] She’s kidding, right? Oh, yeah… Norway HAS a universal health care system […]

  2. […] A third item — a petition from the Norway Annual Conference’s Board of Discipleship/Church and Society — simply declared: “We believe it is a governmental responsibility to provide all citizens with health care.” (Norway has compulsory, tax-funded health-care system.) […]

  3. Jason Shafrin says:

    From Geir Vollsaeter via email:

    “The reference is from 2000 stats and the result of a short term fix in the past to some hospitals and national capacity problems but that turned permanent for good reasons. The option for treatment abroad is for people with psoriasis, skin problems, severe asthma and lung disease etc which is mostly related to Norway’s climate where temperature, humidity and lack of sun is a challenge for those patients during most of the year. So it is entirely useless as an argument for a failure of a national healthcare system. Its a calculated an human response for patients in need of help where natural conditions in Norway, beyond human control, leads to a economically efficient and rational response with patients in mind.”

  4. Kate says:

    hey if it was free I would wait 4 months for a hip replacement

  5. Bill says:

    but the thing is, it isn’t free, you’ll be paying for your hip replacement through your taxes. Heck, you’ll be helping to pay for someone else’s hip replacement too!

  6. […] is my earlier review on Norway.  The information below on Sweden and Finland has not yet been presented before in my […]

  7. […] is my earlier review on Norway.  The information below on Sweden and Finland has not yet been presented before in my […]

  8. Michele says:

    Bill: I would rather pay a fixed tax rate towards my hip replacement AND any other medical problem I may have than pay whatever my insurance company needs me to pay to keep their shareholders happy. If I have to count on the insurance company to pay for my knee surgery, then it is very easy for them to take advantage of their position and find ways to cut costs (deductibles, no accepting already diagnosed medical conditions) in order to continue making a profit. Yes, it’s a free market, and I could change my insurance company to one with competitive rates; but there are so few insurance companies to choose from, and no company wants to lower their rates to the point where they end up having to drop out of the market once it reaches saturation point. No growth, and shareholders stop investing in you. So you will always end up having to pay higher and higher costs. It never ends. Suddenly, if the company you work for decides it can’t make enough of a profit unless it ships your industry overseas, soon you can’t afford your insurance. It’s in your interest to pay into a government health plan that provides a COMPETITIVE level of care; otherwise, the insurance industry will have no reason to stop raising costs.

  9. Geir says:

    Bill
    Norwegians pay 3 % flat on their income to national health care coverage. Benchmark that against middle Americas health care costs. The overwhelming majority gladly pays for someones else’s hip replacement to get the individual back in the workforce to ensure more people are paying into the collective good. Its cheap, fair and works well for 4.7 million Norwegians whom don’t complain much about the system.

  10. Gerry Long says:

    I as an American have a lot of respect for the Norway people and their health care system. It sounds to me it is designed more for the overall good of the Norway people and Norway, and not with the main focus on helping insurance companies make lots of money along with health providers and ect. I’m sure it has faults but those faults when compared to the good would be as many of us here in America would say—-“whoopedee-do”

    G. Long

  11. Jeanette says:

    I am from Norway and except for studying in America the last two years I have lived in Norway my entire life. Yes we do pay a lot of taxes, but there is well worth it knowing that no one needs to die when not necessary. I have ones helped a friend to an emergency room here in America and the information about her insurance/insurance company was much more important than her… I also had a Norwegian friend become very ill and needed surgery while living here, and the Norwegian government did pay for her surgery which was lifesaving for her at that time. I would say it is worth paying extra tax and rather have a healthy population!

  12. Shinn says:

    I agree that the Norwegian centralized health care system is best. One should not have to worry about having health coverage, enough $ for deductibles or medication. Medication can be very expensive, especially for ones on limited incomes such as senior citizens.
    Shinn

  13. Nancy says:

    I live in the USA and was placed on a SIX month waiting period for my hip replacement surgery. Okay, I could have gone to a BAD surgeon and waited only a month, but I was willing to wait six months for the best surgeon who was experienced in the best approach for this surgery. I have health insurance but still had to pay thousands of dollars afterwards 1) to the hospital 2) to the home health company 3) to the surgeon 4) to the anesthesiologist. Give us single payer so we can stop subsidizing the rich who can afford to pay out of pocket but don’t because they generally have access to the best group health insurance plans

  14. Nancy says:

    @Bill: You already ARE paying for someone else’s hip replacement. You are subsidizing everyone who has on a group health insurance plan and your taxes are paying for everyone who cannot afford any health insurance. And who do you think pays for all the people that the health insurance companies refuse to cover? That’s right, the federal government sends money to hospitals to pay for treatments for the uninsured. If we Americans stop being so selfish and started thinking about helping one another, we could reduce costs for everyone.

