With all the talk about health insurance lately, I wanted to share a few things about the Norwegian public health insurance scheme. I think Americans need a better sense of what we’re missing. I should add the caveat that this post is based on my personal experiences in Norway as an academic on a cultural exchange program, rather than my professional expertise, but the more I learn about the healthcare system in Norway, the more I feel the need to vent about how the US system stacks up against the Norwegian one.
Last night I looked up some of the co-pays in Norway. With current exchange rates, these are particularly good, but even if the exchange rate were closer to what it has been in the past, these prices would still be a steal in the US these days:
Visit to a general practitioner: $17.75
Visit to a specialist: $40
These are the two that really get me:
X-ray: $28.50!
Lab test: $6.40!
Here’s one that anyone who’s dealt with infertility in the US will lose their minds over:
IVF costs $150. That is not a typo. $150 and you get THREE TRIES.
In the US you have to basically take out a mortgage to pay for IVF.
Children under 16 do not pay co-pays and once you hit $325 in co-pays you get a “free card”, which if I understand correctly means you don’t pay co-pays for the rest of the year.
Public health insurance seems to have had an impact on the private market as well. I’m not covered here and needed to see a specialist, so I saw a private one. I had a consultation, two tests (one that’s free in the US because of the ACA, but one that is usually QUITE expensive), and she ordered my prescriptions. WITHOUT insurance, I paid about $200 for all of this (and I saw places online that offered the same services for cheaper, the range was maybe $115-225).
My medication seemed to cost about the same (again, without insurance) as I pay in the US with insurance, but then guess what? When I actually picked up the medication, there were three times as many doses in the same package. So for what I usually pay in the US for a one-month supply, I actually got a three-month supply.
Meanwhile, my employer back in the US has informed us that they were able to avoid a 38% increase in premiums and get it down to a modest 14-15% increase. The deductible for the cheapest plan is $10,000 for a family; the out of pocket max for a family is $13,000 (!!!). Covering part of these costs is increasingly hard on employers, especially non-profits like St. Olaf or the public school district my spouse works for.
We’ve had the private insurance system in the US for a very long time now, and costs just keep rising. (Dr. Jessica Knurick has written an excellent piece that explains how racism and classism informed policies that have prevented the implementation of universal healthcare in the US.) Of course, Norwegians debate how to make their healthcare system better all the time. Lately, there are many concerns about keeping rural hospitals open amidst demographic changes, just like there are in Minnesota. But public healthcare gives Norwegians a freedom and sense of security that most Americans don’t have–you don’t have to stay in a job you don’t like to keep your insurance, you can go back for more education and keep your insurance, you can start a new business and keep your insurance. If we want to live up to the ideal of being a nation that values freedom and innovation, we need to improve our burdensome healthcare system.