I have been hearing a lot of pundits and politicians bemoan “socialized medicine” and its supposed inefficiencies and inequities. These horror stories are never accompanied by data, just hearsay and anecdotes from “a friend of a friend” in Canada or the United Kingdom. Rarely have I heard from people who have themselves experienced a universal public health care system. As one of those people, I thought I should speak up.
While living in Finland for three years, I experienced socialized medicine up close and personal. I gave birth to my son there.
Finland’s public health care system is run by a government agency called KELA, and the doctors, nurses, dentists, and other health care workers are government employees. KELA usually covers 100% of the cost of most services at public clinics, with small copayments for prescriptions and hospital stays that are scaled to a patient’s income. Finland also has many private clinics that are available to those who want to use them, where patients pay the extra cost of the private service (KELA will pay up to what the service would cost at a public clinic). When you visit a clinic or hospital you present your KELA card at the reception desk, and if a payment is necessary you can pay at the clinic, or a bill can be sent to your home.
All Finnish citizens and permanent residents are eligible for KELA benefits, as are immigrants on work and political asylum visas. I was eligible for the KELA system because I was in Finland on a work visa, and I paid income and social services taxes from my paychecks. Yes the taxes were high, about 40% of my gross pay. However, it is comparable to my take-home pay here in the US once I factor in my health insurance premiums, deductibles, and copayments, along with my income and social security taxes.
The care that I received in Finland throughout my pregnancy and childbirth, and for the first 9 months of my son’s life, was simply amazing. I saw the same nurse and doctor for monthly pregnancy checks (and later they were my son’s primary medical caregivers); their offices were in the same hallway. Both women knew us by name and by sight, and always remembered what we had discussed for the previous visit. Routine ultrasounds were performed at the maternity hospital; my nurse made each appointment for me and I simply showed up at the hospital for the procedure. When my labor started I headed to the maternity hospital, and the hospital’s nurses and doctors knew exactly who I was, as my medical files were available to them through KELA’s computerized filing system. (Patients must sign a form that allows their medical files to be accessible by other medical facilities, so a patient’s privacy rights are protected.) Every nurse coming on duty reviewed my file before seeing me, and so my discussions with them were focused on what my son and I needed at the moment, not what had been done during the previous shifts. After my emergency Cesarean operation and a four day stay in the hospital, only one bill was waiting for us when we got home, for a total of 260 Euros.
I never had to wait to see a medical professional, nor was any necessary procedure delayed or denied. Every nurse and doctor I saw was caring and knowledgeable, and spent whatever time was necessary to make sure that I received the care I needed.
I have now been living and working back in the US for 6 months, and already I have had problems with my health insurance plan through my employer. I found out the hard way (that is, at the doctor’s office after my son’s vaccination visit) that my son had been arbitrarily dropped from my plan months before, even though I had been paying the premiums for the family plan all along. It took almost a week of phone calls to get him reinstated. All the while, I privately wondered if the two ear infections he had had in the spring had prompted some computer at the health insurance company to calculate that he was “overusing” the system, and automatically drop his coverage.
That may seem like paranoid thinking, but I have seen it all before. In 2001, my mother was diagnosed with aggressive breast cancer. Instead of focusing her strength and attention on recovering from a double mastectomy, chemotherapy, and radiation, she spent much of her time arguing with the health insurance company and the hospital over bills she had already paid, and routine treatments that should have been covered by her insurance plan. Ultimately she lost her insurance altogether when she lost her job, and she has since been living in remission, uninsured.
When these pundits and politicians go onto national television and spew all sorts of false rhetoric about the evils of socialized medicine, it makes my blood boil. They are doing an incredible disservice to their fellow Americans, both those with and without health insurance. For every anecdote they have about a Canadian waiting six months for necessary open heart surgery, I can find twenty Americans for whom that equally necessary surgery is completely out of reach. Now is the time for an honest assessment about what (if anything) can be salvaged from our current system, and to put a system in place that does what it is supposed to do: provide health care.
Audrey Mayer is an assistant professor at Michigan Technological University, focused on sustainability research and education.
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