  15. Neosapien says:

    “The Norwegian tax burden is 45% of GDP.”

    Norwegian healthcare is actually 40% ‘cheaper’ than comparable US healthcare, and mistakes and complications are fewer. It also isn’t really fair to give people the impression that the government takes half your money while giving little or nothing back as in the US. The 45% ‘tax burden’ is the ‘total tax pressure’, and if you include all the relevant posts you would have to pay out of pocket in the US to enjoy the same security and standard of living, you would be looking at a similar figure.

    “These GPs then act as gatekeepers for specialist services.”

    I have never been denied the services of a specialist. Nor do I know anyone who has. The GP merely determines if the condition warrants seeing a specialist. It has to do with cost effectiveness. Anyone is free to see a specialist at any time if they pay for it – and even then it’s cheaper than in the US.

    “There are significant waiting times for many procedures.”

    The thing about treating so many people is that priorities have to be made. Things like hip replacements and tonsillectomies can usually wait. The waiting list for a tonsillectomy is also 3-4 months, however I had an acute bout of tonsillitis and was operated that same day by a surgical tonsil specialist.

  16. […] The Norwegian healthcare system is organized into five regional trusts, whose underlying philosophy is similarly communal. Each runs on tax revenues, which are allocated to the hospitals based on the size of their catchment area, with adjustments based on the population’s age and socioeconomics. Hospitals that are able to manage their affairs on less than their budget are able to invest the surplus in research or new programs. But the CEOs I spoke to were all about population health: how to use their resources to promote the best health for their communities. Nobody seemed concerned about profits, bonuses, or the other accoutrements of market-driven healthcare. They see their mission as providing a social good. […]

  17. Nancy Wilson says:

    I was just figuring the other day that, as the primary earner in my household and source of employer based health insurance…I pay about 25% of my income SOLELY for health care…insurance premiums, copays, deductibles for medical, dental and eye care.
    about 20 more out of my check for taxes…and I earn just over the 2X poverty level for my household size (thus do not qualify for help).
    I also work at a pharmacy and see the ridiculous amount of money for high end drugs (paid by ALL plans, not just gov’t or private)…when no one has even tried the cheaper alternatives….so it is not a matter of just swapping out public for private care, there is a whole overhaul that is needed.
    The basics should be covered. The documented illnesses above and beyond that should be covered. We should accept a small amount of bureaucracy in insisting that cheaper alternatives be tried first. Then we would be one step towards a much saner solution….
    I came here to see how one of the economies doing best during these hard times handles their health care. I was not surprised at the answer….

  18. Debra says:

    To Bill, who commented about paying for someone else’s hip replacement: Sir, do you not realize you already pay for someone else’s hip replacement, oxygen treatments (because he/she has emphysema from years of insisting upon their “right” to smoke); or the native american woman who would rather run her children through ER (because that is covered on the reservation for free) than take them to the local town clinic, which would be out-of-pocket; or the man on a CPAP machine and diabetes medicines because of his perceived right to over eat and make poor choices in his dietary habits for years. All these things are already being covered by you, in part, through the ever-increasing health insurances premiums offered to you (at gun point) by your employers. No matter how you slice, most everyone helps to fund most everyone else’s health care.
    Remember, the original plan was a “government For the People, By the People.” We all benefit with a national health care system in place – exercising as an extension of the government – for the good of the people. A healthy citizenry assists is creating a a healthy economy and a healthy world presence.

  19. John J says:

    I am a Norwegian, and I work as a computer and copier technician – making an average industrial workers wage (about 70 000 us dollars). That’s not much – at least since my wife does not work.
    That’s about 5833 us dollars a month before tax. After tax I’m left with about 3650 us dollars.

    I have 3 children and a wife that’s home with the children.
    I get 200 dollars for every child a month from the state. My wife get about 1000 dollars for staying home with the children (but will be reduced if I have the children in a kindergarten, because the government subsidizes kindergartens in Norway.
    So I (we) get 1600 dollars back from the government.
    I have then 5250 dollars a month.. they take some and give some back :-)

    Anyway.. my children gets free dental care until they are 18 years old. Then they have to pay 25% of the costs until they are 20 and 50% until they are 25. They are now expected to have a job so they can pay the full price – OR be a student (at a free) university. Many universities have free dental included or have reduced prices.

