Health Care

I’ve been asked about the Norwegian health care system a few times, so I thought I’d write about my (thankfully) limited experience with it.

When I first came to Norway, I had to register as a resident and then wait for my personal number, the Norwegian equivalent of a US social security number. Once I had my personal number, I was then in the health care system and able to register for a doctor, or fastlege, either online or by phone (+47 815 70 070).*

Now I ran into a bit of trouble actually figuring out the fastlege website, unsurprising considering that it’s in Norwegian. This led to me calling the health care phone number. Now one important thing to know about Norwegians is that they excel at rule following and conflict avoidance. Conflict avoidance paired with one confused and frustrated person, me, did not lead to a great phone conversation. Our circuitous 30 minute conversation can pretty much be summed up below:

Me: Hi, I’d like to register for my fastlege
Customer Service: Who would you like to register with?
Me: Well I’m having trouble with your website and would just like to have a doctor who is based close to me in Trondheim.
Customer Service: I’m sorry I can’t do that. Normally people just call and tell me which doctor they want. I’m also in Oslo so I don’t know the Trondheim area well.
Me: Well can you assign me any doctor in Trondheim.
Customer Service: Well, no. I’m sorry, but this isn’t usually how things are done. You need to tell me what doctor you want. I can’t help you.

After much convincing, I finally managed to get the person on the phone to assign me a doctor. Though instead of assigning me a doctor in Trondheim, they decided to give me one in another city. So my first experience with the Norwegian health care system was a pretty frustrating one.

After that encounter, I decided to give up on the phone line and eventually managed to piece together parts of how the fastlege website works. Here’s a bit more about what I’ve learned. While the website is far from grand, you can narrow down the list of doctors to a particular city. The problem that I was running into was that it shows you all of the doctors in the city, not just those that are available. To make things more complicated for me and my limited Norwegian, the way you can tell if a doctor is available is by looking at the last column of the website, titled “Ledig.” Google Translate has “ledig” translate to “free,” which to me originally meant that the column should be filled with some equivalent of yes/no or true/false. Instead you’ll see numbers. One of my initial downfalls was thinking that the number stood for the number of patients the doctor currently has (a zero would mean no patients while a high number would mean that the doctor was stretched thin). The numbers actually tell you the complete opposite–how much availability a doctor has (a zero would mean that the doctor cannot take on more patients, while a number will tell you how many patients a doctor can take on). And it is here that my knowledge of the fastlege website comes screeching to a halt.

One other interesting thing to note is the way that a doctor’s prescription works. Because Norway is hip with technology, a lot of your information in Norway is tied to your personal number, and this includes prescriptions. In fact, you can usually just go to the local pharmacy, tell them your personal number, and have your prescription handed back to you. Your doctor just inputs all of your prescription information online, and it’s accessible to every pharmacy in the country. Pretty neat!

Having universal health care has certainly seemed great. I haven’t really had to use the health care system since coming here, but it’s clear that its very presence (rightfully) gives a good deal of comfort to many Norwegians. Many of my students have said that they find the US health care system confusing and expensive, before proceeding to tell me how awesome it is not worry about their health (part of the reason why I suspect they tolerate such icy streets during winter–they don’t have to worry as much about injuries). And while I am a supporter of universal health care, I will be the first to admit that I cringed when I saw more than half of a paycheck go to taxes. The welfare state certainly comes with a price, and while I don’t think it will ever fully reach the United States, it’s been great to see how well it works here in Norway.

*One neat thing about Norway is that once you have a bank account set up, it’s possible to use your BankID as a login for a number of Norwegian websites, including the one for your fastlege.

The Svalbard Museum

My second day in Svalbard was much more low key. This time I was able to see more of the town simply because there was more daylight, and when I say daylight I really mean twilight. After about a 40 minute walk, Sarah and I made it to the University Centre in Svalbard (UNIS) and Sarah dropped me off at the adjoining Svalbard Museum.

The museum was great and full of useful information (pretty much everything below is taken from informational slides in the museum). Svalbard was originally seen as international and communal land; however, with the rise of the coal mining industry it became important that there be a governing body that could settle disputes. Things were finally established at the end of World War I with the Svalbard Treaty. In the treaty, Norway was given “absolute and unrestricted sovereignty over Svalbard.” However there are a few restrictions on this sovereignty. Norway is required to give the citizens and companies of the Svalbard Treaty signatories (as of 2005 this includes Afghanistan, Albania, Argentina, Australia, Austria, Belgium, Bulgaria, Canada, Chile, China Denmark, Egypt, Estonia, Finland, France, Great Britain, Germany, Greece, Holland, Hungary, Iceland, India, Italy, Japan, Monaco, New Zealand, Norway, Poland, Portugal, Romania, Russia, Saudi Arabia, Spain, Switzerland, Sweden, South Africa, The Dominican Republic, USA and Venezuela) equal rights regarding:

  • Entrance to and residence on Svalbard
  • Fishing, hunting, and trapping
  • Maritime, industrial, mining and commercial activities
  • Acquisition and utilization of property and mineral rights

Norway is still allowed to regulate the rights above, it just isn’t allowed to discriminate against a particular country. Svalbard itself is under the jurisdiction of the sysselmann, or the governor. The governor is not elected by those living on Svalbard, and is a part of the Norwegian administrative system. Fun fact: even though the sysselmann is part of a bureaucratic hierarchy, apparently the status of the sysselmann is the same as that of the king of Norway.

