What the U.S. should learn from Sweden

so says professor Per Bylund in today’s WSJ:

shutterstock_161022188The overall quality of medical services delivered by Sweden’s universal public health care consistently ranks among the world’s very best. … Sweden’s problem is access to care. According to the Euro Health Consumer Index 2013, Swedish patients suffer from inordinately long wait times to get an appointment with a doctor, specialist treatment or even emergency care. Wait times are Europe’s longest, and Swedes dependent on the public-health system have to wait months or even years for certain procedures, or are denied treatment.

For example, Sweden’s National Board of Health and Welfare reports that as of 2013, the average wait time (from referral to start of treatment) for “intermediary and high risk” prostate cancer is 220 days. In the case of lung cancer, the wait between an appointment with a specialist and a treatment decision is 37 days.

This waiting is what economists call rationing—the delay or even failure to provide care due to government budgetary decisions. So the number of people seeking care far outweighs the capabilities of providers, translating into insurance in name but not in practice. This is likely to be a result of ObamaCare as well.

The data that claim costs are lower in nations with some form of single-payer systems do not account for the “costs” of waiting in line:  suffering, loss productivity, and sometimes even death:

Stories of people in Sweden suffering stroke, heart failure and other serious medical conditions who were denied or unable to receive urgent care are frequently reported in Swedish media. Recent examples include a one-month-old infant with cerebral hemorrhage for whom no ambulance was made available, and an 80-year-old woman with suspected stroke who had to wait four hours for an ambulance.

Other stories include people waiting many hours before a nurse or anyone talked to them after they arrived in emergency rooms and then suffering for long periods of time before receiving needed care. A 42-year-old woman in Karlstad seeking care for meningitis died in the ER after a three-hour wait. A woman with colon cancer spent 12 years contesting a money-saving decision to deny an abdominal scan that would have found the cancer earlier. The denial-of-care decision was not made by an insurance company, but by the government health-care system and its policies.

The end point is a two-tiered system in which those who can afford to buy private insurance on top of the higher taxes they’re already paying for free healthcare.

This is why Swedes over the past two decades have been rushing to purchase medical coverage through private insurance, which guarantees and delivers timely and qualitative care. Insurance Sweden, the country’s national insurance company trade organization, reports that in 2013 12% of working adults had private insurance even though they are already “guaranteed” public health care. The number of private policyholders has increased by 67% over the last five years, despite the fact that an average Swedish family already pays nearly $20,000 annually in taxes toward health care and elderly care, including what Americans call Medicare.

I lived in Sweden most of my life and have firsthand experience of the rapid expansion of the public sector in the 1970s and ’80s—followed by the welfare state’s decline and failed promise. The outcome of a government-run and controlled health-care system in the U.S., such as that in Sweden, is as predictable as it is frightening. But it is avoidable.

Sweden has started to self-correct, choosing a more sustainable path: private health-care options that allow for competition, customer choice and better overall care for Swedes. America should learn from Sweden’s experience and follow the Nordic country’s recent example, turning away from government-controlled health care to embrace a free-market solution.

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