Kevin Steinman on Norway healthcare: I feel as healthy as I ever have

Thumbnail image for Kevin_Steinman_Fjord_singing_Espen_Willsersrud.jpg
Photo by Espen Willserrud
Another advantage of Norway? You get to sing in the Fjords.

By Kevin Steinman

One year ago, my wife Ina and I posted our Ikea furniture on Craigslist, watched as four strong men packed up my studio gear, guitars and piano, hugged friends and family after my farewell concert in Minneapolis, and flew to Norway to begin our new adventure here. (Read about my reasons for leaving here.)

Since then I've received six Remicade infusions for my Ulcerative Colitis, and I'm happy to report I feel as healthy as I ever have. When I first arrived in Oslo last August, I didn't yet have a Norwegian social security number, so I felt no small measure of stress as I approached their health system as a new immigrant. The doctor I visited at the University of Oslo health clinic immediately understood that my treatment schedule merited a quick prioritization, so he made up a number for me, just to get me in the system. He assigned me to a private hospital (still covered under the national insurance plan), where they have lots of experience with the kind of treatment I get, and predicted I would be very satisfied with my care. He was right.

See Also:
U.S. healthcare is too costly for Kevin Steinman, so he's moving to Norway

Kevin Steinman says farewell and thanks to the Twin Cities
Kevin Steinman's farewell show at Bryant Lake Bowl, 7/23/12


Hege, my nurse, explained on my first visit that everyone at her hospital works very hard to make sure patients feel well, and that I was "heartily welcome to continue to receive my therapy there now that I'd moved home" to Oslo. During that first infusion, she asked if I'd like some salmon, since the two-hour treatment was over lunchtime. I automatically declined her offer at first, because I didn't have any money with me; but then it dawned on me that it was probably free, so I said yes, thanks. The lunch was free.

The plate of tasty salmon, salad, and bread which arrived a few minutes later caused me to blink back tears of gratitude, as I reflected on the Saltine crackers I'd always been offered in Minnesota during my infusions. Though no one understands the cause of Ulcerative Colitis, if I were a betting man, I'd wager that preservatives such as the ones in Saltines probably can't help chronic digestive disorders like mine. Here in Norway, I've been served a free hot lunch during every infusion so far.

I should note that I have not bought health insurance here (despite the fact that health care is offered publicly, some people choose to do so in Norway). Still, after each infusion, I pay only the equivalent of around 50 dollars, which covers my co-pay for the Remicade, blood tests and nursing services. This compares favorably to the $5,000-per-dose uninsured cost of the same treatment in the U.S.

After leaving behind the health insurance and out-of-pocket costs per eight weeks in the U.S., my total health expenses are down 97 percent. But that staggering difference in health costs between Norway and the U.S. will only grow larger in August, once I hit my yearly out-of-pocket maximum of $300. (Everyone living in Norway has a yearly medical expense cap of roughly $300 USD, so after August, all the rest of my infusions in 2013 will be 100 percent free for me.)

Kevin_Steinman_Stone_Arch_Randy_Vanderwood.jpg
Photo by Randy Vanderwood

At no point when I check in for treatment here in Norway does anyone ask whether I am insured, or how I plan to pay. It's a small detail, really, but for me it frames the whole hospital experience here in a radically different light from my treatments in the U.S. Everyone I've met in the health system here has been infinitely more concerned with how I feel, how my treatments are working, and my infusion schedule than with the business questions that seem to crowd the beginning of American doctor visits with a sense of impending doom. To be sure, there are also people in Norway who just handle payment. But here they don't seem to be a part of the problem. They seem, rather, to be a neutral part of a relatively smoothly working system, designed to offer the maximum benefits of health care to all people.

Another glaring difference: here in Norway there is no paperwork for patients. Save for the odd result in which my most recent blood test shows a low level of some vitamin, I get nothing in the mail from my hospital. I see nothing in written form about the costs related to my care. Romney had his binders full of women. In America, I had binders full of health insurance documents, explanation of benefits forms, and bills, not to mention the odd collections notice. On the psychological front I'm feeling blissfully recovered from the onslaught of pressure to pay for my treatments while living with Ulcerative Colitis in the U.S. Incidentally, since selling my car and buying a monthly bus pass, my overall stress level has also gone down significantly.


