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.

Is This Country Crazy?

One of the best parts of the Fulbright retreat was being able to shoot the breeze with other American expats (if you are interested in another account, my colleague Lud Baldwin has quite a funny one on his blog). Living in another country will always present a new set of challenges ranging from the mundane to the more complex, and while that is common to expats everywhere, I think that being American presents its own set of challenges. As the token American in most conversations, I am often asked a lot of questions about my home country. In the classroom, I’m asked to go a step further and teach about America. But although Norwegians tend to be too polite to ask me hard hitting questions, it is clear that they are uninterested in the very tired refrain that America is the “home of the free, and the land of the brave.” Not that I would necessarily even provide them with that song and dance.

Since coming to Norway, I have been asked to talk about some of our more controversial topics: immigration, Edward Snowden, the war on drugs, the Vietnam War, our political system. Because most of my conversations about America do take place in the classroom, my role has largely been to try and present America in an unbiased way. To give my students the facts and to clearly articulate the pros and the cons of American thinking and American policy. Yet it is not unusual for my students to be confused. Teaching the facts does not always result in acceptance. I am occasionally left with the impression that they think America has gone crazy.

So this leads me to my title. One of my co-teachers, Maria, who also happens to be an American expat, sent me this article on the Huffington Post. Entitled “Is This Country Crazy?” (yes, I stole her title) the article is written by Ann Jones, a fabulous, if intimidating, former Norwegian Fulbrighter, and it spends some time delving into the American expat experience and the broader perception of Americans abroad. And while Ann does a great job of talking about the ways in which Americans are viewed today, talking to other American expats makes me realize how far back this negative perception of Americans extends. As someone who hasn’t lived in Norway for an extended period of time, it’s been interesting to talk to Americans who have been here since the 1960s. It is from them that I learned that being an American was not something people have advertised in Norway until the election of President Obama. The Vietnam War was highly unpopular in Norway, and if my students are any barometer of popularity, still is. If anything, our reputation only went further south with Bush, although it has recovered somewhat in recent years. And yet…I still wouldn’t necessarily say that we have a great reputation abroad.

Since coming to Norway, a slew of major events have happened back in the United States that I have found difficult to explain:

  • Explaining the deaths of Michael Brown and Eric Garner in a country where racism isn’t talked about and crime, much less police brutality, is not a major concern.
  • The midterms elections having the lowest voter turnout in 72 years at 36.3%, while Norway routinely has a voter turnout of over 70%.
  • The Rolling Stone article “A Rape on Campus.” The article was later questioned for accuracy, but it gives an incredibly damning portrayal of sexual assault on college campuses. And while the reporting was later shown to be inaccurate, that does not diminish the severity of sexual assault in the U.S. People in Norway are rightly horrified when I say that 1 out of 5 U.S. women will be assaulted in their lifetime.
  • The difficulty of implementing Obamacare (it’s on round two in the Supreme Court) and why so many people reject the idea of national healthcare, when Norway has had universal healthcare since 1956.
  • The measles outbreak in the United States and why so many people question vaccines (granted Norway as well as other European countries also have their share of people who don’t believe in vaccination).

These events, and many others, are shocking. But it’s strange to be in the position of an outsider. While I get status updates on these events on my Facebook Newsfeed, that is hardly the same as experiencing them or their reactions myself. I had no civil rights rallies to attend or extensive conversations to engage in over these issues. Reading about these events is not quite the same as living through them. Yet I am the person who is called upon to give a voice to what is going on back home. To explain these events which I cannot quite experience by virtue of being abroad.

This in between, or this sensation, is even well articulated by the very word “expatriate.” “Ex” meaning outside and “patria” meaning country. As expatriates we our outside of our country, yet it is unclear where we are instead. We are stuck. Not quite being a part of our home country and yet not being a full citizen of our host country. And yet we are still largely held accountable for what goes on in our home countries.

