Sweden Blog: The good news and bad news

Välkomna till Sverige!  (Welcome to Sweden, Y’all!)

Let me describe Sweden at “midsommar,” the longest day of the year (June 21).  This day is one of Sweden’s biggest holidays for good reason…It’s the most beautiful time of year in Scandinavia, the season of the “midnight sun.”  The midnight sun is only visible as far south as Arctic Circle, which lies several hundred miles north of Stockholm.  But Stockholm is far enough north that it never gets totally dark, even at midnight.  The flowers are blooming and the birds are singing.  The Swedish people are very happy to enjoy the long days.  They wear their skimpiest clothes in order to absorb as many sun rays as possible.  It’s a great time to visit the country, and only the second time in all my Sweden visits to be here in June, since my music tours always took place during the winter.

Sweden is at the top of my most-favorite-nation list, and Stockholm is my most favorite city.  Between 2005 and 2009, I traveled to Sweden every year in the middle of winter to play five musical tours with the India-Jazz band, Mynta.  In the course of those tours, I managed to visit more small towns in Southern and Central Sweden than the average Swede has ever seen.  During my first visit to Sweden in 1971, when I lived in Stockholm for seven months, staying out of the states to avoid the Vietnam War, I began my study of the Swedish language.  Though I rarely have occasion to practice speaking Swedish in Reno, in this ten-day visit, I’ve managed to regain reasonable fluency in the language.  Underlying the circumstances of this visit is the fact that I love the people, the country, and the culture.

The contrast traveling from Qatar, hot and dusty at 40C/102F, to Sweden, cool and rainy at 20C/68F, was clearly visible from the plane.  Qatar and the rest of the Middle East is characterized by bare brown landscapes, with green only found where people live.  Sweden is green all over, with the only non-green colors found where people live.  We were forced to pull out our long-sleeve garments out of our baggage, which had not been necessary during our previous three hot weeks in Israel, Jordan, and Qatar.

Swedish Healthcare

After our first two nights in Stockholm, we traveled by train to the town of Karlstad in central Sweden, to visit a Swedish friend who previously lived in Reno.  Part of our friend’s motivation to relocate back to her homeland was to receive medical treatment through the Swedish healthcare system.  She requires daily nurse visits for infusion treatments and frequent doctors’ exams and tests.  She is ecstatic that she’s never had to pay anything under the Swedish system (except for minor deductibles).  I asked if her taxi fares to the hospital were included, and it turns out that she only pays about five dollars for any taxi ride to a healthcare appointment.  (Under German state healthcare, taxis for healthcare appointments are 100% covered by their national health insurance.)

We visited another friend at his country home outside Stockholm.  Earlier that week, he had been pruning an apple tree, standing on a branch, when the branch suddenly broke, causing him to fall and injure his leg.  He related that he had visited the emergency room, waited about an hour, was seen by a nurse, received x-rays, and finally after another hour was examined by the doctor.  Luckily, no bones were broken.  He is still sore in that injured leg, but is able to walk carefully.  He explained that under his standard Swedish health coverage, he had to pay a deductible of around $50 for that emergency room visit and treatment.  He would have to pay $50 each for two more medical visits during the year, but after he passes a total of three visits in one year, everything else is covered 100%.

Another friend is scheduled to have “ablation” treatment for his heart arrhythmia.  He explained that about eight doctors and technicians will be attending to this surgical procedure, during which catheter probes are inserted to find the correct spot inside the heart ventricle to cauterize.  In order to ensure that the electrical impulses of the heartbeat are coordinated correctly, he will be required to remain fully conscious during the procedure.  The medical procedure is totally covered by the national insurance.  All Swedes with whom I discuss healthcare express that they are thankful to live under the Swedish system as compared with what they know about the American healthcare system.

Yet, all is not well here.  Today’s newspaper reported that 3,000 Swedish doctors are protesting proposed reforms in Sweden’s healthcare system.  Swedish authorities are proposing some of the same reforms that have already been tried unsuccessfully in the US, such as regarding patients as customers (inappropriate for patients who have no choice in their treatments and where to receive them) and paying doctors according to the number of treatments performed (leading to fee-for-service expansion of superfluous tests and procedures, carried out after short rushed visits by the doctor).   The newspaper stated that the reformers’ motivation is to apply innovations from the business world to this government agency.

