Having followed both sides of the US health care debate, I approached the Danish health care system with skepticism. I was prepared for long queues, difficult access, and a poor level of care. But, I’ve been pleasantly surprised!
I’m not sure this is the place to be if you’ve got a life threatening illness, there’s too much potential for cost cutting and shortcut-taking. But the more I think about it, the more I see that the US system plays a similar game with PCPs, referrals, pre-certifications, etc. My experience in Denmark so far has well exceeded expectations. It’s at the very least equal to, and in some ways, better than, the private system I was used to in the US.
The CPR number is the Danish equivalent to the US Social Security number. I swear you cannot do anything without one of these. This little yellow card is my health card, library card, and ticket to a Danish bank account, the tax office, and pretty much every other practical aspect of setting up a life here. In Denmark, everyone who has residency (temporary or permanent) or citizenship has health care.
They’ve also introduced something called, NEM ID. It’s basically a single sign-on to the tax and banking system. I enter my username and password, then I get a 4 digit code, which I look up on a paper card that’s sent in the mail. Each 4 digit code corresponds to a single use PIN that I can then use to login. Once I’m out of codes, they automatically send me a new card.
My bank account and the tax office (SKAT) are linked, so my income, interest earned and paid, etc. is automatically shared by my bank with the tax office, and my Danish tax return is figured automatically. As an American, this is an uncomfortable system for me. I’m not used to Big Brother having such easy access to my health records, library records, and spending habits. Yeah, I know, “if you’re not doing anything wrong, there’s nothing to worry about.” Whatever. I’m not a fan of the Patriot Act, either. It’s not because I’ve got anything to hide, it’s because I was raised with a certain expectation of privacy and giving that up makes me a bit anxious. It’s just so — not American. But, the system is incredibly efficient. If I need to book a doctor appointment, I go to a website, sign in with my CPR number and book online. I can email my doctor and receive a reply the next day. I can call any weekday morning between 8 and 9 and speak with my doctor. I have direct contact, not just an empty promise of “the doctor is with a patient, I’ll have her call you.”
My asthma has sent me to the hospital twice, by ambulance once, (costing me over $1200 with insurance), and I’m scared to death of having an asthma attack. So when I moved, I was very concerned about how I’d manage my asthma. I chose a health clinic when I applied for my CPR number and I can see any doctor at that clinic. Shortly after figuring out how to navigate the Danish website, I booked an appointment online, showed up for my appointment, swiped my yellow card, saw the doc, and left without a copay. I waited maybe 10 minutes past my scheduled time, but I’ve had longer waits in the US.
Based on some things I’d read online on various blogs and expat forums, my stomach was in knots at the thought of having to go in and ask to speak English, but no need, my doctor is lovely. She introduced herself by her first name and asked if I preferred to speak English or Danish. Her office was big, bright, and nothing like the dismal inner city Planned Parenthood sort of place I was expecting. She asked a lot of questions about my asthmatic history, and looked up both of my medicines to make sure she was prescribing the Danish equivalent. Then she asked if she could up the dose of my primary treatment because she felt I was using my rescue inhaler too often. I didn’t feel rushed, as I sometimes did in the US and I didn’t at all feel marginalized for speaking English.
The weakest part of the system for me is that we don’t have prescription coverage. Here, I pay for a one month supply of asthma medicine about what I paid for a 3 month supply with prescription coverage in the US. It’s expensive. I hear the prescriptions get less expensive the more you refill them, but I can’t comment on that yet. Refilling. I’m almost out of medicine so I had to deal with that last week. I didn’t know if there were refills left on the last prescription, if I needed another office visit, or what. So, I emailed my doctor and asked for refills. The next morning, I got a reply asking me to call her because she was worried that I might be using my rescue inhaler too often. At first I was annoyed because in the US, I could call up and get refill on almost anything without a hassle. But then, I felt grateful that she had such an interest in helping me control this so I can live without worrying too much about another major attack. I called and explained that I still have most of my rescue inhaler left, but would like an extra one to keep at work. No problem. And she said if my asthma gets worse in the summer or starts acting up when I’m trying to run to be sure to come in for a lung capacity test and so she can adjust my treatment.
OK, so taxes are high, my health situation has been straightforward, and I won’t say I’ve drunk the Kool-Aid, but I’m definitely sipping it. So far, I give Denmark an A+ in health care.
