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Monday, February 7, 2011

Swedish Health Care Part II

On January 25th I posted a blog about our experience with health care in Sweden.  It was titled, "Enjoying the Benefits of Higher Taxation."  Scot McKnight "retweeted" it onto his Jesus Creed blog and because a large number of people read and comment on his blog, I started a rather lively conversation about health care and social security in the US.  If you click onto Jesus Creed, you'll get to the original article along with all of the comments.  After also getting many responses on my Facebook page, where the blog was also posted, and reading through the Jesus Creed comments, I feel compelled to respond.  What is staggering to me is how defensive and heated this conversation becomes immediately, and it is often driven by misinformation and assumptions.  So for instance, the first comment begins, "Well, it may cost $0.00 but make no mistake, they are all paying for it out of higher taxes."  I never, ever said that the health care was free and the title of my piece indicated that high taxes were a part of the deal.  I know that we are paying for our health care through our taxes but the main point of my blog was to reveal that we got good, decent, emergency care and weren't going into a financial hole because our tax structure required that we be prepared for such a emergency.  I think that's a good use of tax dollars, helping everyone be prepared for crises and disasters over which they have no control. 
I have never claimed that Sweden's system is perfect or even superior to the US's.  I also admitted that the two countries are vastly different so it is difficult to compare them.  In fact, here's a direct quote from the first blog:  "Now, I’m not saying that we can compare the US to Sweden because the issues are complex and complicated, but I am saying that people really need to quit saying that countries like Sweden are really messed up."  Again, what surprised me about the comments is how many people started, angrily, it felt, with you can't compare the two countries.  I know that.  I admitted that.  My main point was that I've grown weary of the criticism launched at European systems that are run by the government through taxation.  It's not all good, but it's not all bad.  What staggers me about the defensive commentary that inevitably emerges is how protectionist people sound.  I will be the first to admit that there is government incompetence and that turning our health care over to the government has many issues related to it.  But our system is far from perfect and much incompetency can also be found and not just in Social Security and Medicare.  The bottom line for me is that most people in the US cannot reasonably afford health care so in the end, it matters very little how great our care is.  If you cannot access it, what's the point?  And my driving question is this: Who should be able to access and afford health care?  Should it be only the right of the privileged or can we do better?  (I consider myself part of the privileged.)
To be fair, a good friend who has a chronically ill boy (Crohns disease from a very young age) commented extensively on Facebook that they had a really rough time in Sweden trying to get consistent, aggressive care.   I hear her pain and I will concede that if your health issues fall into straight forward categories, you can count on decent access and health care in Sweden.  If your condition is chronic, acute, or a bit out of the ordinary, you can have a rough time trying to get the level of care and attention you will feel satisfied with.  I feel deeply for my friend who is having an easier time with treating her child in Switzerland and I am thankful she feels better about her care.  But here's something we must all face.  All of our perspective is driven by privilege.  Most who read this blog or Scot's come from a place of economic means and choice.  The fact that I can even consider getting health care in more than once place is a staggering point of privilege and wealth.  Those critical of other countries are accessing and paying for the high level of care that it requires to attain such benefits in the US.  Most who think government run health care systems are creations of the devil have never had to consider Cook County Hospital as a place to find care.  Yes, there are levels of care in Sweden and again, we've been privileged to access some of the more private, elite places where medicine is practiced and for this I am grateful.  But I am utterly thankful that should we fall on hard times, we could still go to the Dr. that lives down our street and get what we need to get healthy.  And we go to her most of the time and Doug's leg care was not through the private hospital, but through the system that anyone and everyone could access.
My main issue with this conversation is that we need to stop to consider how to help people get the care they need, regardless of economic status.  Tax based systems level the playing field because they aren't relying on profit driven insurance companies to pay the bills and people who are unemployed can still get care.  I don't mind paying higher taxes because I see the benefit of my contribution spread across society and I feel that contributing to a healthy society raises the quality of my life.  In the US, we have a real problem with how our tax dollars are spent and that creates one of the problems with going to a universal health care system.  But for those of you who are critical of a universal, tax based system, help me understand how we can get to a place where you don't have to have money, job, prestige, or connections to get health care in the US.  I have never said that Sweden is the Nirvana of health care.  There are issues. I've seen things I don't care for.  But please don't attack Sweden without at least looking at the flaws in the US system.  And remember the place of privilege and power from which most of us are forming our opinions.
Finally, comment 40 from Scot's blog took a real pot shot at me.  Here's the comment in full: "I just didn’t grow up thinking that anyone else should be responsible for paying my bills or that I’m entitled to 35 days of paid vacation time just because I turn 50. People who are in need should definitely be helped, but there is a cost to all of this “free” stuff and it comes from people who work and sweat and keep the midnight oil going. People who pay taxes. People who can’t just close up their business in order to take a month vacation. I find it perplexing to hear someone say we might like higher taxes if it means it could help others…and then she jets off to travel for the winter. Just saying."  First of all, I have never intimated that I grew up expecting that anyone else should be responsible for paying my bills and the Swedes don't think that either.  But, in my limited experience (12.5 years living there), I have seen that as a society they don't mind thinking more collectively about providing for the whole of society through taxation.  The concept isn't really based an expectation that others will pay your bills, it's just a mentality that says no one should have more access to care based on financial resources.  She also used 'free" again, which I have never used and then says that it comes from people who work and sweat and keep the midnight oil going.  I work.  I sweat.  And I am super lucky to be able to do so.  I hope this person never loses her job, or gets a debilitating illness and can't work, or has a sick child that requires most of your attention because then she'd have to rely on the kindness of others and generosity and perhaps even some government aid.  She thinks that people who pay taxes can't close up their businesses and take a month off.  Well, she's obviously never been to Sweden in July because that's exactly what a vast majority of society does.  And guess what...it creates a much healthier society.  Swedes are more interested in time off than more money and so they live differently in order to take the time off during the year that helps them enjoy a better life.  It's just a totally different way of looking at life.  I have not closed up my shop...we worked hard before our holiday to ensure that our church would remain strong in our absence and I will return to my job as a senior pastor of this church refreshed, renewed and ready to give my all to my congregation.  Taking time off to care for yourself, visit family and get some perspective is a valuable gift that most Americans have no opportunity to enjoy.  I think this is sad.  I just don't fully understand why she thinks that my paying higher taxes to ensure that everyone in my society gets health care and then proceed to take my time off is such a disconnect.  Cathy...you just sound bitter and petty.  Not sure what's driving your comment.  I work hard.  And I play hard.  And I'm very comfortable with how much tax I pay and how it's used.  And I'm not ripping off anyone by taking a vacation, and I am likely a lot healthier in body, mind and spirit than many Americans who have to work like dogs to afford a lifestyle that is way out their reach or pay unexpected bills that are burying them in a hole of financial burden.
Sweden and America are totally different places.  My perfect world would be a blend of the best of the two nations.  My quest in writing these things is rooted in helping people understand that another system isn't always as dark as it seems and also to help us all realize that for those of us who have means and access, all of our commentary comes from a place of privilege that affords us choice.  What are we doing in the US for those who do not have choices, means, or access?