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37 comments
spellofsolutiontempl
spellofsolutiontempl


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HarleyD
HarleyD

The Norwegian people are pretty kind hearted to work hard and pay over 40% of their pay checks so that this guy can come over there and freeload off of their backs.  Typical musician... thinks the world owes him a living.  It would be interesting to check his tax returns here in MN to see if he paid income taxes on his cash gigs.  He probably complained that someone else should "pay his fair share".  What a man.  

allegory77
allegory77

Please take our 10 million illegal aliens over there with you. Kthx. 

ArtAsSocialInquiry
ArtAsSocialInquiry

 So eloquently expressed.  Thank you.  

The great sadnesses I hear of everyday in my work.....leave me aghast. The general public doesn't understand until they have a catastrophe and realize they are underinsured; lose a job and lose insurance when they need it; or cannot even get insurance because of a preexisting condition.

The great moral failure of the US system and the broken promise of the employer-based system will fell us.  

Things will change because when the money people say no more. We cannot compete when other countries are spending 10% of GDP on healthcare , getting better outcomes, and the US is spending 18% with the worst outcomes in the civilized world (except for some cancers.)

But how many deaths do we, as Americans, have to pretend don't matter before the change happens?

andreas.nettmayer
andreas.nettmayer

How many americans would exchange a 30% tax rate with stress about health care, college costs, and retirement for Norway's 43% rate with none of the above mentioned stress? I would. Any day of the week. And I'm someone in the category Mitt Romney would label a "producer." I can't imagine why anyone with less earning power than I have would opt for the current system when something like what the Scandinavian countries offer is possible. Our system only seems to be in your best interest if you are in the very top tax brackets and consequentially have enough money to not be stressed about retirement, college costs, or health care costs.

Darling
Darling

Yeah, uh I'm sure in Norway if you're WHITE or look on the lighter side of European, you're cool and down with the system.  I mean we wouldn't have such a healthy racist attitude in Minnesota without these past Scandinavian immigrants.

JimSmith777
JimSmith777

I think it is great to hear about this.  He makes some great points!

This doesn't get talked about enough.

Contrary to military "hero" propaganda: ("We are the greatest country! Blah!")

We tend to forget that there are millions of people outside of the U.S., living wonderful lives, without ever thinking about us.

He stated: "Everyone ought to be able to afford and have access to the treatments they need to survive. It's as simple as that. America, like Norway, has the resources to accomplish this goal."

Well, "America" squanders those "resources" on Military Empire.

Another thing he forgets, is to compare the size and history of Norway with a huge Empire like the United States Federal Government.

The United States is too big.

In a ranking of happiness and standard of living (2009) by sociologist Steven Hales, the top nations are Norway, Iceland, Sweden, Netherlands, Australia, Luxembourg, Switzerland, Canada, Ireland, Denmark, Austria, and Finland, all but Canada and Australia small. 

And a "sustainable society index" created by two scholars, adding in environmental and ecological factors, ranks only smaller countries in the top 10 – in order, Sweden, Switzerland, Norway, Finland, Austria, Iceland, Vietnam, Georgia, New Zealand, and Latvia.

My suggestion is to abolish the Federal Government and each State could become its own country.

Look at Norway and Switzerland and how they are not meddling, invading and destroying other countries.