    They get 100% free medical care until they are 18 years old. When they turn 18 they have to pay about 15 dollars for every visit to the doctor or hospital. I make 34 dollars an hour. I work 37,5 hours a week.. more and less.
    I get a 5 week holiday with pay every year.
    A pregnant woman gets at least 1 year maternity leave with full pay after the child is born and a few month before birth. She also gets 100% free medical care in this period.
    If you are ill a lot, or have a permanent decease – there is a limit on how much you will be charged, including the 15 dollar fees. I think it’s about 3-400 dollars. After that everything is free. Medicine included of course.
    The 15 dollar is for every doctors visit, and includes the meds. It does not matter if you get 10 pills, 500 pills or you need heart surgery. It is 15 dollars anyway.
    It you are retired, on welfare and stuff like that – you don’t pay at all.
    The government will also refund your traveling expenses too – so the 15 dollars is usually something you get back – unless you are next door neighbor with the hospital.

    We get subsidized price for the kindergarten and for SFO (you can deliver the school children earlier at school and pick them up later – and the school will the the “babysitter” and help them with homework or let them play or both)
    My daughter was born with a heart defect (hole in the heart) that needed surgery. There is basically no waiting time for this kind of surgery. Buy we had to travel 250km to another hospital that have specialized themselves in heart surgery on small children. The trip is free. They fixed the heart via a blood vessel in the thigh. Now I can not even see a scar.
    A few years later they discovered she had diabetes. We can choose to use shots/pens or a pump. Everything is free. Also when she gets an adult.
    We also get another 150 dollars a month because of the potential inconvenience the disease could be to us.

    The other children have also been to the hospital a few times. No waiting time.

    If you are older and need a new hip joint for example – you may have to wait for a while.
    It is not the cost of the surgery but there is a limit on how many doctors/surgeons the government can have on each hospital. They need to be effective and they have to include a lot of technology to reduce the number of man hours. So hospitals are now very automated : http://www.youtube.com/watch?v=rutHGN4IMB8
    They can use a lot of money on systems like this – and it will still be profitable because we are a high cost country.
    If you are working for a company, and they know you have to wait 4 month for a surgery – they can opt to pay for it, so you can come back to work much faster.
    There are also some deceases or surgeries that we don’t have enough experience to fix, or foreign hospitals can do better. That is special instances. Then the government buys these services from another hospital in Germany, the UK or somewhere else.
    There are talks now about sending more patients abroad to reduce the load on the hospitals in Norway for a while. There are talks about using some international hospitals in Thailand: http://www.youtube.com/watch?v=YScPBuig6l0 which would be cheaper for Norway, because people get back to work faster and can start to make money again – and pay taxes :-)

    They are also talking about offering free dental care for everybody. It will cost, but I think it is worth it. It is cheaper to fix the teeth early, before the patient get serious problems. Just like medical care, some people smoke, eat fatty food, don’t exercise and don’t brush their teeth. But the cost is divided among so many people that it is doable.

    As you can see from my tax level and what I get back – I really get more back then I pay. If you are really rich, you pay more – but you have more money to begin with. With a healthy educated population there are less risk of being robbed or mugged too.
    So in the end I think everybody wins with this kind of health care.

    But with a system like this, it is important that the government use the money wisely. People have to take a responsibility to stay healthy and exercise. There are always some people that will take advantage of this system.

  20. gungaden says:

    I have enjoyed the discourse, above, especially the details provided from our Norwegian allies.

    I agree that Norway has since about 1970 enjoyed a very high standard of living. It is a standard of living coveted by the citizens of many nations.

    I feel that it is important, however, to state several facts to place the details in proper perspective. Since the 1970’s Norway has established itself as one of the World’s leading oil exporters. Norway receives more oil export-generated tax relief per capita than perhaps any nation on earth. This tremendous source of federal government funding has permitted Norway to provide many social programs which are simply not possible for other countries. Certainly, the U.S. does not have the capability to match Norway’s oil exports per capita. Moreover, Norway has a total population of only 5 million people. The U.S. has a population of 307 million people. Norway can certainly afford to provide strong government-assisted care for its people for the short term because of the per-capita oil export revenue currently provided. It is noteworthy that one of Norway’s current concerns is how they can provide for the future when the oil revenues subside.

    Again, I believe that it is foolishness to make generalizations regarding the economic situation in the U.S. (or any other country for that matter) to Norway in regard to standard of living or governmental programs. Norway is a fine country blessed by an abundance of natural resources per capita, but is very small in comparison to many other countries in the world in population, GNP, and economic complexity. What works for them is not likely going to work for larger nations with vastly more complex economies.

