Healthcare in the United States vs. Sweden and Norway

In the United States, most residents are covered under private health insurance about 67.2 percent. Employer-based health insurance continues to be the most prevalent with 56 percent receiving coverage through work. 19.3 percent of the population was covered by Medicaid and 17.2 percent was covered by Medicare in 2017. Healthcare coverage in the United States is not universal, 91.2 percent of the population was covered for all or part of 2017 under a health insurance plan.

In Sweden and Norway residents have universal coverage. The majority of the residents in both countries are covered by the public health insurance available through the government. There is also limited private medical insurance available for the residents to purchase if they choose to. Currently about 1 in 12 residents in Sweden has opted for private health insurance coverage.

The United States spent 17.8 percent of its GDP on health care in 2016, compared to Norway which spent 9.7 percent and Sweden, 11 percent.

Though Sweden and Norway both have universal coverage available to its residents, healthcare is not free. Residents pay copays for office visits and hospital stay, but there is a spending cap per year. In Norway, the annual limit of expenditure is 2,000 Norwegian krone, roughly $220.61 in U.S. currency. Swedish residents have an annual limit of 1,100 Swedish krona, roughly $120.99. Once these caps are met in a 12-month period, both countries cover health expenses at 100 percent.

Healthcare in the United States is expensive, with the out-of-pocket maximum limit reaching up to $7,150 for an individual and $14,700 for a family in 2017. These amounts do not include the monthly premiums each individual is responsible for paying.

If an individual is covered under Medicaid, then they do not have any out-of-pocket expenses for covered medical services. Medicare Part A has a deductible of $1,340 per year, and Medicare Part B has an annual deductible of $183. Without a Medicare Supplement or Medicare Advantage plan, Medicare beneficiaries do not have an out-of-pocket maximum, so they could end up paying a lot more for their medical expenses.

The health systems in Norway and Sweden are largely funded by taxes. The majority of the hospitals in Norway and Sweden are owned and operated by the government. In the United States, about 21 percent of the hospitals are federal or state government hospitals. Most physicians work for the public health systems in Sweden and Norway, whereas in the United States, the majority of physicians work for private organizations.

Both Norway and Sweden have a decentralized health care system. The goal of both countries is to move the healthcare away from the central government. They transfer authority to the local governments; however, the federal government does have overall managerial authority. Sweden has local municipalities which are responsible for deciding what is covered under the public health system. The biggest issue Swedish and Norwegian residents face when it comes to health care is receiving care in a timely manner. Sweden passed a law in 2005 which guarantees its residents receive health care when they need it. Swedish residents are guaranteed a primary doctor’s visit within 7 days and a specialist or operation within 90 days of seeking treatment. Norway is also improving at reducing their wait times, with the average sitting at 60 days to start treatment.

Norway and Sweden have a better overall health system than the United States though it is not perfect in either country. The greatest difference in the health care systems of the United States versus Norway and Sweden is the cost for the residents. The out of pocket spending for healthcare is much lower in Norway and Sweden than it is in the United States. Both countries also offer universal healthcare coverage, whereas in the United States there is still a high number of uninsured residents — about 12.2 percent in 2017.

Raman Kaur is a student at Eastern Washington University studying for his masters in public health.