For further reading, find the book "Human Scale" by Kirkpatrick Sale.

dwfnd77
dwfnd77

Just because it doesn't cost you doesn't mean it doesn't cost! Saying "it only costs me $50 a dose compared to the $5000 per dose in America" is completely misleading! Just because it costs you $50 there doesn't mean the procedure only costs $50. Someone is still paying for it! Your effective tax rate in Norway is 43% compared to an average of 30% in the US!!!(sorce: www.inc.com/magazine/20110201/comparing-tax-rates-in-the-us-and-norway.html) That means on a salary of 100k in Norway you are only bringing home 57k vs. 70k in the US. You are DEFINITELY paying more than a $300/year deductible; you're paying $13,000 a year. This just shows the world of delusional naïveté some of these people live in! Stay in Oslo buddy! America doesn't want you!!!

djgls5
djgls5

Nothing is free. It may be free for you but someone is paying for it. His attitude is disgusting. "No, I don't want the meal if I have to pay for it." "Oh, the Norwegian's slaving away at work and paying high taxes are footing the bill for my fancy salmon meal! Well, okay then!" It isn't the responsibility of the hospital and Norwegian people to pay for your salmon. Eat lunch at home. How entitled 20-somethings of today are. They want everything for free.

jennica.harper
jennica.harper

The doctor MADE UP a social security number for him???? 

I.V.S.
I.V.S.

@Darling Universal healthcare = healthcare for EVERYONE, regardless of race, age, social background, income, profession etc. 

andreas.nettmayer
andreas.nettmayer

@Darling You're 100%. Racism is 10000x stronger in the US than in Norway. Why? Because we were where racism was used to justify the economic model of slavery. Norway and Europe wasn't out of this 100%, as they benefited from slave produced cotton and sugar, and they certainly aren't racist free. But on the balance, they were removed from the horrors of race based slavery and subsequent removal of racist ideology from the culture has been easier. 

gnarltroll
gnarltroll

@JimSmith777 I am not sure comparing it to the US military budget does the problem of US healthcare expenses justice. Its a difference of scale.

The US spends just under 5 % of GDP on the military. It spends close to 19 % on health care, with many people not covered. Other developed nations cover everyone at 9 % of GDP. The waste in US healthcare is twice as big as the military budget!

gnarltroll
gnarltroll

@dwfnd77

I don't think you quite though that through: You are assuming that all of the difference in taxation between Norway and the US goes to fund healthcare. 

Healthcare is not even the biggest expence on the social budget of Norway. (Pensions is). From that difference in taxes, Norway not only provides free heathcare, but provides free universities, a years maternity/paternity leave per child, pensions, unemployment benefits, and much more.

What is more, I think you need to read your own cite a bit more throughly, especially the bit about comparing healthcare expenses for employees in Norway and the US :)

andreas.nettmayer
andreas.nettmayer

@dwfnd77 Hmm, I'd take a 43% tax rate if it meant no stress about how to pay for retirement, the kid's college, and health care. It'd mean I could quit my day job and go full time at my side job for my start up. I wonder if it wasn't for the economic stability I need from my regular job whether I might be a multi-billionaire by now, if I had the time to devote to my true business passions.

Seems to me if I were in Norway I'd have more opportunity to try and pursue happiness.

shawnmcb
shawnmcb

@dwfnd77 "Ayn Rand devotees in America don't want you."
There. Fixed it.

DavidFoureyes
DavidFoureyes topcommenter

@djgls5 And yet, Norwegian's are measurably happier...likely because they believe, as many of us do, that when we all feel better, we all feel better. 

If I gave such a shit about money that I could put three exclamation points after acknowledging that I would take home 13% less money every year so that my neighbors could all have healthcare, I'd be fucking miserable. It's money. It is a construct. Health is real.

Insurance is less about money for me and more about the retarded (meant literally) waste of time it represents. If we are talking about dollars and cents, my time is worth money, my time is worth my companies money, and I waste an inordinate amount of time determining what insurance to use, which combinations of insurance to buy between the plans offered by me and my partner's companies, submitting FSA and HSA reimbursements, determining which hospitals we can take out kids to, figuring out who takes our insurance in a location before we travel...not to mention the amount of time and resource my company must invest is sourcing insurance and putting together all the crap I have to read to figure out what they and I are going to pay for. Then I get six insurance cards in the mail, a FSA and HSA card tied to accounts I don't really want, a receipt every time I submit a claim...Waste, waste, waste, waste, waste. Give me a bill. Make it 5, 6 ,7% higher than the premiums and deductible I pay now. Let me get on to the important part of life instead of managing something so stupid and let my neighbors who can't afford it have health care.

