Sick-sick-sick Incompetence, part cubed

I am now registered with Försäkringskassan. It only took 3 months and me sending the form 3 times to the 3 different addresses given me by the 3+ people I talked to on the phone for them to essentially add 3 bits of information to their database: my name, my Swedish person number, and the fact that I'm a Swedish citizen. All information that they already know since they have access to the Swedish person register.

But don't fret, the epic isn't over -- all this means is that I am now able to start the process of demanding reimbursement for my part-time sick leave. Something that also apparently isn't as automatic as one would have thought -- despite the fact that my employer has reported when and how many hours per day I was sick, told them how much my salary is and sent copies of the required medical documents that prove that a doctor has decided that I am not fit to work full time. I received a form home in the mail (yes, yay, registration done, new forms to fill out!) asking me what illness prevented me from working, what the symptoms were, if I could have worked full time given different tasks or alternative means of transportation to work, etc. -- in other words, once again information that they already have, this time because all of that is covered thoroughly in the medical forms that they've already received. The end of the form contains a reminder for me to send these forms. I guess they want me to write "post traumatic stress symptoms after a late second trimester miscarriage" in triplicate?

The whole thing strikes me as very Catch 22. If I were as sick as I claim to be, how could I possibly have the presence of mind to fill in all these forms and go through all this bullshit?

What gets me the most is that they have to have all this information in order to decide if they will approve my sick leave or not. I find that bothersome because that means that some office workers will put themselves in the position of diagnosing me from afar based on some information on a paper instead of trusting what an actual doctor who has actually met me has written. I know for a fact that they don't think 2 months of sick leave is necessary for a miscarriage, especially given that mine didn't start until a month after the miscarriage occured. I've looked up their guidelines. But if it comes down to that, I will respectfully request that they stick it in their ear, since their guidelines only account for early miscarriages (and ones where one doesn't witness a nurse flush one's dead baby down a toilet).

In case you're wondering, my vitriol is enhanced by the fact that I saw the movie Sicko last night. The film basically told me how freakin' awesome health care is in all of Europe, and I sat screaming at the television that I beg to differ.

My opinions, I'll say right off, are colored by the fact that I was always excellently insured back home and was never critically ill or injured. However, I've spent lots of time with doctors in my life due to certain chronic illnesses and conditions, so I feel I have the right to compare many aspects of how one is met there versus here. I feel that the quality of the health care I received was hands-down better in the states than it is here. But the quality was not in question in the movie; as Moore puts it, it's not how satisfied a patient is that is the question but rather who gets to be a patient.

Something definitely needs to be done about access to quality health care in the U.S., but seriously -- it's not all that very peachy keen over here, either. The movie either proves that Sweden is alone in getting something pretty-often-wrong that France, Canada and the UK have gotten dazzlingly right, or the film is simply not very balanced and a piece of propaganda more than a documentary. Many of the problems described with insurance companies in the U.S. are very much alive here. A good example is the girl who needed two cochlear implants but the insurance company only wanted to pay for one. Östergötlands Landsting -- the people who decide over health care issues in my county -- came out a few years ago and said they would only allow such operations on one ear (or one knee, if both were broken!) because they were cutting costs. And to me, there's a difference to be seen in "what will our insurance company pay for" and "what proceedures will the hospital perform". I know that such costs are prohibitive to most families and that the insurance company denying payment is essentially the same thing as the hospital refusing to do the proceedure, but I personally feel there's a significant difference created by that word essentially. When both the cash and the hospital are run by the same people, in a culture of "if it works for one person, it works for everyone," the chances of being seen as an individual who needs care instead of as an expense virtually disappear.

I tend to be on Michael Moore's side (especially when his movies don't clearly take one side or the other, which I contend was the case in Bowling for Columbine), but there were so many stones left unturned in this piece. Most notedly, no rebuttal was offered for the claim that the NHS has outrageously long waiting lists for important proceedures, and none of the many people out there who I know are disgruntled with the NHS were spoken to, passed over in favor of talking to doctors and hospital staff about how they themselves rock and a man who claimed the NHS is as uncontroversial to Britons as women's suffrage. Furthermore, talking to a doctor about how much money he makes and how motivated he feels despite working for the government was, I feel, the wrong angle. In my opinion, if he wanted to get to the bottom of pay and incentive differences between socialized and non-socialized medical systems and the effects these have on quality, he should have interviewed a nurse.

He also uses his examples -- France, the UK, Canada -- to make sweeping generalizations about "the entire Western World." In the movie he claims that the U.S. is the only country in the Western World in which health care isn't universal and free. Not true -- health care is not free in Sweden. Nor can it be considered universal in the same sense as he claims in the film -- that a tourist who injures himself in Britain can waltz in and out of a hospital without paying -- since I know for a fact, having visited a doctor here when I was still "just visiting," that non-residents have to cough up the cash. He makes the same claim on his website, quoted by CNN: "In the rest of the Western world, everyone and anyone can be a patient because everyone is covered (And don't face exclusions for pre-existing conditions, co-pays, deductibles and costly monthly premiums)." Again, not true, as we have both deductibles and co-pays here. At today's exchange rate it costs me $16 to see a GP in Sweden and $40 to see the gynecologist.

This is all, of course, on top of the fact that CNN uncovered a bit of cheating with statistics when the film first came out. For example, the studies used to claim that the U.S. spends $7000 per individual on health care and Cuba spends only $251 were made in different years and had different scopes (read more about this here: CNN's response to Michael Moore). The study that said Cuba spent $251 per year also said that the U.S. spent $5,711, and one has to wonder why they wouldn't use that figure if it wasn't a deliberate attempt to exaggerate.

I was probably all wound-up in irritation mode by the time the movie reached what struck me as a frightening bit of self-righteousness. Apparently the guy who had the "most notable" Michael-Moore-hatred website had to shut it down because his wife became ill and they needed to save all the money possible for her treatment. Moore talked about how he anonymously sent the $12,000 that they needed in order to get her care. He showed screenies of the e-mails the man sent in reply to his "Guardian Angel." Well, it's not "anonymous" anymore. By putting it in the movie, it strikes me that he took something charitable and turned it into a childish and self-serving "screw you!"

But there were at least two things right in the movie. The first is that we need a better system in the states. The second is that we really are taught subtly from an early age to hate French people. What the hell is that about? Oh well, I'm sure they hated us first. Silly baguette-eaters and their awesome health care can't be trusted!

(Google Analytics claims that a person from France reads my blog. I'm hoping said person understands sarcasm.)