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?
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Numer of visits to specialist doctors