Swedish authorities would be well advised to consult with American healthcare experts before they institute measures that will lead to the same types of problems that plague the American healthcare system.  In both countries, it’s the case that politicians and businessmen would like to treat healthcare like any other business, which (especially in the US) has resulted in expensive sub-standard care.

Swedish Taxes

          Swedes pay among the highest tax rates in the world (45% according to one friend).  About a third of their taxes goes to finance Swedish healthcare, which includes eldercare and long-term care.  “Medical bankruptcies,” common in the US when someone who doesn’t have health insurance contracts an expensive medical condition, are unknown in Sweden.  In addition, university studies are free to Swedish students.  Swedish students graduate free from the student loan debt that is common in the states.  Also, Sweden has an excellent public transit system (though the bus workers’ union has just gone on strike in Stockholm and several other cities).

We first traveled by train from the airport into Stockholm, and later on the 2&1/2 hour trip back and forth to Karlstad from Stockholm.  The trains are electric, and thus are very smooth, quiet and fast.  Internet service was available throughout the journey.  The standard cruising speed was around 120 miles per hour.  These are regular trains, not the famous high-speed “bullet” trains that travel around 180 miles per hour.  We found it very pleasant to travel by train in Sweden, compared with the stresses associated with air travel.

An Incredible Library

This is the third time when visiting Stockholm that I have had the opportunity to tour the Swedish medical library, the Hagströmer Bibliotek.  This tour was made possible by our friend in Karlstad introducing us to the library’s curator.  This library of over forty thousand books is not open to the general public.  Instead, it is available for use by specialized researchers, visiting diplomats, and visiting luminaries such as Bill Gates (who had received a private tour just prior to my previous visit).

The medical library contains books dating back to early Greek and Latin texts as early as year 800AD, hand-written and hand illustrated books from the early Middle Ages that predate the printing press, as well as the earliest texts in biology, surgery, pharmacology, and dentistry.   The total value of the 40,000+ books has not been calculated, but it is certainly many millions, while certain rare one-of-a-kind volumes are priceless.  Just being in the midst of so many antique books fills one with feelings of humility and awe.  The life’s work of so many scientists and scholars concentrated within one building is astounding.

On the tour, the books are introduced and explained by the library’s curator, Ove Hagelin, whose life work is dedicated to acquiring, cataloguing, preserving, and understanding the many books in this library.  He is nearing retirement, but he has been grooming a successor for a number of years, who will take over when Ove finally retires.  But I don’t know how anyone could know as much about the books in this library as he does.

I took quite a few photos.  Memorable images are shown here, such as the painting of a leper.   Lepers were forced to live in isolated colonies under terrible conditions due to ignorance about the disease.  “Punishment by god” was often assumed to be the cause.  The bacillus that causes leprosy was discovered by a Norwegian, Dr. Hansen, after which the official name was changed from leprosy to Hansen’s Disease.

Another notable image is from John J. Audubon’s first edition book of wildlife illustrations, of the American passenger pigeon.  Passenger pigeons existed in numbers so great that their flocks would “blacken the sky.”  Yet, by the middle of the 20^th century, they were hunted to extinction in America and around the world.  The American bison (buffalo) almost suffered the same fate, but was rescued with only a few animals remaining to be protected and restored to preserve this unique species.

One priceless book was the diary from the ship’s medic on Captain Cook’s second voyage in the 1500’s.  (On his third voyage, Cook was killed in Hawaii.)  It was on this second voyage that the medic discovered that if the sailors ate citric fruit (oranges, grapefruit, etc.), they would not suffer from scurvy, a common sailors’ malady of the time, unknown to be caused by a lack of vitamin C.  Thereafter, English sailors were known as “limeys”, for their habit of sucking on limes and other citrus fruits.