  21. Bon says:

    I just have to comment to gungaden above here about a few points.
    In Norway, we do not spend all our oil money to keep our “social programs” running. We have a whooping 3000 billion kroner (600 billion USD) fund, where we invest the money to gain revenue and keep the norwegian market stable, as well as saving it for future generations.
    And your argument for having 307 million people vs 5 million people can be used just as well against you, as you would have taxes from 307 million people as we have from 5.

    Norway rules, and I truly LOVE taxes, would gladly pay more of them!

  22. MimiR says:

    In the US, all states have free Kindergarten. FYI. We have for more than 30 years.

    Median household disposable income in Norway and the US is virtually identical, adjusted for PPP. If you adjust our non-European-descent numbers to match yours, US median disposable income becomes higher, even accounting for health care expenses. And that’s without crazy amounts of oil money going into the public coffers.

    Most people have dental insurance already–many more than those who should, really, since it’s just not worth it financially for many.

    Most of our high medical costs come from “unnecessary testing,” but it’s that “unnecessary testing” that gives us the highest cancer and heart attack survival rates in the world. It’s really expensive, per person saved, but most Americans feel it’s worth it if they have a chance of not dying. Acute care in Norway is pretty awesome, and Norway has managed to instill a better sense of responsibility in its citizens when it comes to diabetes and asthma management (these ARE diagnosed in good numbers in the US, and they DO have access to medication and doctors, but lower SES groups refuse to manage the diseases properly). But the government control of cost-effective medicine means that, yes, more people really do die of preventable things.

    Americans also choose to have more surgeries than Norwegians for the same conditions. We are on more medicines, as well.

    Please note that the poor in the US do have a number of subsidies, including a full food subsidy, a pension system, disability benefits similar to that of Norway, free medical care, and the like. The debate is about the people who have the disposable income for some health insurance but choose not to buy it–whether they should be forced to buy insurance or whether the government should put everyone on the same plan. Right now, the government pays so little for its medical plans that the insured and out-of-pocket subsidize the government system by paying more.

    Poverty rates are set at levels that are also a bit ridiculous in the US because of extreme differences in the cost of living in different areas. Three-bedroom, two-bath houses can be had in mixed blue-and white-collar neighborhoods in some areas for well under $100,000. In a lower wealth area, still without high crime, houses can go for $60-80,000. In comparison, houses in some areas start at $500,000 and more for structures that aren’t as nice as the $60-80k houses. Rent where I came from started at about $450/month in areas that were low crime. Here, they start at $1300 a month. So a family has to make more than $10k more here to even start at the same place!

    Yet there is a single government poverty rate for most of the US. In many areas, the cost of living is low enough that people below the “poverty” line are doing very well. The median household below the poverty line has a 40% chance of living in a house that they own, and living spaces are notably larger than Western Europe’s averages. The structural condition of the median dwelling below the poverty line is good, and the number of appliances is comparable to the average European house. Food prices, too, vary drastically from area to area and can easily be 150-200% higher in some areas. So in some areas, people at the poverty line are truly struggling–impossibly so, in some places. In most, they really aren’t.

    I’d rather have more control of my spending and be more rewarded if I work hard and achieve, thanks all the same.

  23. don short says:

    Well yes, Norway exports a lot of oil and the U.S. imports a lot, but that difference is not the reason that Norway can afford universal health care and the other benefits it accords its citizens. The reason is that Norway OWNS the oil company doing all the drilling–yes, I know that there is that nasty socialism–and the profits go directly into the government coffers just as our income taxes do.

  24. […] Norwegian healthcare system is organized into five regional trusts, whose underlying philosophy is similarly communal. Each […]

  25. Mohamed says:

    I have been studying different health systems as a part of my education in health administration. I came across this article and I wanted comment on it. I researched multiple systems extensively. I have to say that social contracts in health systems where you have proper partnership between the government and the private sector is the best. Relying on private payers is a risk, paying for some aged group and not others wouldn’t benefit the system as a whole. The government is needed to control the system from regulation, cost, and budget stand points. Private sector is needed to provide alternative solutions to citizens who choose to get care faster and avoid waiting list or opt out. In healthcare, you have got to control cost, use of technology, and salarie along with expectations. Companies such as drugs and advanced technologies can adjust their business model in a way to maintain their presence and competitive edge. However regular citizens wont be able to adjust their basic healthcare needs. It is better to have a basic system that covers all population with some contribution from the private sector. Such model won’t exist in the US for the following reasons; corporation, lobbyiests, strong AMA and desired high clinical professionals compensation, shortage of healthcare providers, the highest expenditures on the US economy on other sectors such as defense, litigious society, and the individualistic cultural values of americans. To sum up, In the US it will continue to be harder to challenge the current system and impose proper reform.