Because Svalbard is in some senses an international territory, the taxes and fees that are collected on Svalbard can only be used to benefit Svalbard’s residents. There is income tax on Svalbard, but there is not VAT (Value Added Tax) or fiscal taxes. The Norwegian government also helps subsidize the Svalbard budget.

Right now about 60% of Svalbard is covered by glaciers. That’s 36,600 kmof land covered in about 7,000 km3
of ice. Svalbard’s glaciers and mountains add new dangers to living in Svalbard, mainly in the form of crevasses (people will occasionally fall in them when they are covered with winter snow) and avalanches. Yes, the total number of things I could severely hurt myself with or die from on Svalbard was at about four (frostbite/cold, polar bears, crevasses, avalanches). It felt good to be alive on Svalbard.

Svalbard was discovered as Northern European nations looked to find a Northwest passage to the East. They didn’t find such a passage, but they did find whales, seals, and walruses. Whale and seal products slowly became more popular as the European demand for oil increased. In order to meet this demand, whaling was developed and in 1612 organized whaling came to Svalbard.

Until the 17th century, whaling was done near Svalbard’s coasts and inside the fjords. As whaling continued year after year, more permanent settlements were slowly built. In order to actually catch a whale, numerous boats were used. The whales were essentially hit multiple times with harpoons and then sailors waited until the whales tired out from fighting the sailors and from blood loss. The whale was eventually dragged back to shore where it was finished off and then processed for oil. You can get an idea of what these settlements looked like how whaling worked from the pictures below.

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Svalbard was originally located down by the equator, which is what allowed it to develop coal deposits. Once whaling and trapping died down in Svalbard, coal mining gradually began to replace it; however, the mining industry encountered low oil prices in the 1970s. The price of coal was so low that in order to save Store Norske, the big Norwegian mining company on Svalbard, the Norwegian government had to buy nearly all of its shares in 1976.

Because the company was now owned by the State, it became politically necessary for Longyearbyen to transition from being a company town to being a family friendly town. Normal welfare and public services were introduced in Svalbard starting in 1975, and the State introduced or expanded education, hospitals, the postal system, administrative system, and telecommunications. These days the services offered on Longyearbyen exceed those found in some of the more rural areas in mainland Norway. Though with regards to healthcare, there is only one doctor that services the approximately 2,000 people living on Svalbard. What really helped normalize Longyearbyen however was the opening of the airport in 1974, effectively ending Svalbard’s long periods of isolation.

Things have continued to expand since the 1970s. In the 1980s, the coal industry was again hit with a crisis. This prompted the development of more businesses on Svalbard, particularly those related to research, tourism, trade, and services. The university, UNIS, was established in 1993.

Right now, Svalbard is considered more of a research town than a mining town (they actually have super fast fiber optic Internet due to all of the research that goes on). In fact, coal prices hit another low this year, causing the coal company to be in the red. Apparently this prompted the company to make a joke presentation at this year’s holiday party proposing that the government replace the coal industry with the timber industry. How can you tell this is a joke? There are no trees on Svalbard. How’s that for an arctic desert? But even though it’s a silly presentation, it does speak to a wider problem. As coal gets more and more expensive to mine (if I remember correctly there is only one working mine out of the ten that exist near Longyearbyen) the communities on Svalbard will have to start coming up with alternative ways to get fuel.

Once I finished reading through all of this history, I had a fun time looking around at some of the animals on display. The polar bear was huge in reality. On all fours it came up to about my shoulder (around just over four feet/1.2 meters tall). Sarah actually told me that one of the professors she works with was responsible for shooting it. Apparently he was so against shooting the bear he waited until it was 1.5 meters away before shooting.

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After that we went back to the barracks and spent the rest of the day lounging around one of the common rooms. I had a good time talking to some of the other students and working on some of my knitting. Guys, I’m getting better! Finished fox scarf featured below. Pattern here with the English version towards the bottom.

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One thing that I found interesting was talking about the upcoming solar eclipse. The eclipse is scheduled to happen on March 20th and Longyearbyen is one of the only places in the world where you can see the complete eclipse. This has sparked a huge wave of tourism to the island. The office of the sysselmann has estimated that approximately 50,000 people are flying into the island to see the eclipse. The population of Longyearbyen is just 2,000 people, so it’s literally 25 times more people coming to the island. This also means that the government is worried about people having places to stay. There is one hotel in Longyearbyen that hasn’t even been finished yet (it doesn’t even have walls or a roof) that is completely booked for the eclipse. One friend told me that when she stayed at an airbnb in Longyearbyen, her hostess told her that her house had been booked for the eclipse five years in advance. People are making a fortune renting out their houses, and apparently most rooms are going for tens of thousands of kroner a night. At this point hotels are charging a minimum of 10,000 NOK a night (1322.36 USD/night). The government is concerned that many people will arrive and not only lack a place to stay, but will also lack the necessary protective gear and clothing to survive the cold. There is currently talk of opening the local gym and using that as a place where people can sleep. All in all it seems a bit ridiculous, even more so since the weather on Svalbard is so finicky. There is a good chance that all of these people will show up and that it won’t be a clear day. But oh well. I guess that’s the risk that people take.