The Norwegian Versus the American Healthcare System

America’s history is rooted so deeply in freedom of choice to either win or lose in one’s economic decisions. This can be epitomized by so many early Europeans coming to the New World in search of a new life, many of which had very little wealth in terms of personal property or education, but eventually pioneered much of the American wilderness creating farms, small communities, and big cities. From the earliest Americans that came to Jamestown Virginia to the more recent immigrants coming through Ellis Island, many of these Americans have argued for less government intervention in their lives and created a culture that keeps the government from controlling everyday choices like gun control to even universal healthcare. Even today, America does not even have a universal healthcare system, even though many other industrial nations do.

Many Americans argue that a universal healthcare system will not work in America because a large portion of Americans will simply take advantage of the system, in terms of not altering their unhealthy behavior, thus, running up the costs for everyone. Moreover, many feel that healthcare is simply not a privilege to be handed to everyone, and should be employer based to ensure everyone pays for their own healthcare, as much as possible. This seems to be a cultural issue rooted deeply in the American value of individuals being independent as much as possible from government influences. On the other hand, a country like Norway has some pure socialist practices, especially in the area of healthcare. In fact, everyone in Norway has healthcare. It is the law of the land.

Norwegians are more practical than Americans in how they spend their money, they enjoy saving money for quality health care. According to Bruce Bartlett, a Forbes Magazine columnist, on a per capita basis, Norwegians spend $4,763 per year, and covers everyone, while Americans spend $7,290. By various standards of health quality, like life expectancy or rate of preventable deaths, Norway does better than the U.S. One key measure is physicians per capita: America has 2.43 physicians compared with Norway’s 4 doctors per every 1,000 people, even though Norway spends a third less of its Gross Domestic Product on health care than the U.S. does.

Why is the cost of healthcare in Norway less than that in America? The eye catching statistic that reveals Norwegian superiority in providing lower cost healthcare is that the number of doctors in America, per capita, is actually less than in Norway. Perhaps increasing the supply of healthcare providers in America could lower overall healthcare expenditures for healthcare. Perhaps there is a deep rooted cultural reason in Norway that is helping to keep healthcare costs down. Maybe their society has a healthier population than countries like America.

Finally, it appears capitalistic and socialistic policies both can benefit a nation like America. America has the greatest GDP of any nation, but yet, does not provide a universal healthcare system for its citizens. One would think that through sheer size and because of its economic output, America could keep its healthcare costs lower for its citizens than a country like Norway. Perhaps the free market system in America will one day solve all of the demands that its citizens want, like universal healthcare. If not, perhaps a more controlled socialistic policy will be created providing universal healthcare that is similar to the one implemented in Norway. There is a school of thought for each economic approach, but the bottom line is, there is a cost to be paid, and ultimately the consumer/taxpayer will bear that cost.

Cynicism or a Healthcare System That Needs Help

This story is about a patient with no real experience in the healthcare system.

A patient was having some sinus issues in December of 2012. Basically, mucus had settled into his sinus cavities. It was like talking in a tunnel and difficult for him to hear.

To get relief, he started with his family doctor in December. The family doctor prescribed some antibiotics-a fast, powerful dose. After a month, experiencing no relief, he went back. The doctor prescribed more medication. No relief. He sent the patient to an Ear, Nose and Throat (ENT) specialist.

The ENT prescribed steroids. He claimed that cured 80% of the individuals with this problem. The patient had high hopes but the steroids did not work, either.

The ENT recommended a CT scan at the hospital. After much searching and aggravation, the patient found out it would be about $2,500 (Note: the patient did have insurance but had a $2,500 deductible and 20% co-insurance). He shopped around (an arduous process) for a clinic to get a price. He found one that would do the sinus CT scan for $400.

The CT scan confirmed everything. The sinuses should have been black (denoting air) but they were gray (denoting mucus).

The doctor recommended a sinusplasty. This is a procedure where the sinus passageways are stretched to allow for draining. A balloon is inflated to allow this to happen. The mucus present would be sucked out through a kind of straw. It was an outpatient surgery, taking about 1.5 hours. It was scheduled for May 31st. The patient said ok.

Of course, prior to the surgery tests had to be done (really?). A blood test, chest x-ray and an EKG. The EKG was because the procedure included a general anesthetic.

The nurse called him two days prior to surgery. The tests were fine. But the EKG indicated a Myocardial infarction (MI)-age undetermined. That meant the patient had experienced a heart attack sometime in his past.

What???

The patient was stunned. Other than being overweight, he had no health issues. If he had a heart attack, he was not aware of it. It didn’t matter. The surgery was cancelled until the patient could obtain cardiac clearance. He had to see a cardiologist to get that.

After an exam, the doctor told the patient, he probably didn’t have a heart attack. The EKG was faulty. The machines were sensitive and could give a false reading pretty easily (the patient was of course, still charged for it).

After another EKG and a heart echo sound, the doctor confirmed there was no attack and that, in fact, the patient’s heart was hale and hearty.

Cardiac clearance was received and the surgery rescheduled for July.

While everyone seemed to mean well, was all of this really necessary? Are all of these doctor’s visits, tests and medications normal? The patient is not cynical by nature but…

Sue (Sunni) Patterson, CMBA, Co-Founder
As an accomplished marketing professional, entrepreneur and lifelong learner, Sunni constantly seeks out dynamic business opportunities. Sunni started in the healthcare industry as a senior medical claims processor with a major insurance payer and since then has partnered with RMK123.com, a top medical billing and revenue management firm. Sunni leveraged this to create Medical Bill & Claim Resolution (MBCR), a medical bill patient advocate firm assisting individuals with interpreting their medical and hospital bills, disputing erroneous charges and resolving/understanding insurance claim decisions. Sunni holds the specialist Certified Medical Billing Advocate (CMBA) designation, which is issued through the Medical Billing Advocates of America upon successful completion of their exam