I may not have a good answer as to whether or not the U.S. is crazy. Some days it feels as though it is, while on other days it feels quite good to be an American. The only thing I, and the other Fulbrighters, can do is to serve as cultural ambassadors. As representatives of the U.S. government and the State Department, we can only hope that we can explain some of the more “crazy” aspects of American culture and even talk about the aspects that we disagree with. Overall I hope that when I leave Norway I leave people with positive memories of Americans and fewer questions about America.

Politics and Social Science

I was invited early on in the week to guest teach in a Politics and Social Science class. While I readily agreed to teach the class, I have to admit that I was a bit apprehensive considering the small disaster my last guest lecture was. This time, I consulted with my main co-teacher at Byåsen and was told that the students I would be working with would have a pretty good grasp of English. Still, just to be safe, I made sure my lecture was on the simpler side, which I think helped make the lesson a success.

I was asked to teach about voting in the United States and started out by covering some very basic voting qualifications:

  • Be a US citizen (in Norway if you are allowed to vote in regional elections, municipal elections, and stand as a municipal candidate as long as you have been a legal resident for at least three years)
  • At least 18 years of age on election day (the same policy applies in Norway)
  • A resident of the state in which you register (not applicable)
  • Not currently serving a prison term (felons are allowed to vote in Norway)
  • Not currently on parole or other post-release supervision (felons are allowed to vote in Norway)

After covering these basics, I explained that in the United States you need to register to vote–something that is not required in Norway.

Then I went on to explain the political parties. Again, my students thought that the Republicans were a bit strange and had a much easier time understanding the Democrats.

From there I talked a bit about what Americans vote on in elections. I didn’t get too involved when explaining presidential voting since I was pretty sure explaining the electoral college would get too confusing for the students. Next, I talked a bit about what sorts of issues Americans vote on. In order to engage my students a bit more I showed them a commercial for this November’s midterm elections. Most of the students that I’ve worked with are very very quiet so I was hoping that showing these students a celebrity studded commercial might make them a bit more talkative:

Thankfully my strategy worked! They liked watching Lil Jon transform his hit song “Turn Down for What” into a song about voting, and they had fun identifying some of the other people that appeared in the video. The video also gave them a really good idea of ballot issues. The commercial is almost overwhelming in the number of topics that it raises, and from a teaching perspective it meant that none of my students had a problem raising their hands to answer my question “What are some of the things Americans vote on?”

After that I talked a bit about how despite star laden commercials and encouragement to “Rock the Vote,” the United States experienced its lowest voter turnout in 72 years this past midterm election. The number is pretty grim at 36.6%. Because I didn’t want to leave my students with the idea that most Americans are wholly indifferent to politics, I spent some time explaining some theories on why voting rates in the United States are low. Some of the most popular theories are:

  • Voter Registration. The United States is one of the few democracies that requires voter registration in order to vote.
  • Tuesday Voting. Voting on Tuesday made a lot more sense when America was a predominantly agricultural society. Because people lived so far apart most voters would travel into town from long distances. This meant that having voting on Tuesday allowed eligible voters to spend Monday traveling into town before voting on Tuesday. Weekend voting wasn’t a practical option at the time because citizens were going to church on Sunday. Clearly the  Tuesday voting system doesn’t make much sense in a modern day context, but we have yet to catch up with the times.
  • Felon Voting. Again, the United States is one of the few democracies that does not allow current (and in some cases former) prisoners to vote, disenfranchising a significant number of the population.

If you look at the first two reasons you can see that they have a lot to do with convenience. In fact, studies on this last midterm election show that states that allow for mail in voting or early voting have high voter participation rates. But making voting easier won’t necessarily solve America’s participation problem. In fact, even though some states have made it more convenient for their residents to vote, no state had a voter participation rate higher than 60% in this year’s midterms.

After this I talked very briefly about how the United States has implemented different types of voting restrictions over time. I decided to show them part of another video, this time one showing current Harvard students taking and failing Louisiana’s 1964 literacy test. Literacy tests were designed to disenfranchise different groups of people because they were almost impossible to pass:

If you want to learn a bit more about the test you can go to the YouTube page and read more under the video’s description.