  26. Tedlink says:

    Folks, Norway was a population of 4.9M people. That’s the size of Alabama, the 22nd largest state and only one million more people than Puerto Rico. Wake up people. That single payer government model would be a massive nightmare in a country of 310M people. it’s just not feasible…heck, even Medicaid and Medicare are a mess, rife with Billions of fraud and waste.

    What’s needed is tort reform, less defensive medicine, cross state portability like the very competitive auto insurance industry. I don’t want the govt touching my healthcare or getting between me and my doctor. 5M citizens in Norway vs. 310M….night and day folks, one size or approach does not fit all.

  27. Rick Horwitz says:

    Tedlink,

    The billions of fraud and waste are perpetrated by the health care providers (i.e.) the private sector, not the gov’t.

    Beyond that, I doubt one could find any research that support your comments regarding tort reform, etc.

    Right now, your insurance company is getting between you and your doctor… at least that is the way it is on this planet.

    Doesn’t medicare and the VA have cross state portability…

    Why not explain massive nightmare…actually, the opposite is the truth, price drop with scale…that’s why the push (by the current administration) is to automate.

    Think you have been listening to Rush.

    Rick

  28. gobnait says:

    Rick: two words: Medicare fraud. Google the story of Medicare fraud linked to Cuba. Tedlink’s comments are spot on especially as regards purchasing insurance across state lines. Health insurance can be obtained in Alabama for $1500 per year while it cost thousands and thousands more in northeastern states.

  29. Selcuk says:

    It appears everyone is missing a critical point.

    “What is the quality of health care that you are receiving?”

    My wife is Norwegian and the pregnancy care (diagnostic) is awful in Norway compared to a regular clinic in the US which will cost about $3,000 per pregnancy and/or covered by insurance.

    Furthermore, we read stories in Norwegian publications a) Norwegian doctors have little liability, they malpractice, get a warning and then back to business, b) you cannot choose your doctor, c) you have to wait and wait for any specialist, d) several deaths each year due to patients waiting cancer treatment, e) horror stories about misdiagnosis after misdiagnosis, f) no information about your doctor anywhere (what the education, how many warnings etc.) g) families have no rights! you ask for a doctor in the hospital and you are reprimanded by the nurse, i) personal experience you have no privacy – our first ultrasound was in Norway and the room had two doctors (while we were having the ultrasound.) m) Also personal experience what the doctors missed in Norway, doctors “immediately” caught in USA (our baby had heart surgery.)

    So, anyone who thinks that governmental health care is a substitute for private health care (incuding myself in my younger days) is a “fool.” Governemtal health care is a “minimum.”

    I am sorry for the Norwegians in general. You live in the richest country in the world yet you have no idea what “good health care” could be like. Simiar to Eastern German driving their trabbants, they had no idea how well a Mercedes was like. It was surreal.

    This is my analogy – yes, USA has a maor health (expense) crisis but at least I have the option a) to choose what I want and can pay for and b) I can rate my doctors, I can sue them and most importantly I AM IN CHARGE OF MY HEALTH… I do not trust any doctor blindly yet in Norway – Doctors are Gods. In the US, they are here to serve me.

    Yet, I agree that a health issue should not cause financial disaster to an uninsured family in the US. Perhaps the new Health Care law in the USA will improve it.

    I work and pay about 1/4th of my income to health care – I do this because my insurance plan allows me to see any specialist that I like. I can lower it or pay even more for additional coverages.

    In summary – Having free healthcare means nothing as long as the quality is bad.

    US could certainly afford to set up a free/tax payer based healthcare system equal to Norway’s – which would mean “no decent care for elderly, ” “wait and wait and wait diagnosis”, “no liability in case there is mistreatment, misjudgement”, “overbooked rooms,” and “a few decent regional hospitals” in the all the country.

    Let’s get real – Norway healthcare is a “GOOD IDEA” but it is “BAD PRACTICE.”

    US healthcare is “EXPENSIVE” but “EXCELLENT.”

    Ultimately you always get what you pay for… Dreams are free!

