A small peek into one of the finest health care systems in the world

I have read and heard several times that Norway offers some the best health care in the world. I do not really know what goes into these statistics, but they are currently ranked #11 by the World Health Organization (U.S. is #37). Prior to moving to Norway, I was immersed in the US Healthcare system while working as a Physical Therapist. I was up to date on Medicare and Medicaid laws, understood the importance of working with clients to minimize expenses while they navigated their way through copays and deductibles, watched to make sure no one exceeded their max allowable visits,  and tried my best to maintain constant communication with the client’s physicians and case managers (often times multiple physicians , one for each specialty). It is not easy to navigate through this complex system and it often adds stress to the already stressful event of being injured or dealing with chronic pain.

Moving to Norway, I was excited to learn more about a fully socialized health care system. I had, like many Americans, heard stories from the Canadian system, where people complain about long waiting lists to get elective procedures and limited choices with health care providers. We typically hear those who complain louder than those who are satisfied because the stories of a nice, easy system are boring. It is the opposite with the pictures we share with our friends and family where we are always smiling and having fun, our kids are on their best behavior, and we  are living the American dream. We show our best faces forward and share stories of how great our family adventures are (I am obviously guilty of this:), then complain about how others act, our politicians, and our social systems. So, it was a welcome change for me to get to experience the social health care system first hand rather than just hearing the negative stories second hand.

Fortunately we have all been quite healthy since moving to Norway. No need for trips to the hospital or doctor with sickness. I don’t know if it is the fresh mountain air and plenty of exercise or the cleanliness of the Scandinavian public spaces, but it has been quite nice to  not have sick kiddos. So, I have no experience with the emergency care here, but do have friends who confirm that it is quite easy to get in to see a doctor if you are sick…as long as it is during working hours. Not so easy in the evenings or on weekends, so you better plan to get sick during the work week:) Just joking, you can get care during non-working hours, but you go to the hospital rather than calling your pediatrician or family care doctor as you would during the week (much like the US system in some areas).

My experience with the Norwegian System began with a letter in the mail that arrived the week that Odin started 1st grade. When translated it read that we were to bring Odin to the Centrum Helsestation or Center HealthStation on Tuesday the 17th of October at 9 am. He was to see the doctor at 9 am and the nurse at 930 am. If we were unable to attend there was a phone number to call to change the appointment. We learned that this is a yearly routine health check for all kids in Norway when they start school. There was a questionnaire attached asking the typical questions about allergies and medical histoy, but then there were also several questions about what he eats in a typical day, what hobbies and sports he plays, names of his friends in Norway, what type of outdoor exercise he gets each day, and whether he is independent with self care such as getting his clothes on and tying his shoes. It was quite detailed.

We had no idea what to expect so we showed up 10 minutes early to the Health Station. The appointment started as typical in the US he was weighed and measured by the welcoming nurse then we sat to wait for the doctor. When 9:03 rolled around and the doctor had not come, the front desk nurse apologized profusely and said she was going to go see what was taking so long. The doctor was only 3 minutes late! The doctor quickly arrived by about 9:08 and again apologized profusely for being late…what???? We went to her office where she spoke to Joel and I for just a minute about where we were from, language, etc… She then turned to Odin and mainly interacted with just him for the next 20 minutes. She again did most of the typical US doctor visit screens of heart, chest, ears, etc.. She talked to him about how he sleeps at night and if he likes school, what he likes to do outdoors and what he likes to eat. That was the end…we thought we were done…but then we were directed to the nurse who took us to another room where we visited with her for a full 45 minutes! She again spoke to Joel and I for just a minute then directed her attention to Odin. She spoke to him in Norwegian first then English when he could not understand. She had him look at a book and identify shapes, colors, objects in the pictures and describe what he saw and then would ask him why he thought things were happening in the picture. It was kind of a reasoning or logic test as far as I could tell. Next she had him sit down and do some writing, drawing, and cutting with scissors (fine motor skill testing). Odin’s favorite task was next, jumping, hopping on one foot, throwing and catching a ball (gross motor skill testing). Odin then completed a typical hearing test and vision test.  The nurse ended the session by talking with Odin for about 15 minutes about what foods he likes, does he know that he should eat fish, meat, fruit and vegetables every day. She told him not to eat candy, chocolate, or Nougatti (Nutella in the states) during the week that those were treats for the weekends only. The nutrition conversation was extremely detailed. She also asked him a lot of questions about who his friends were, what he did at recess, and what out door activities he likes. As we were leaving, the nurse mentioned that if at any time with have questions about Odin’s health or issues at school that we can contact her. She also suggested that we go ahead and make an appointment for Adelheyd as well because it is recommended to start these health checks at age 4 (prior to that it is mother/baby health checks).

Adelheyd’s appointment was a month later and was very similar to Odin’s with the exception that they changed the fine a gross motor skill task expectations. The nurse still spent a considerable amount of time talking to her about what she eats, her outdoor play, her friends, her time at school, etc…

Needless to say we were quite astounded and impressed about this process:

1. Accessibility of health care. We were automatically given an appointment and told when to show up making it much easier to ensure that each kid undergoes their health check.

2. Timeliness. Very little waiting which is not the norm in Norway from our experiences. Typically there is A LOT of waiting to get things done. Not with health care.

3. Focus on the children. The amount time the doctor and nurse spend with the children, speaking mostly with the children, not their parents.

4. The emphasis on nutrition and exercise.

5. Broad spectrum of services. The in depth evaluation of motor skills so as not to rely on parents reports which are often skewed to make their kids sound wonderful (I am guilty of this for sure!). The nurse was also interested in social and school related health. I have since heard that they are very on top of preventing bullying in Norway. It is a huge national priority. After all…in a social system everyone should be equal, not picked on or shunned for being different:)

6.  IT WAS ALL FREE!!!!