So I finally decided to start a blog! I'm having a great time abroad in Copenhagen, Denmark, so I thought it would be nice to share some of my experiences with friends and family. I just got back from traveling to Stockholm, Sweden and Tallinn, Estonia on an academic study tour w/the Medical Practice & Policy group @DIS. I had a really great time--lots of partying, but I also learned a few things about their health care systems, as well as their culture.
Before I left for Stockholm, I asked another girl from Sweden who also lives @Egmont what I can expect for my trip to Stockholm--I was curious what the atmosphere was like and how it was different from Denmark and the United States--I figured she would have a interesting perspective seeing how she's studied in all 3 countries. She told me that the people in Stockholm are very pretentious--that they are all very rich, beautiful, and successful...and they flaunt it. They brag about what kind of car they drive, wear only high-end fashion and pay $20 per drink when they go out, and they won't let you into clubs if you're not wearing the right shoes or clothes. Fortunately, she said its not like that in the rest of Sweden. Malmö is another city in Sweden (only 40 mins from Copenhagen) that's more comparable to Copenhagen in the sense that everyone considers themselves equal and they're more down to earth, so you can always find a place to fit in.
I had an interesting discussion about the Swedish health care system w/a pediatric surgeon named Nicholas during one of our academic visits @the Karolinska Hospital. Nicholas and another doctor gave our class a presentation on the Swedish health care system and presented a multitude of graphs from the OECD that represented Sweden's superior ranks in health outcomes (i.e., life expectancy and infant mortality) when compared to the United States. I found their ostentatious approach during the presentation to be somewhat amusing, mostly because of the fact that they were depicting themselves as stereotypically conceited Swedes. I had a few disputes with their omission of data that would skew the story and make the Swedish health care system appear less than perfect. First of all, their graphs listed only 12 out of 21 OECD countries--many countries, such as Japan (which has better health outcomes than Sweden), were omitted simply to portray Sweden as being the best. Nicholas continued to point out random factoids about Swedish healthcare and how he loved his job, but he didn't really mention anything relevant to issues in health care today. I think pretty much every student in the room felt as though he was glorifying the Swedish health care system and downgrading the US health care system, with no comparison between the countries or possible explanation for why these differences in health outcomes exist. If he had simply recognized the fact that the United States' lower ranking had more to do with it's large, heterogeneous population, I would have had a little bit more respect for him.
One thing you have to keep in mind is that Sweden is a homogeneous, affluent society--due to Sweden's neutrality, they did not undergo the two post-World War rebuilding phases that the rest of Europe experienced. This entire time, they had plenty of intelligent, hard working people who made a lot of money that went toward improving their standard of living and solving domestic problems. However, because of the fact that Sweden has such a comprehensive welfare state and b/c they pride themselves on "helping those in need," they are experiencing a lot of immigration problems. The initial influx of immigrants came after WWII. But ever since the Iraq War began, Sweden has accepted more Iraqi refugees than any western country. Although externally, Swedes want to help, they also want to preserve their culture--so in order to become a citizen, not only do you have to speak their [ridiculously hard] language, but you also have to get a job and support yourself, which is often very difficult due to the fact there is a lot of racism toward those who lack "Swedishness". Immigrants are expected to shed their cultural identity and become Swedish, but because of the fact that Swedes fail to communicate the rules and culture they live by (because they want to avoid conflicts and remain neutral), immigrants struggle with adapting to their way of life. Because of this, many cannot get a job and they end up living off the comprehensive social welfare state. When a government hands out extensive welfare benefits to a growing immigrant population that's not paying taxes, its clear to see why economic problems would ensue. Sweden is now placing tighter restrictions and limiting the number of immigrants allowed into the country. This is a country that prides itself on its social welfare system, openness, and acceptance...yet their policies don't necessarily reflect that conviction. They don't provide health care to those who aren't citizens, they fail to communicate effectively how to adapt to their country, and they are beginning to narrowly restrict immigration.
I guess the fact that Nicholas failed to acknowledge this detail about their immigration problems while simultaneously bragging about how healthcare in Sweden is better than it is in the US just hit a nerve. Since he was boasting so much, one might think that he knows how to create the perfect health care system, right? I asked him, "Keeping in mind the demographics of the United States vs. that of Sweden...since you seem to really be bragging about the superiority of Sweden's health care system compared to the US, I was wondering how you think a system like this could be implemented in the US?" His response was completely off topic, and he just pointed to a graph where Sweden was at the top and said that "something must be working right?" When I asked him what challenges he thinks the US would face in adopting this system, and he just claimed that he's a surgeon, and therefore, he's a "simple-minded man." Then he proceeds to comment on my question later on, claiming that caring for one another is inherent in Swedish culture and that they think of health care more as a right...haha and then he quotes the fact that 48 million Americans are uninsured and how that's morally wrong, acting as though most Americans find no fault or shame in this statistic. I tried explaining to him that was not the case--that most Americans share the same empathy and values as Swedes and that it had more to do with demographic heterogeneity in the US and fundamental differences in views of the role of government in health care between the Republicans and Democrats--most of which are shaped by their religious differences. However, I quickly recognized that he was too ignorant and pretentious to acknowledge Sweden's flaws and recognize why their health care system is not something that we can easily adopt in a country as large, heterogeneous, and complex as the United States. So, needless to say, I learned something. I was given another example (Denmark was the other) of why an extensive welfare state, lax immigration policies, and failure of the government to establish effective policies to ease the assimilation process for immigrants isn't sustainable. You could easily just look at the US and see that, but nevertheless, its interesting to witness this problem as it unfolds in a pretentious country like Sweden, where they have the "world's best social welfare state."
...sorry this post is so long! You can look forward to reading about my experience almost getting arrested in Estonia next time! :-)