    Thank you

  30. TommyHolly says:

    Hello,
    I am currently writing from this from Telemark, Norway. Here’s just a few things people are overlooking:
    1. Norway has insanely high taxes on everything mainly to help pay for thier healthcare.
    2. Thier ain’t no such thing as a free lunch. When I ask Norwegians who is paying for thier healthcare, they always say other people, rich people, greedy companies, the government but in essense they are stealing from one group to pay for another. (That only lasts so long.)
    3. They recently have found huge amounts of oil and have been using those profits to further subsidize healthcare. Although costs are starting to greatly increase rapidly.
    4. They have extremely long waits for major surgeries which is why this article mentioned that so many of them leave Norway for the really important stuff and pay out of pocket.
    5. Most people who like these Government run systems are young and healthy and only need it for a cold, a broken leg, stitches… Since there is accounting board that ultimately controls how much can be spent you can be turned down for something potentially risky that may save your life.

    I just paid 650 KR for a stupid concert ticket and 100 KR for a beer last night. That’s almost $150 US Dollars which would of cost me about $30 tops back in Chicago. I just helped pay for someone’s “Medical Spa Treatment” that Michael Moore was bragging about above… Let them enjoy it for now cause it’s all gonna come crashing down soon. “Socialism is a great idea… until you run out of other people’s money.” – Margaret Thatcher

  31. Telcontir says:

    Selcuk:
    It seem you are missing the point. Ofcourse amazing healthcare can be bought with lots of money. But on average the Norwegian healthcare system is better (according to all studies I’ve seen), cheaper and fair.
    In Norway litigations does not go against the doctor personally but rather the hospital. That does not mean the doctor cannot loose his/hers license if convicted of malpractise. But it does mean that they do not need the very expensive indemnity insurance which again drives up costs.

    Another point to make is that Norway wealth from oil is really beside the point as all other Scandinavian health care systems are similar, despite no oil revenue. As mentioned by others the centralized healthcare system is much, much cheaper than the American model anyway and would suit any country, rich or poor.

    There are so many reasons why costs are spiralling out of control in the US, eg doctors dole out unecessary tests, medications and procedures. And don’t be fooled into thinking that equates better healthcare. No medication is without side-effect and no procedure is risk-free. But the doctor will get more money (and less litigations) if being “generous” like this. As mentioned in the article the Doctors in Norway are usually on a set wage and will not rake in money by doing uneccessary tests etc.
    Also money is wasted by hospitals needing to cater for every doctor’s whim when it comes to brands (of medications and surgical equipment). That means lots of stuff sitting on the shelfs (and lining medical companies pockets). In Norway the hospital decides what is the best equipment and everyone will use this. Following the same therapeutic guideline might seem like less choice for the patient, but honestly what patient would be better qualified to choose anyway. It also make it easier to conduct proper research into what works best, and since everyone (including nurses) are familiar with the system, less mistakes are made.

  32. Telcontir says:

    TommyHolly
    Pretty much every point you make seems utterly ignorant.
    1. The Norwegian tax is actually lower than many other European countries (like France or Italy). The taxes pay for free Healthcare, free Education, lots of subsidies etc. Which is why people are healthier, better educated and get better paying jobs, able to spend more time with children growing up, less crime, the list goes on and on. In pretty much every stat Norway is way up there despite the horrible weather. And please don’t bring the oil into this because Sweden is usally even better and have not one drop of oil.
    2. As other people have mentioned all healthcare systems depend on many paying for the few, that is the very essence of insurance of any kind. The difference is that Norway does not line the pockets of all the in-between people.
    3. Recently found oil? Costs greatly increase rapidly? Uhm no.
    4. 4 months wait for a hip replacement is actually pretty darn good. It’s usually for a long term condition anyway. Very, very few people go abroad for treatment and often that is cosmetic surgery anyway. If treatment is better vailable abroad then the government pays for that actually.
    5. That point made no sense what-so-ever. Why would this system be preferred by the young and healthy only, shouldn’t it be the old and sick? What life-saving treatment would be denied? All treatment is free, for everyone. Isn’t it poor people in the US that are denied treatments?

    Not sure why a concert ticket should cost that much less in Chicago, but I can assure you that the money you wasted would only sponsor the “spa treatment” for the band you watched.

    If the whole population runs out of money then no model of healthcare would be able to function, but at least the Norwegian one would last longer since it is ultimately cheaper than the American model.

  33. KL says:

    With the upcoming election here in the US, I always find myself drawn to the hot button topics such as Medicare, “Obamacare” and the likes. I found the post by John J on July 29, 2011 at 7:37 pm to be extremely enlightening, and I am left dumbfounded by the push back that so many Americans (I’m sure many of whom are Republicans) have in adopting a Universal Healthcare System.

