Reykjavík Grapevine - 05.12.2014, Page 18

Reykjavík Grapevine - 05.12.2014, Page 18
After the ceremony, I speak with her family. They tell me that Rósa barely managed to keep a roof over her head in recent years, and that she often couldn’t afford to seek proper medical treat- ment. These difficulties, they tell me, were caused by structural changes to the healthcare system, which increased the cost of medication and outpatient ap- pointments. The results of Rósa’s autopsy were inconclusive, they tell me. Although they remain hopeful that further testing will reveal her cause of death, they may have to wait a while. At present, the Icelandic healthcare system is arguably going through its most tumultuous period yet. The nation’s first doctors' strike is in full effect. Medical staff are overworked and exhausted fol- lowing prolonged austerity measures. Some hospital buildings are infested with mould. And so on. The question is: how did we get here? And, perhaps more importantly, have we reached the point of no return? Iceland maintains a universal health- care system, under which all legal residents are covered by the Icelandic social insurance system. All hospital admissions are paid for by this system, as is the majority of the cost of outpa- tient appointments. There is a token fee to see General Practicioners (GPs) and specialists, with fees for the latter con- siderably higher, particularly after the economic collapse of 2008. Iceland’s primary healthcare is split up into hospitals, health institutions and healthcare clinics. There are two hospitals, Landspítalinn, the National University Hospital of Iceland (hereaf- ter referred to as LSH), which is located in Reykjavík and serves as a general and specialised university hospital; and Sjúkrahúsið á Akureyri, or Akureyri Hospital, a generalised and specialised teaching hospital located in Akureyri. There are furthermore twelve major health institutions along with numer- ous healthcare clinics spread out all over the country. Historian Jón Ólafur Ísberg says that Iceland’s medical system as a whole has mostly remained the same since the 1970s, when the neighbourhood health- care clinics were founded. They pro- vided people with primary health care, where individuals could seek medical help with or without an appointment. “Before that, GPs would visit infirm people in their own homes,” he says. Unlike other northern European countries, Jón says, Iceland has never made a comprehensive medical plan, leaving progress to technological ad- vances and the whims of medical pro- fessionals. “It’s the specialists who want bigger hospitals, newer equipment and fancier gadgets,” he says, “and that’s what gets prioritised.” In another difference from other welfare societies, patients in Iceland don’t need referrals to see a specialist: they can go directly to them. “If you have a headache, you don’t have to first see to your GP,” Jón says, “you can go straight to a neurosurgeon, which is both unnecessary and costly for society as a whole.” The statistics show that there’s been a drastic increase in specialist visits in recent years—they went from 373,878 in 2003 to 493,678 in 2009 and then 658,855 in 2012—which is ostensibly more costly for the State, and a trou- bling development. 18 The Reykjavík Grapevine Issue 18 — 2014 In a small and private ceremony in a chapel in Fossvogur, around 30 friends and family members are present to pay their respects to 50-year-old Rósa Mikaelsdóttir, a single mother of three who passed away on November 17. Rósa had struggled with mental disorders for most of her life— in particular severe anxiety and depression—and, follow- ing the 2008 banking crisis, had a hard time making ends meet on her disability allowance. Words by Gabríel Benjamin Photos by Hörður Sveinsson & provided by The National University Hospital of Iceland. Squeezing Blood From A Turnip Iceland’s universal healthcare at risk Iceland’s Healthcare System: How Does It Work? 700.000 600.000 500.000 400.000 300.000 200.000 100.000 0 19 91 19 92 19 93 19 94 19 95 19 96 19 97 19 98 19 99 20 00 20 01 20 02 20 03 20 04 20 05 20 06 20 07 20 08 20 09 20 10 20 11 20 12 Numer of visits to specialist doctors

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