Times are tough for most airlines. Scandinavian Airlines used to offer a choice of entrees even in economy class. That ended a year or two ago. I found out when the steward handed me my food with a grumpy face. “I thought there was a choice”, I said. His grumpiness deepened, and he quipped “You have a choice whether to eat it or not”.
The Stockholm newspaper I read shortly after takeoff from Newark had side-by-side articles on Swedish health care. One piece described the waits for elective surgery within Sweden’s socialized system. At Stockholm’s Karolinska, the wait for knee replacement surgery is currently 20 weeks, down from 52 weeks in 2005. The smaller Södersjukhuset makes patients wait 32 weeks to have their gallbladder out, which is better than suburban Danderyd Hospital’s 44 week wait.
Other than going to one of very few strictly private hospitals, patients have few options but to wait. Right now, they can’t seek elective care at a hospital other than the one near where they are legally residing. That will change in 2009, but the new freedom to choose hospitals will only apply to certain surgical procedures.
The second article mentioned that until recently in Stockholm, patients were not able to choose which primary care clinic to use. Now patients can choose freely, but their new freedom has not yet resulted in enough resources going to the clinics with the most needs and highest volume.
Of course I remember working under this system, but I hadn’t been thinking about the waits and the lack of choice for a while. The private option wasn’t available when I practiced in Sweden. It is a nice luxury option for those few who can afford it, just like flying business class. However, the majority travels economy class through life and has the choice between waiting many months for elective surgeries like knee replacements, and not having them at all.
Maybe Sweden needs to learn from American insurance companies about medical tourism – sending elective surgery patients abroad for what is touted to be high quality, low cost care.