I then wrapped up by talking about modern day voting restrictions. Currently many people in the United States are talking about photo identification laws. These laws require photo ID in order to vote in certain states, and they currently disenfranchise an estimated 23 million voting aged Americans (approximately 11% of Americans).

After that I was done lecturing and it was time for an activity. I provided my students with a list of potential 2016 presidential candidates and groups of two were supposed to report on a candidate to the rest of the class. Unsurprisingly, Hillary Clinton and Joe Biden were the first candidates that my students wanted to present on. I did however stop them from only reporting on Democratic candidates and made some of them look up Republicans. While not all of the students were enthused about their candidates (none of them liked the Republicans) it was fun walking around and helping them understand what these candidates believed in and explaining political terms such as “polling” and “pro-choice”.

Bank Security Compared

About a week ago I finally got everything I needed to get access to my Norwegian bank account! This also made me realized that I’ve had to open quite a few international bank accounts over the years. At last count, I’ve had to open accounts in:

  1. United States
  2. United Kingdom
  3. Norway
  4. India
  5. South Korea

and although I don’t use all of these accounts, or regularly check them (in fact I’m pretty sure the accounts in India and Korea are empty if not closed), I thought it’d be interesting to compare the level security required by each country’s banks.

United States

In the US I’ve always gone to the bank to open up a new account (and this distinction will become slightly more clear later on). In my current US accounts, all I need to access my account information online is a username and password (but if you forget either of these things a much more thorough process is initiated to confirm your identity). That’s it. To access your account at an ATM you have to have a PIN, but you have the freedom to pick your own PIN code.

I don’t have any credit cards that are chip and PIN, so at the end of the day the only pieces of information I really need to remember are: online username, online password, and PIN for ATMs.

United Kingdom

Security gets a bit tougher when you open an account in the UK. Again I went to the bank to open this account and was able to get online access. The interesting thing is that I have to have both an online password and what they call a piece of “memorable information” (which I think of as a second password). Whenever I want to access my account online I need to type in my password and then answer questions about my memorable information. The questions are usually along the lines of: What are the 3rd, 5th, and 6th characters of your memorable information? The questions about the memorable information change each time I log on, thus enhancing the security of the account and ensuring that whoever is logging onto your account genuinely knows what the piece of memorable information is.

My account also comes with a debit card that has a pre-assigned PIN number.

So, I need to remember the same things that I do in the US, but I also need to remember my piece of memorable information and my debit card PIN.

Norway

Norway has the strongest security that I’ve seen by a wide margin. When I opened my bank account they explained to me that in order to access my account online or to use my debit card online I would need up to three things: my online password, a pre-assigned PIN code, and a code that I get from my own personalized bank device. Unfortunately I have no idea what the machine is called but here is a picture:

2014-10-01 15.07.42

Every time I want to log into my bank or approve an online transaction I just push the button on the left and then input whatever number flashes on the screen.

I also have a pre-assigned and separate PIN for my debit card.

So, I need to remember: my username, password, online PIN, debit card PIN, and have the bank device to use my Norwegian bank account.

India

The company that I worked for in India was responsible for setting up my bank account, which meant that I never actually had to step foot in the bank. This also meant that once I had my debit card up and running I made no attempts to actually try and get the account online. So I unfortunately have no idea about to the level of security required to access an Indian bank account online.

South Korea

Again, my employer was responsible for setting up a Korean bank account for me. This time I actually did entertain the idea of trying to access my bank account online, but I was told by my co-workers that if I wanted to do that I would have to download special security software onto my computer and phone. Korean banks won’t let you access your account online unless they are reasonably certain that your device has enough security. This being said I gathered that once the security software is actually installed, all you needed was a username and password to access your account information.

While I don’t actually have too much to report when it comes to Asian online bank security, banking around the world has definitely been a learning experience. Overall, I’d say that US banks have the lowest level of security, while European banks have the highest amount of security. While trying to count out the different characters of my memorable information is a bit annoying, as is inputting three types of information to get a simple online transaction approved, it is comforting to know how seriously my UK and Norwegian banks take my accounts’ online security. Hopefully some of the security practices I’ve seen in Europe will eventually make their way over to the States.