BHDickerson
BHDickerson

@jennica.harper that might explain the lack of paperwork being mailed to the house. I hope some poor shit who has that social security number isn't getting shafted with the bills.

dwfnd77
dwfnd77

That's not the problem! I have a friend that has a practice down here where I live. He had a patient come to his office with a URI. The doctor prescribed an antibiotic for the patient and the patient got better. Total cost was $75. A few months later the patient has another infection but the doctor is unavailable. The patient goes to the ER. After labs and a visit from the ER doc, the patient was prescribed with the exact same antibiotic and sent home. My doctor friend came back in to town and asked the patient to bring in a list of the ER charges with them to the next visit. Total cost for that one ER visit was over $20,000 for the EXACT same outcome as the $75 visit! I totally agree with you that our expenses are out of control in healthcare. We agree on something!!!!! But I can't understand why everyone thinks the resolution is Universal Healthcare! Accountable Care Organizations have started to be implemented throuought the US which I am a huge fan of. It's my opinion that the physician based ACO's will end up saving us BILLIONS in healthcare over the next 10 years. Universal Healthcare has nothing to do with it.

dwfnd77
dwfnd77

@shawnmcb @dwfnd77I wouldn't be so presumptive. I support gay marriage and wish Hillary Clinton was president right now. Don't just assume I sit on that side of the isle because of my thoughts here. I'm just sick of people who follow blindly on either side of the argument without knowing what they are talking about or see the whole picture.

gnarltroll
gnarltroll

@DavidFoureyes @djgls5 Odds are, you'd be paid a lot more in Norway, so a higher tax rate does not neccessarily mean you'd take home less money. Of course Norway has a higher cost of living. Once you adjust for that, median household income is almost exactly equal between Norway and the US...but with Norwegians already having covered stuff like university, health care, pensions, maternity leave etc.

dwfnd77
dwfnd77

Next time ill use 4 exclamation points to really prove how much I like money.

jennica.harper
jennica.harper

@BHDickerson @jennica.harper It sounds completely unethical, and not something to boast about. Not to say things don't happen here too. I guess overall I don't see the point of this article. He sounds like a snob!

dwfnd77
dwfnd77

Make sure the link in my comment has the +states at the end

dwfnd77
dwfnd77

@JeniKay @dwfnd77 I LOVE IT!! I am woefully ignorant. JUST BECAUSE YOU SAY THAT DOESNT MAKE IT TRUE OR EVEN COME CLOSE TO BACKING UP YOUR STANCE! Have you ever heard of the Federal Poverty Level? Google it. It's a thing. Each state (INCLUDING FLORIDA AND TEXAS) base their eligibility for Medicaid off of the Federal Poverty Level. In Florida, "all pregnant women", for example' "with family income at or below 185% of the Federal Poverty Level may be eligible". For a family of 4 this is $43,567!!!!! (you can find this information on the fam med fact sheet at the Florida Medicaid website). You just proved my point JeniKay! "Woefully ignorant"...? I believe you owe me an apology :-)

JeniKay
JeniKay

@dwfnd77 I think you're woefully ignorant as to what programs are actually available. We're fortunate in Minnesota, but do you realize what the income cap is in states like Florida and Texas is for Medicaid? If you make more than $5,000 a year, you're too rich for Medicaid there. Do you think you could live on that? I'm fortunately enough to have qualified for state subsidized medical here in Minnesota, but the alternate would have been a continual deterioration of my health that would have forced me to quit working and become completely dependent on government handouts. Common sense dictates that it makes far more sense to provide health care that enables people to continue to be productive citizens,

