1.

Have the Swedes solved their health care crisis?

Page II

On Monday, August 4, 1975, one month ago, a Swedish hospital chief physician wrote the following in a major Swedish paper: "Every system of course has its advantages and its disadvantages. Without questioning Swedish health care in

many areas still being first class one must still acknowledge that the situation in some respects is disturbing and that the over-all view is less favorable than it was ten years ago. Despite enormous cost increases, the patient waiting lines are growing everywhere. situation for the old and the sick today is, without presumptious words, a dis

grace for our society".

Comment:

The extended care crisis has become chronic and the

Instead of hedging against soaring health care costs, the Swedish governmental take-over caused a sky-rocketing cost. The maldistribution problem and any other imaginable parameter of the so called "crisis" is still there together with an array of new problems, created by the system itself.

2. Did not the Swedes "demand" a socialization?

Maybe some union pressure groups, which have been the true political force in recent years, but the public No! Allow me to quote Irvin H. Page, M.D., editor Modern Medicine, June 6, 1975: "We should immediately dispose of the myth that the public understands and demands certain bills or any bill at all".

Comment: The Swedish Social Democratic party has been able to stay in power by a systematic lolly-pop approach: By selecting carefully certain groups of voters, promising a free lolly-pop for everyone, any party could stay in power indefinitely. It is a simple bargaining process. Paying for doctors and hospital bills was one of those big lolly-pops.

Page III

3.

Isn't there a better utilization of hospital beds in a well controlled system

like Sweden's?

No! There are 7.4 beds per 1000 population in the USA and these are said to be The number of beds in Sweden is 18 and empty beds are virtually unheard of. The average length of stay in hospital is 7.9 in the USA compared

too many.

to 11.9 in Sweden.

Comment:

one cost

Before the "total control" legislation of 1970, there was little utilization control but public and hospital restraint. Now there is a lot of red tape but rubric rose from $1 billion in mid-sixties to 2.77 billion in 1972, and neither the public nor the bureaucrats know how to spell "restraint". Parasites don't want the death of their host so the bureaucrats proliferate and happily propose new and extended health services.

4. Do differences in vital statistics reflect differences in the quality of health

care in Sweden and the USA?

In the quiet backwaters of norther Europe, the Swedes are exposed to a very small number of diseases compared to the 211 million American citizens, gathered from all corners of the world. Think of sickle cell anemia and high blood pressure, that kill millions of blacks prematurely, tuberculosis in Indians and other prone groups and an array of infections, not seen in Sweden.

5. Don't the uniform and egalitarian Swedish hospitals create an atmosphere

with relaxed attitudes, where employees can give more tender, loving care to

everyone?

Page IV

The answer is frustrating: Sweden has a depersonalized, factory-style, assemblyline care, unchallenged by all other nations, (with the possible exception of New York City's Hospitals). A Swedish ward nurse is not supposed to spill her precious time "gossiping" with patients. The nurses unions have in vain protested about these working conditions. Of course, no other categories are supposed to talk to the patients either. TV's may be found at the end of the hall, where patients least in need of it may gather in the evening.

Comment: The Swedes are often found boasting over their living standard, which including all coverages, benefits and pensions would challenge even the USA s. disagree; living standard has to be something more than only being kept alive. that respect, the USA is unchallenged by Sweden and probably otherwise too.

6. Is there nothing the USA could learn from Sweden?

I

In

Maybe. I'm thinking of the regional planning to avoid wasteful duplication of expensive services and the Swedes more realistic approach to pregnancy and delivery, routinely only three visits to an M. D. are made before delivery and if no complications are anticipated, midwives will take care of the delivery. But these things seem to me already implemented in the recent law, National Health Planning and Resources Development Act.

Discussion: Between 80% to 90% of this country's population has access to the world's most sophisticated health care, highest standard of living, standard of education and so forth. The fact that the services seem prohibitively expensive for some groups of citizens does not warrant the term crisis. This term is minted on the presumption that costs are too high and unreasonable. simply not so. What the public and some pressure groups fail to understand is

This is

Page V

the fact that the cost of pushing up life expectancy one year for a whole nation today may be tenfold what it once cost to lift it up from 65 to 70 years, but the demands for continuing improvements are there. It is said that the Swedes in choosing between an annual trip to their beloved Spanish Island of Mallorca and a good health care probably would choose both! This has been the situation the last few decades and possible because of an unusually favorable economical developement (entirely within the private sector).

The reasons for legislating a National Health Insurance in this Country are exactly the same as we know from the government take-overs in Great Britain; Sweden and lately Australia. The experience from these and other government run health care systems could be put on blueprint: Confiscatory income taxes, flourishing bureaucracy, inefficiency, widespread abuses and skyrocketing inflation plus serious economic burdens on industry. What do these countries have in common? One thing for sure: Socialist governments, sensitive to labor pressure. Personally, I cannot remember any one union in Europe showing any degree of

restraint.

Economists predict "worst" recession for 1978 with a double digit inflation returning in 1977. Government has directed fiscal and monetary policies exclusively at stimulating consumption while retarding investment. The prediction is, with present economic policies, an unemployment of staggering 12% by 1979. We must ask ourself what we are doing if we add to this increased taxes and increased spending by an imaginary "free" health care.

Page VI

If this Country embarks on the route towards "free health care" for the needy, we know for sure that we are inviting and getting worsening inflation, stagnation, unemployment and a bureaucratic health industry, paralyzed by suffocating rules

and regulations.

Ignoring the warnings, the Swedish government found severe unemployment figures With added taxes unemployment programs had to be started (but not by stimulating the economy; that is not to their liking and less palatable for the politicians, who want to please their voters and the unions). Retirement age was cut down in

steps from 67 to 60 years, thus removing people from the market, mandatory schooling was expanded, thus delaying people from entering the market. Schools and universities were suddenly open for next to everyone, unemployed at unemploy ment offices were offered courses in welding, lumbering, carpeting, etc. and these too them were "off" the unemployment list, but the courses did not lead anywhere so the men were back to the agencies again, only to accept another course and so on. These are only a few examples of the Swedish large scale unemployment cover up.

Let's not make ourselves any illusions about NHI: Taxes will increase, inflation will worsen, and an army of bureaucrats will tell doctors and hospitals how to work and patients where to go. If doctors are made employees of the government

the much needed doctor-patient relationship goes down the drain as in Sweden.