Russetid på Kolbotn :)

Russetid på Kolbotn :)

Oslo, Norge

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Wednesday, March 24, 2010

My View on Health Care

I have been living in Norway off and on for the past 3 and a half years.

I am against health care being controlled by the government. It's really a fundamental position rather than a practical one. I know that socialized medicine works fairly well. I also know, however, that true free-market health care would work at least as good, accept without as much cost.

I do not live in a country with free health care, and neither does anyone else. Nothing, absolutely nothing, is free. Norwegians pay an average income tax of 30%, a tax on the purchase of food of like 15%, a sales tax on non-food grocery items (like soap) at 25%. There are taxes on money you don't spend, there are taxes on inheritance, there are taxes on your social-security payments, there are taxes for owning a TV even if it's sitting in your house not being used, there is paying an average (depends on how many driving hours you end up needing) of 20,000 NOK ($3,365 USD) for a drivers license... I can't even name all the ways the government takes money from the Norwegian people because I've only been here for a few years and have no idea about what taxes on businesses are like accept that I know that the more you earn the higher income tax percentage you pay.

So the most obvious cost to near-"free" health care (as well as near-"free" education and all the welfare programs there are in Norway) are taxes, more than even people from my home state of Taxachusetts can imagine.

The less obvious, yet more important, cost to big government is freedom and choice. For instance: Because of the government near-monopoly on health care, if you want faster or better health care than the government can provide you basically have to be pretty well-off. Another example considering health care: Since the government is paying for it all, naturally the government gets to decide what sort of treatments you can get. This results in that many medicines and treatments that are commonplace in the US are either illegal or highly restricted in Norway.

There is a common over-the-counter cream in the States that I would always use under a band-aid if a got a cut. It protects against infection, relieves pain, and generally helps the cut heal faster and with a smaller chance of scarring. I can't remember the name of it now since it's been so long (I think it starts with an N), but I took a tube of it to a local pharmacist about 3 years ago to see if they sold it. He looked at the active ingredients and looked them up in his big book of medicine, and told me that one of them was available by prescription only, while the other was not yet approved for use in Norway. Meanwhile, the cream had been an over-the-counter drug in the USA for probably 10 years already. That is, I remember using it as a pre-teen. Another example of this sort of thing is that I have yet to use any cold medicine here that works as well as Nyquil.

But like I said, my objections are mostly ideological. Here's how the system works. All emergency care is 100% payed for by taxes. Any doctors appointments, psychologist appointments, medicine on the "blå resept" list, and approved medically necessary travel expenses get listed on a card you have called "Kvitteringskort for egenandeler" (Receipt-card for deductibles). Once you have spent more than 1,840 NOK ($309.57 USD) of your own money that is eligible to be put on the card, you send in the card in along with all your receipts. If everything is in order, they give you a "Frikort", which is a card you carry around with you that is valid until the end of the year which makes all the rest of your medical expenses for the rest of the year "free", or rather payed by the government via taxes.

Also, if you are pregnant you get the following for "free": 1 appointment with the doctor or jordmor (earth-mother, midwife which extra education in pregnancy and child-birth assistance) every 4 weeks, 1 ultrasound around week 18 of the pregnancy, and any extra care or ultrasounds that the doctor or jordmor deems necessary as a result of any complications. Our child isn't due 'till May, but I have heard stories from many that when the time comes they are reluctant to let you come to the hospital until you are 100% sure that the baby is coming. Then you get a minimum of 3 days at the hospital, longer if the baby is premature or something else complicates things. They are generally much more reluctant to give c-sections than in the States, but this varies slightly compared to where in the country you live. I do not know weather the government pays for abortions.

As for waiting lines for non-emergency care: they definitely exist. I had to wait 6 months for an appointment with a psychologist. This was not an anomaly, it was general policy written in the letter I received after my main doctor sent an appointment request on my behalf. I think they might have expedited it if I was feeling suicidal or something like that though. In a more serious case than mine though, I have a friend whose arm is permanently damaged because of waiting lines to get surgery. He used to be a waiter, but can no longer handle to load of bringing dishes to and from the kitchen.

Despite this, I must still admit that my problem with socialized medicine is much more ideological than practical. The Norwegian system does indeed work better for more people, in a practical sense, than the current U.S. system. However, I believe the U.S. system could be fixed via the use of more free-market principles. Any solution that allows for more personal freedom and responsibility is inherently better than a solution that puts power into the hands of the few.

Here are some things I believe would make the American system much better.

1. Allow the purchase of health insurance across state lines. This would automatically increase competition dramatically. Prices would go down while quality would go up, just like when competition increased in the car market or the computer market etc.
2. Make health insurance companies have to follow the law based on which State their headquarters are in. The State that has the best health care laws would get the most health insurance businesses. Based on that, other states could improve their own health care laws by copying the states which attract the most health insurance companies.
3. Doctors often give extra unnecessary tests for two reasons. The first reason is that they are afraid of getting sued. The second reason is because the health insurance covers it. I have read research that suggests doctors would be less willing to recommend unnecessary tests if they knew that their patient was paying out-of-pocket. Thus, if more people used health savings accounts, the cost of health care would decrease.
4. Make all legitimate health expenses tax-deductible, so people with lots of health problems would have a much lower tax burden.
5. Make the sale of all medical equipment and medicine completely tax-free. This would reduce the cost to hospitals, doctors etc. which would be eventually passed down to patients
6. Generally get rid of as many government programs as possible in order to get rid of as many taxes as possible. With less taxes to pay, the people would have more money to pay for their medical expenses and spend money in other ways that would create jobs for those who do not have them. The more money people have in their own pockets, the more money also they will give to charities which help the uninsured.
7. Either use force to kick out all illegal aliens, or give them all legal status. Their presence here as illegals, unable to by health insurance or demand higher wages, is a financial burden on emergency rooms everywhere.
8. Either end or dramatically change the Federal Reserve in order to prevent these financial bubbles and bursts which cause major economic havoc that in tern causes problems to being able to pay for medical care.

I am sure there in much more we could do to improve our country by reducing government power rather than increasing it. One place that I get much of my inspiration from is the Downsize DC Foundation. To check out some of their views on health care, click here. You can find more information on health care and other topics of interest by reading their blog archive by category or checking out their other campaigns.

I hope that isn't too much and you find it useful.

In Love and Liberty,

Christopher D. Osborn
Siggerud, Ski, Akershus, Norge