dwfnd77
dwfnd77

Here is one of my FAVORITE empassioned talking points; how heartless America is because we allow sick people to go bankrupt! ANYONE who has a disability for two years or more in America can apply for Medicare and be fully covered! Anyone who is poor can apply for Medicaid in America and be fully covered! Hell, you can be an illegal immigrant in America and be fully covered by Medicaid! Our state and federal governments are ALREADY insuring the poor and the needy! I provide care EVERY DAY to people on these two programs! 90% of our patients are fully insured through Medicare and Medicaid! Now, you can roll your eyes and claim 'Oh the stupidity' or only comment on the non-substantive portions of my post, but you can't argue 'America doesn't provide for the poor and disabled' as a need for universal healthcare. I can't tell you why people don't choose to use these programs and choose to go bankrupt, but they are there for anyone with a real or fake social security number (Just like Norway!!)

gnarltroll
gnarltroll

@jennica.harper @BHDickerson There is no bills, and the number is not identical to the US social security number. That should be obvious. Since a lot of record-keeping uses the number, doctors have a list of numbers for use with foreign patients who need to get into the system quick.

gnarltroll
gnarltroll

@dwfnd77 @I.V.S. If you are "very familiar with the costs" I am sure you know that litigation makes up 2% of the costs, and defensive medicine 9 %.

And that the total costs of government health care in the US, not even counting private insurance is more per person than what almost all developed countries pay for 100 % coverage. The government already spends more money on health care than UHC would cost.

The big drivers of cost in the US is adminstration, medical waste and ineffciency. Some hospitals have as many people dealing with billing as they have beds!


PS: Don't use examples from inside a system that is failing to argue against solutions. To compare to government run health care, compare to hospitals in the Japan or Scandinavia. VA hospitals are affected by many of the same overarching systemic problems as other US hospitals.

dwfnd77
dwfnd77

Have you ever even been to a VA hospital??? They are probably the BEST example of why government has no place in health care! (David has me shy about using too many exclamation points). They are a joke! PLEASE go to your local VA hospital and compare it to one of your private local hospitals and come back and tell me you want to have your next baby at a government hospital. Only then will I accept your argument.

andreas.nettmayer
andreas.nettmayer

@dwfnd77 @I.V.S. You are correct that someone is in fact footing the bill for health care in countries like Norway. But you fail to accept that the method they use actually costs the country less than the method we use in the United States. In the US we pay 17.6% of our GDP to health care. In the rest of the OCED highly developed countries, the average is about 9%. Norway's is at 9.4%. Their method provides better results at lower costs. Yet, you defend our system. Why? If your primary concern is saving money, then you be deriding our system, regardless of whether or not you think it provides the best results. There are many, many, many ways to achieve universal health care. Government operated insurance and government operated hospitals (like we have with the VA and the UK has with NHS) is ONE way. Government operated basic insurance and private hospitals are another.

dwfnd77
dwfnd77

@I.V.S. So I thought Kevin said his treatment schedule warranted a 'quick prioritization'? He was giving the impression that the health system was so high and mighty and quick over there. But you are saying it was two weeks later he got his number and even that was 'long before medical treatment was given'. Can you see how this is misleading? Hey, I have no problem with people having a bias; I obviously have one myself. The problem I have is the people out there promoting 'Universal Health Care' that have no idea what they are talking about. I work in the health care industry and am very familiar with the costs. The biggest offenders are hospitals that charge $20,000 for labs and treatments (to cover their own asses due to our litigation-happy society) when a person can receive the same treatment in a physician office for $20. You want to fix our health care system? Take the power away from the hospitals and incentivise the care providers (not insurance companies) to save money and make it more cumbersome for people to sue. You want your government to pay for it? Where do you think they get all of their money from?????? You and me!!!! So if now the government has to pay for our medical bills on top of everything else they are paying for, where do you think the money is going to come from????? You and Me!!!!!!!!!! Higher taxes, less money in your pocket. Health Care WILL NOT BE FREE! You and I will merely not be given a bill; they will just take it directly from our paycheck. But look on the bright side, at least there will be less paperwork :-)

I.V.S.
I.V.S.

The "made up" number was created solely to book an appointment. Kevin received his actual number two weeks later, and the hospital's system was updated long before medical treatment was given.

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