Sweden


Beginning after the millennium year, I lived in Sweden for ten  years.  Or at least for the warmest six months of every year, snow birding to the tropics or Southern hemisphere for the other six months.

As a permanent resident of the European Union, I have an E.U. health card entitling me to the same health care as a citizen of any of the 27 countries in that federation.  I traveled extensively in Europe for 30 years and sampled the health care system in quite a few of them.  And I have spent the winter months in dozens of countries all over the world, in  many of which I used their health care.  On the basis of my experience, I believe Sweden's health care may be the world's best.

Sweden concentrates on keeping its citizens healthy and active and productive into old age and they live longer and happier than in  almost any other country.  They were probably  the first country to use Artificial Intelligence to run their medical system more than 30 years ago.

For example, suppose I wanted to consult my Swedish doctor within a couple of hours. Before 9:am, I would phone a computer which could "talk" to 100 or more folks at a time.  It would know my phone number from the phone system and would politely ask for my Personal Number.  These together would identify me and it would look at my medical record and my doctor's schedule so far for that morning.  Calls after 9:am would be scheduled for the next morning.

Every Swedish legal resident has a photo ID card with his unique and verifiable  Personal Number, which he may be asked for several times a day.  I cannot imagine how illegal immigrants can get along without a valid Personal Number.

Back to my phone call.  The computer asks me something like  "Can you be at that phone between 10:30 and 10:45 this morning?  Please answer yes or no.  Your doctor will call you then".

Later that morning, when my name is next on the doctor's call schedule, the computer displays my medical history on the doctor's monitor.  With, perhaps, a copy of my mugshot off my ID card.  When my doctor signals he is ready, the computer places the call.

After he has heard my tale of woe, the doctor may decide some medication is indicated.  He does not write  a paper script which can easily be forged, but uses his laptop to prescribe my pills on a secure website.  Any pharmacist in Sweden can swipe my Personal number off my ID card and my unfilled prescriptions will display on his monitor.  He keystrokes his intention to dispense the pills. which takes that item off the available list and credits the pharmacy with the cost of the medication. plus his dispensing fee, minus the co-payment which he collects from me.  The co-pay amount depends on my income tax bracket, similar to the Ontario system.  The computer might analyze prescribing patterns and report any suspicious activity to the authorities.

Or the doctor may want some sort of test or imaging which he arranges on his laptop and promises to contact me when he gets the results

If he thinks a personal consultation is called for, he schedules a visit to his office, probably for the same afternoon.  All important activity is automatically added to my history.

Most Swedish doctors are female.  I had a hernia operation there.  Both surgeons were women, as was the anesthetist.  The only male in the room aside from me. was one of the nurses.

In England, I noticed a good innovation.  To see my doctor I queued up in his waiting room, occasionally for hours.  But in that room was a self-service blood pressure machine which dispensed its results on a paper strip, much like a cash register receipt.  A sign asked patients to bring three such strips with them when called to see the doctor.

Sweden's birthrate is very low and several benefits are offered to try to increase it, including free public transit.  An adult with a small child boards the bus by the center EXIT door, while others use the front door to pay their fare. 

Very generous.  monthly child allowance is paid until a child reaches the age of 16. If you have more than one child, you also get an extra family supplement, which increases further with each additional child. A family with four children under age 16 receives a monthly benefit of about CA$700 per month.  Parental leave is 480 days paid at 80% of earnings.  Parents in Sweden also have the legal right to reduce their normal working hours by up to 25% until the child turns eight.  Preschool child care costs a maximum  of CA$160 per month so  high maternal employment rates keep the child poverty rate at just 4%.  All schools supply free lunches to every child and free education continues into university because the government gives a grant for students.

Sweden has perhaps the world's most generous safety net but all this money has to come from taxation.  Americans believe such tax levels are confiscatory but Swedes seem very prosperous.  A high percentage of families own a summer cottage or ski chalet or both.

The Swedish income tax return was a big surprise.  It came in the mail, all filled out, with every question answered right down to the bottom line - TAX OWING.  And that was a bigger surprise.  It was ZERO!  Sweden thought I was too poor to pay any income tax.

I didn't know I was so poor.  I always thought I was comfortably middle class.  My pension income supports me with only occasional dips into savings.  And my nest egg financed the purchase of a small Swedish house and a big Volvo Estate Wagon, both paid in full.

The big Volvo was a mistake.  Petrol is heavily taxed and my Volvo was VERY thirsty.  The annual road tax was also eye-watering but some of that got rebated. The car license plate stays with the car for life and you get a small tag when you pay your road tax - a different color every year.  The tag has a very clever glue that sticks like death just once and never again.  When we took the car off the road to go south for the winter, we pried the tag off the license plate and found the secret pin number.  We then phoned a computer, gave it my Personal Number and the secret pin number and were told to keep the vehicle off the road.  A similar call in the spring put a new tag in the mail next day and a welcome rebate showed up on my bank statement.

Sin taxes are very high on things like alcohol and tobacco.  I did not notice any poverty,  and no obvious wealth either.  When I left Sweden, the country was transitioning to a four-day work week.  Shift workers had been on a 32-hour week for years and any extra hours had to be compensated in extra time off.  My brother-in-law accumulated four months vacation every year by volunteering overtime on the night shift.

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