Something Swedish

Swedish Health Care

23 Comments

My first Swedish doctors appointment was not the experience I expected. When you arrive in Sweden as an immigrant you are given a list of clinics to choose from and sign up to after you receive your personnummer. You are quickly approved to start going to your new health clinic. One of the only things people know about Sweden is that we pay high taxes and in return we get socialized medical coverage – something I looked forward to when I found out I would be moving here, since I hadn’t had medical insurance for almost two years at that point. That being said, I was excited to utilize this aspect of my new Swedish life.

I went in and explained to them that I wanted to be seen since I have not had a check up in about two years. As an immigrant you are given a free one-on-one sit down with a nurse the first time you come in, to talk about your condition, what you are there for, what they provide, and how they can help you. I wasn’t asked to fill out any forms.

The nurse was polite and helpful, but the information she gave me was surprising.

Coming from a country where health care is private and practitioners get paid through their patients or the insurance company (or a combination), I have never dealt with this type of system. The only thing I knew about it was that it is very cheap (Not absolutely free, which is what many people think). However, above all else, this system creates a completely different mentality towards healthcare.

A mentality that upset me until I discussed it more thoroughly and tried to understand. Until then, I felt as though I was politely dismissed or rejected.

The nurse explained to me that a routine “check up” is not the way things are done in Sweden. Also, it would be “very expensive” to run all the tests. That did not surprise me as I have  $700-$900 USD for tests with and without insurance in the past. I asked how much, she answered 500-900 Kronor ($70-$130 USD!). I tried not to look shocked or laugh, and said that I don’t mind paying that amount, but the nurse continued explaining.

“You are young and healthy, only come when you don’t feel well.” (This was magnified by seeing only seniors in the waiting room)

I was shocked, how does she know that I am healthy? Being young doesn’t automatically mean healthy. Routine check ups tell me that I am healthy! I am used to getting my blood tested and my heart rate checked and ‘the works,’ once a year. How else would you detect if something is wrong?

In Sweden it is only when something is actively bothering you, if you are sick, in pain, or not feeling well- then you go to the doctor. No one comes to just have “tests” done. When you come you pay 150 Kronor (20 bucks) and then all the tests you need for that specific problem will be done.

In Sweden, as soon as something is bothering you, you are more likely to go to the doctor and get checked out without worrying about the price tag. Any tests they need to figure out what is  bothering you is covered by that 150 Kronor payment.

Just as it is strange that I want a “check up” for no apparent reason, a doctor in the U.S would think its strange that my husband has never gotten a check-up. Different system, different mentality.

In the U.S. if I don’t feel well, or if something is bothering me, I don’t usually go to the doctor right away- mainly because it is expensive. Sometimes I have been talked into getting more tests done, not understanding the purpose, except seemingly so they can then charge the insurance company. This is both good and bad: more tests means a better chance of finding something which might not have been detected otherwise. But often times, they are extra tests almost identical to others with no benefit.

The argument against socialized health care is that Swedish doctors don’t have a reason to do these extra tests and don’t have the motivation (payment) to do all that can be done for the benefit of the patient.

It also helps that Sweden is of a much better health bracket, so there are less medical problems to worry about. When a society is more concerned and aware of  their health, taking the matters into their own hands – some problems are stopped before reaching any need for medical attention. With a society filled with obesity, fast food, and lack of exercise, the U.S. needs to be more preventative and routinely check for things like cholesterol and heart problems.

I argued that there are diseases and conditions that you find through those routine check-ups and blood work. But, come to think of it a lot of those tests are special and need to be ordered separately, upon symptoms or concerns anyway. While there are things that blood tests reveal about your health that you need to know, many of those problems come to surface with symptoms – which is when the Swedish Health care kicks in. But not before.

Sweden might be less preventative, but at the same time it is more proactive and accessible.

There are many more things that could be said, and that other people often say, but I don’t intend for this to get into an argument – only observations of my first experience with the Swedish Health Care system. It is a system to adapt to, but one that I now I understand better and feel more at ease with. Both (and all) systems have advantages and disadvantages, but both have been in place for a long time and are respectively effective.

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23 thoughts on “Swedish Health Care

  1. My experience somewhat parallels yours. However, I have gotten tests done simply because I, for example, wanted to know what my Vitamin D levels were (they were excellent, thank you) and that is something that would not ordinarily have symptoms connected with it. Also, the 130 kronor is paid for each visit as an administrative cost but after you reach 1000 kronor in any one year, the administrative fee is dropped no matter how many more times you need to see a doctor. About 3 years ago, my wife and I had not had checkups for several years so we went and got checkups, blood tests, the works and did not have a problem. Maybe because we are quite a bit older than you. My wife’s father had heart surgery several years ago. Total cost to him: zero. We had a neighbor in California who had the same operation. Cost: $1,000,000. Go figure. When I see the cost of some item has a 25% sales tax added to it here I comfort myself knowing that if I go into sticker shock, the ambulance ride to the hospital will be free.

    • Yep- vitamin levels is one of the examples I was using with my husband (But really, the only one that panned out, which he didn’t think was important enough lol And good work on your D!) Yes, I forgot to mention the payment ceiling as well as it being cheaper/free? if you are under 25. It is a relief knowing its always readily available in case of emergencies, which is really the only reason I could justify paying for health care in the states- for those “What if?” moments.

