Reykjavík Grapevine - 04.12.2015, Qupperneq 26

26 The Reykjavík GrapevineIssue 18 — 2015LIFE
When describing Iceland’s healthcare
system to Americans, there are a few
examples I find particularly useful. For
instance, the parking ticket I found on
my car the day after my son was born
was more expensive
than his delivery and
our overnight stay in
the hospital. Accord-
ing to the Interna-
tional Federation of
Health Plans’ Com-
parative Price Report
(2012), total hospital
and physician cost
for a normal delivery
in the US typically
ranges from $7,000
to $16,000. That’s a
typical vaginal birth,
with no complica-
tions. As soon as your
body starts doing the
“wrong” thing, re-
quiring more intense
medical attention, the
price tag on your bun-
dle of joy shoots up
even higher. The same 2012 report indi-
cates that C-Sections range from $10,000
to $26,000 (1.3 to 3.4 million ISK). So,
I giggled, paid my parking ticket, and
took my son home. Then we got a home
visit from a midwife over the next several
days. Free of charge. Because, you know…
Scandinavia.
We pay for these services, sure. Taxes
are really high. But, with them, we buy
peace of mind. Everyone gets sick at
some point in their lifetime, and every-
one benefits from living in a community
where you know that if your neighbour
gets really ill she won’t have to sell her
apartment to pay her medical bills. Each
month, I pay into a system, because I
know I am going to need it someday. My
family members, friends, neighbours,
random strangers and even you (yes,
you!) will need it, too! Getting sick is
part and parcel with the whole “having a
body” thing. It gets infected with a thing
here, something breaks there, bing, bang,
scrape, cancer, migraine, stroke, pneu-
monia, tonsils… It is inevitable.
Health for sale; very
good price for you today,
my friend!
I am writing this for a reason. Recently,
I have felt the tone of Icelanders’ con-
versation about their healthcare system
changing. The nation’s nurses and doc-
tors have been striking, and there is sig-
nificant brain drain
from both profes-
sions to countries like
Norway, where they
are paid significantly
better, and work far
less gruelling hours.
We regularly hear
horror stories about
the inadequacy of
facilities at the Na-
tional Hospital. The
healthcare system is
constantly described
as “broken.”
Some suspect
that the system is
being starved on
purpose, to ease an
intended transition
to the private sector.
Unfortunately, that
doesn’t sound too
far-fetched. As Noam
Chomsky posited in
a 2011 lecture at the
University of To-
ronto, 'The State-Corporate Complex: A
Threat to Freedom and Survival': "That’s
the standard technique of privatization:
defund, make sure things don’t work,
people get angry, you hand it over to pri-
vate capital."
I have no idea whether such a scenar-
io is currently playing out. But, I do know
that Finance Minister Bjarni Benedikts-
son has said he wants to “increase the
private sector’s role in healthcare.” That
very Bjarni, incidentally, is the head of
the Independence Party, traditionally a
big proponent of privatization efforts and
home to almost all of
Iceland’s free market
cheerleaders, many of
whom have benefitted
tremendously from
prior instances of for-
merly public goods
being divvied up and
doled out.
Since Iceland is so
small, connections are
everywhere. Some-
times these connec-
tions are suspicious,
sometimes they are
not. Small or not, in
my opinion, it is okay
to raise an eyebrow
when you hear that a
former Independence
Party MP is running a
private sector health-
care firm, and look-
ing to expand (her name is Ásdís Halla).
Paired with the Finance Minister’s state-
ments, some healthy scepticism about
who stands to benefit from privatization
is surely warranted.
Models of health care?
Don’t go West, young
man!
And privatization in healthcare is a big
problem. Because while free market
competition does an excellent job of de-
termining things like how many size 39
blue high heel shoes a store should stock
and at what price, it does a total shit job
of improving healthcare efficiency. The
evidence speaks for itself. If in doubt,
turn your gaze westward, towards my
motherland.
The US spends a shit-ton on health-
care, and it hasn’t made the folks there
any healthier. A 2014 Bloomberg survey
of healthcare efficiency by nation derives
its rankings by measuring average life ex-
pectancies against government spending
on healthcare. On that list, the US ranks a
miserable 44th (eat that, Bulgaria! Sorry,
Iceland wasn’t studied). The chart top-
pers were surprising to me: Singapore,
Hong Kong, Italy, Japan, South Korea…
Diverse as they are, they have one thing
in common: tight governmental control
over a universal healthcare system.
Good ole’ economic theory crumbles
to bits when you try and use it to make
healthcare more ef-
ficient. I am not a ra-
tional actor when I
need a tonsillectomy.
If chemotherapy
becomes 50% more
expensive, it doesn’t
mean I will purchase
half as much if I need
it.
It is privatization
that leads to rich peo-
ple accessing better
care and middle-class
people selling their
homes to pay medical
bills. A 2007 Harvard
study found that 60%
of bankruptcies in the
US were related to
medical bills. Three
out of four of those
filing for bankruptcy
*had* health insur-
ance. Even with the
Affordable Care Act,
which became law in
2010, unpaid medical
bills are still the leading cause of bank-
ruptcy in the US, more than credit card
and mortgage debt in 2013. Oh, and forget
about the poor. They’re totally screwed.
But hey, man…that’s competition.
Take it from an American, please.
Don’t go down that path… for that way,
darkness lies!
For instance,
the parking
ticket I found
on my car the
day after my
son was born
was more
expensive
than his
delivery and
our overnight
stay in the
hospital.
Everyone
benefits
from living in
a community
where you
know that
if your
neighbour
gets really
ill she won’t
have to
sell her
apartment
to pay her
medical bills.
There’s nothing like getting sick to make you appreciate feeling
healthy, just like there’s nothing like moving from the US to Iceland to
make you appreciate a strong, publicly run health sector. Healthcare
economics are insanely complicated, and I cannot claim any knowl-
edge beyond what my own lived experience has granted. However, as
someone who grew up within the US healthcare environment before
transplanting, I can confidently say: I like it waaay better here.
You Don’t Know What
You’ve Been Missing,
Until You Get It
A US perspective on
healthcare in Iceland
by MARY FRANCES DAVIDSON
Photo from the personal
archives of the author