    I was at the local playground with my children just the other day, and my children had brought toys with them to the playground. There were other children there and one of them asked to play with one of the toys. Did I tell the child to go get their own toys because what’s mine is mine and what’s yours is yours? NO!!! Most parents encourage their children to share with other kids, but when we’re older we are suppose to now turn our backs on each other? Not exactly sending the right message now is it?

    That’s what I liken the attitudes of the opponents of Universal Healthcare in the US to. Look, our healthcare system is broken, and instead of trying to re-invent the wheel, we need to research and adopt the healthcare systems of countries such as Norway, Finland, France, etc. Sure, their models may have some flaws, but which one doesn’t? Waiting periods for particular procedures to be performed are not only present in “other” countries, we have those same wait times right here in the good ole’ US of A. The quality of healthcare isn’t the same? How many of our doctors are hit with malpractice suits each year? Approximately 1 in 14. How many of the drugs that the FDA deemed as safe and helpful have killed people or worsened their condition? Rezulin (troglitazone) and Vioxx (rofecoxib) just to name two. Again, I’m sure similar stories are told in other countries because you can’t remove the human element from them, and humans are fallible.

    5 weeks of paid vacation each year? I would have to work over 20 years at the same job before I would qualify for 5 weeks of vacation. One year of maternity leave—-paid? When my wife had our two children, she had to use up all of her vacation time (about two weeks) and FMLA for the duration of her maternity leave. While FMLA protects your job while you are off work, that’s about all it is good for. It is unpaid, job-protected leave. Not every employer is covered by it, and you have to meet certain eligibility requirements. Minimum of 12 months at your employer. You must have worked at least 1250 hours in the 12 months prior to taking FMLA. You must work for an employer who has at least 50 employees within 75 miles of your worksite. Oh, and I had to keep paying her insurance premiums while she was out, too. With a Universal Healthcare system, that would be a non-issue.

    The truth of the matter is, what most other countries have in place doesn’t just stop at a Universal Healthcare system– it extends out to the family dynamic, the education system, and the individual citizens. I could go on and on, but I’ll leave you with this:

    Norwegians, Finns, the French, etc., are more united as a people than the United State of America…..and I think that is sad.

  34. Mary Valentine says:

    I didn’t know there was an average “weight” for hip replacements! How much does the article state that they weigh, now… ? 4 months? And, how much does a month weigh? Probably around 30 days.

  35. Garm says:

    Just a couple of points:

    Waiting times in Norway are generally shorter than in the US. As is the case for most developed nations, except Canada. For example, for a hip replacement, you go to http://www.frittsykehusvalg.no/start/ and just pick the hospital with the sortest witing list. And for a hip replacement, that is less than 4 weeks.

    Hip replacements tend not to be used in serious comparisons of waiting times anyway, because hip replacements wear out at very predictable rates. So an organized health care system will know when it starts to become neccessary, and book you in up to years in advance. A chaotic one will be surprised every time someone needs a new hip.

    By far greatest reasons for Norwegians to get medical care abroad is plastic surgery, liposuction etc, which are not covered by the health care system. The second reson is getting treatments wich are paid for by the Norwegian system, but not performed in Norway.

    The Tanner report is not an acceptable source, it is an argument and generally not factual. It is not research.

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  37. MaryEllen says:

    Don’t get too excited about the Norwegian health care The older you get the longer the waiting list you’ll get put on. At least in the states if I need cataract surgery and I am 90 I’ll get it — maybe in just a week. My Uncle waited five years for it in Norway. Think all your shots are free? No. Want to go to Thailand and need special shots? Nearly $200 a person…not covered. Don’t even begin to think your dental is covered. Also, your local hospital, in most cases, can’t handle everything you need. You’ll probably have to leave your home and go hundreds of miles away by plan to get treatment. My girlfriend has two disabled kids and no one in northern Norway can help them. They have to go to Oslo. It may as well be Rome from where they live. Another friend needed a quadruple bypass. Was told that because of his age he’d have to go on a waiting list. He would have died if he hadn’t gone to Germany and had it done. Do you mind sleeping in the hallway in a hospital or staying in a ward with many folks after having a baby? Or waiting for hours in a doctor’s office just to see the doctor? It’s hardly perfect.

  38. Selcuk says:

    To Telcontir,

    I don’t think I am missing a point because illness is a very personal experience. When you or someone in your family is sick you don’t seek fairness – you seek “best” treatment that you can get.

    The problem in Norway is that you don’t have options. The “state system” overrules over the individual rights to achieve somewhat collectively agreed definition of fairness.