The most shocking images were contained in an English book from the mid-sixteenth century, about a British shipping company’s slave operations being set up in the African country of Sierra Leone.  The illustrations show the way that slaves were crammed into the slave ships and forced to travel across the Atlantic for sale in the English colonies, that later became the USA.  The illustrations shown here demonstrate the cruelty of slavery more directly than any other image I’ve ever seen.  To its dubious credit, England abolished slavery fully twenty years before the US did in the great American Civil War 1861-65.  Of course, slavery has existed for most of human history.  Until modern times, the losers of wars were often forced into slavery to serve the victors.  All the great Roman coliseums and temples found in the countries around the Mediterranean Sea were constructed by conquered peoples enslaved by the Roman armies.

Recent Riots in Sweden

This blog would not be complete without addressing a most unusual recent occurrence: immigrant riots in Sweden.  Some cars and a few businesses were burned, and rocks were thrown at police by the protestors.  The immigrants were protesting their lack of jobs and the racial tension of segregation from ordinary Swedes.  Some Swedes said that the protestors were mostly disaffected teenagers from the suburbs dominated by immigrant residents.

Sweden has traditionally been one of the world’s leading recipients of asylum seekers from repressive regimes around the world.  For example, Sweden has accepted many more refugees from Iraq and Afghanistan than the US has, though it can be argued that the US should bear more responsibility for accepting refugees that resulted from the American invasions.  More recently, Sweden has taken in more than four thousand refugees from the escalating civil war in Syria.  However, the Julian Assange affair (of Wikileaks fame) has shown that Sweden will not necessarily offer asylum to a political refugee that might be subject to deportation under Sweden’s extradition treaty with the US.

To its credit, Sweden extends generous subsidies to immigrants compared with other nations, in accordance with its general welfare policies.  Free Swedish language instruction for immigrants is widely available.  But being a democracy that is open to diverse beliefs, there is a minority political party in Sweden that would like to stop admitting new immigrants and expel old ones.  Unfortunately, “ultra-nationalists” such as these in rightist political parties in Sweden, Greece, and other European countries are reminiscent of the Nazis, based on their antipathy toward other peoples and cultures and their desire for some imagined ideal of national “purity”.

There was a thoughtful commentary in the local paper on immigration issues that mirrors discussions in the US.  The arguments against immigration are typically expressed as:  Immigrants cause unemployment among citizens, consume welfare funding, lower school achievement levels, commit more crimes, etc.  The counter-arguments are:  Immigrants take the worst jobs that citizens don’t want to do; Immigrants pay more in taxes than they take in welfare; Education for all is good for the overall society, especially for immigrants who might not have educational opportunities in their home countries.

Immigration issues in common

The complicated reality of how immigrants are dealt with is similar in Sweden and the US.  Immigrants tend to be stereotyped into low wage manual labor jobs, such as house-keepers, gardeners, farm-workers, eldercare, and the building trades.  The result is a segregation of foreign workers from the rest of society.  Cultural integration becomes difficult if not impossible.  In the US, there is the added barrier of the fact that there is no practical legal pathway for a poorly educated immigrant searching for work to obtain legal status in order to perform menial labor.  But since labor is a commodity that follows the market forces of supply and demand, the US market has attracted and assimilated twelve million “illegal” workers into its labor market.  To deport so many millions of Latin American workers from the US would be an act of ethnic cleansing.  This had led to a long overdue examination of antiquated US immigration laws, which bar desirable skilled workers as well as less-desired unskilled ones.

There is also the issue of how to deal with the children of immigrants, who face the prospect of being hindered by their parents’ lack of skills and education. In the US, children born of immigrants in the US are automatically citizens.  But the status of immigrant babies brought into the US is problematic under current law, which regards them as equally “illegal” as their parents, though these children have never known anything other than the US as their home.  The proposed “Dream Act” would legalize the status of such children.  By contrast, Germany has six million Turkish guest workers living for several generations in Germany, but there is no established path to German citizenship for children of these foreign workers born in Germany. Sweden confronts their variations on these issues, which led to the recent immigrant riots.  Will the US eventually experience violent social unrest if proposed immigration reforms continue to be blocked in Congress?