  2. “The argument against socialized health care is that Swedish doctors don’t have a reason to do these extra tests and don’t have the motivation (payment) to do all that can be done for the benefit of the patient.”

    Good summary of the american mindset, rationing is a very dirty word.

    The truth is, neither Sweden nor USA can afford an american healthcare system, which is about three times more expensive. Ironically, you have infact moved to a less socialized country, medicare+medicaid+VA cost slightly more per capita than the whole swedish system does.

  3. Very interesting, Meg,especially since I am a senior!

  4. Interesting and something i never consider before… I usually solve this “check-up problem” by donating blood…u get a ok check-up and the feeling to help the society out…

    Hope all is well with u and esby! cu in Mop? 😉

  5. I guess I’m stuck in my Swedish mindset because it makes no sense to me to go see a doctor if you’re not feeling sick. Doctors and nurses have more important things to do than to run tests on perfectly healthy people all day long. Although I do go to my dentist for check ups once a year, and pay for it.
    In my mind the fewer people in white I see the healthier I feel. And I’m not sure I would be comfortable with putting my health in the hands of some money grubbing insurance company.
    I hope you stay healthy and don’t have to experience too much of the health care system!

    • Nothing wrong with the Swedish mind set, just something different for me! For example, I have been to the doctor and found out that I am borderline Anemic which is something to keep an eye on through blood tests. Of course, Anemia comes with symptoms, but if you have had the tiredness and fatigue your whole life you think it is normal and don’t really look into it further. Same for any vitamin deficiency. Honestly, those and cholesterol are the main ones that come in mind and wouldn’t be terribly dangerous if not detected routinely, but are things I have always been told are important to check once a year. Good to hear- Dental check ups are important, too many people don’t do that (I was a dental assistant for 8 years) Is it recommended once a year in Sweden? Because our check ups in the U.S are every 6 months (But most do once a year) I certainly see what you mean about not WANTING to be in the doctors office more than you need to be!! That we can agree on, no matter the country or system!

  6. just pretend to be tired or a bit sad and they will check all your levels straight away 😉

    • Ah, good to know! Especially since I am usually tired anyway 🙂 Which is something I didn’t think of mentioning because I was so shocked and thought “Come when you are sick” was more literal. Thanks!

  7. Really interesting post! Especially since it’s from an ex-pat in Sweden! I would probably be as baffled as you. That sounds kind of like what I do anyway- I don’t really go in for routine checkups, but any time I feel slightly sick I get in to see a doctor (I once ignored a sore throat as a kid and come to find out I had tonsilitis and a staph infection in my throat… never again). Just out of curiosity, and I don’t know if you would know this or not, but what is treatment like there for people with chronic conditions? I am missing an enzyme and have to take a synthetic one. It doesn’t cause me any problems, really, but it is something I have to take medicine for daily. I want to live in Europe someday, and I’ve always wondered how that would work across the pond…

  8. In the UK it is pretty similar, if you asked for a general check-up on the NHS you would get some pretty strange looks 🙂 I did get a private check-up done once (because I was very ill and the NHS doctor kept sending me home with a recommendation to take paracetamol) and it cost me £500 *gulp*. At least it sounds like in Sweden, if you do want a general check-up for any reason, it is affordable…

    • I’ve heard a lot of people comparing our system with the UK and complaining that Sweden gets the reputation for better health care but the UK is actually better- I don’t know how true that is or what aspects they are talking about. I think each system balances itself out. And yea, believe me- I know what it feels like to have to spend hundreds on one visit. Really hurts.

  9. Interesting. I’m a Swede who has never been denied bloodwork here in Sweden. When I came back from my long stint in the US (don’t get me going on the tedious bureaucracy you go through there) I decided to do a health check up and was scheduled by my local doctor’s office and got all standard bloodwork done. I think it’s less common here – you don’t fuss as much over your health as over there – but it’s by no means prohibited. I’ve never experienced any reluctance to perform bloodwork or necessary tests here.

    • Oh! I never meant to sound like it was prohibited by any means – just a lot less common and maybe seen as unneeded by many. This is of course just from my personal experiences and hearing of many stories throughout my time here, I’m sure it’s not as bad as it seems!

  10. PS Thanks for an interesting blog! I really appreciate to get new perspectives on Sweden. 🙂

  11. Dont they require medical records, bloodwork, etc for you to be able to work/live in the country and obtain your personal number and healthcare? We have thought about going for a “long stay” but maybe we should see a doc here first 😉

    • Nope, none of that is needed, unless of course you yourself know that you have a complicated medical history and want to show your doctors something (I would assume you would have to get these documents translated though) I’ve never heard of anyone doing it though, especially not to be able to get your personnummer or health care. I assume because it shouldn’t really matter your medical history – it’s not as if you would be denied based on these things, you would simply receive help once you get here and take care of any problems that arise. If you want to have bloodwork done here I’m sure they would do it, it’s just not the same as back in the US where it is done regularly as a check up – you would have to request it. Without a personnummer though (since you mentioned a long stay), I don’t think you have the same access to the medical system, so check that first.

  12. Hi!!! Thanks for your post it was very helpful! I got my personal number but dont know how to get sccess to The doctors. I didn’t get any list of clinics like you say. Any idea how to get a doctor appointment? Do I need to register somewhere else? Tack!

  13. This post is VERY useful! I was about to do the same thing and show up at my doctor’s office for a check up. I am glad you save me the embarrassment. 🙂

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