    But what is fair? If the argument is fairness you include ideals to a pragmatic matter – that is health, and my health.

    In my earlier days, I would have accepted these ideals but when life tests you with real diseases and with real health challenges, trust me, you will not worry about social definitions.

    What is “unnecessary” becomes “unnecessary” if it cannot detect anything, but if your doctor is suspecting a rare case of say 1% type of cancer and orders several tests, trust me the piece of my mind of knowing you are cancer free or knowing that it can be detected early is worth the extra cost that insurance companies pass on to people.

    Where as in Norway, if you are reading the news you will hear stories of elderly men begging their ONLY family doctors to test them for years, women losing their lives due to breast cancer spreading due to tests not conducted on time.

    I am not a social planner and at this stage in my life clearly see that health is a personal issue. Just like any government should not tell me how many children I should or should not have, or what I should eat or not eat, no government should be able to overwrite my freedom to choose a doctor of my choice.

    In Norway this choice simply is taken away from you. I have been in hospitals in Norway and USA. I have been in clinics in Norway and USA. I have seen both sides and while I realize openly both systems shortcomings – I am not willing to return to Norway mainly because the health care system is not anywhere close to what I am accustomed in US.

    It is yes a good system (in Norway) compared to having nothing but if you can afford (and you really don’t have to be rich and there are amazing programs in the US as well that cost you much less than the national insurance contributions) the US healthcare OPTIONS is incredibly advanced and remains the best in the world.

    On a final note – when you go to your doctor in Norway, can you even see where they graduated from? if they had any warnings? if they had any good or bad reviews? I can simply do this in the USA by googling the net and checking sites that review doctors.

    In the US one can breathe knowing that you will get the best care – even if that means you may have to pay for it or get into debt… But can you really put a price on health? Can you put a price on human life? Do you want your doctor to treat you and test you with all available methods or do you want your doctor to think if the cost is justified first? I want the best treatment rather than the doctor worrying about saving money when it comes to my health. Let me worry about saving money but let my doctor worry about being the best doctor they can be.

    The healthcare in Norway, as much as you want to be proud of it, is unfortunately not adequate especially on complex issues. It needs a serious reform. Healthy people are not aware if it until disease hits their families and nothing and nothing compares the freedom to seek the best therapies rather than worrying about whether your family doctor will refer you to a specialist and how long you have to wait for a specialist and then how long it will take for your treatment.

    Last month a friend of mine’s wife went to a routine check-up and was diagnosed with breast cancer. From diagnosis to treatment = 1 week! In Norway, she would be probably not diagnosed, and be dead.

    In summary – it is not FAIR that some Norwegians have to die waiting but it may be FAIR that all Norwegians get the equal amount of rationed health care. It is not FAIR that some American’s who cannot afford INSURANCE will not get the same level of treatment of those who can but at least they still have the option to use the Emergency Room.

    By the way, I am not a nationalist and believed with all my heart Norway was an extremely well managed country. I wanted to live in Norway and now while I could technically move to Norway anyday, including my Norwegian wife after experiencing the freedom in USA, is realizing that life in Norway is very socialistic, suppressed and individual rights are usually not as well protected, respected as they are in the US. Just challenge your doctors in Norway next time and see what happens!

  39. JS says:

    I am an Oz ex-pat who lives in Norway and has experience with the healthcare system. I have had serious illness treated there and due misdiagnosis, failed treatments and general abject ignorance I chose to seek treatment in Oz. The standards were night and day.

    From my perspective I would prefer choice, service, malpractice recourse, quality and technical competence over self-regulated general provision of mandatory healthcare. And for those deniers in Norway your health care is far from free, you pay for it…

    I live here, I earn 120KUSD a year, pay 50KUSD in direct tax, 25% sales tax on everything I buy, 100%+ import tax on cars, up to 500% import tax on food items, Fuel tax, road tax, road tolls, tv licences, tax tax tax… at the very least 75% of my income goes in tax of one form or another.

    I would far and away prefer to pay 28% income tax + 10% GST and then choose where the remainder of my hard earned income is spent than bolster the coffers of an ineffective socialistic bureaucracy that answers to no-one.

    The best way to ensure quality and service is through private healthcare, the best way to ensure coverage is through socialism. Blend the two and we will see a better system for all emerge.

    The role of the government being a regulator – to regulate treatment regimes and standardize healthcare insurance packages (low, medium and high coverage). To place a tax on income to allow minimum coverage for all (3-5%). To allow for higher levels of coverage for higher premiums paid. To enforce patient rights – any patient, any Dr, any hospital, any time.

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