By Kevin Steinman
One year ago, my wife Ina and I posted our Ikea furniture on Craigslist, watched as four strong men packed up my studio gear, guitars and piano, hugged friends and family after my farewell concert in Minneapolis, and flew to Norway to begin our new adventure here. (Read about my reasons for leaving here.)
Since then I've received six Remicade infusions for my Ulcerative Colitis, and I'm happy to report I feel as healthy as I ever have. When I first arrived in Oslo last August, I didn't yet have a Norwegian social security number, so I felt no small measure of stress as I approached their health system as a new immigrant. The doctor I visited at the University of Oslo health clinic immediately understood that my treatment schedule merited a quick prioritization, so he made up a number for me, just to get me in the system. He assigned me to a private hospital (still covered under the national insurance plan), where they have lots of experience with the kind of treatment I get, and predicted I would be very satisfied with my care. He was right.
U.S. healthcare is too costly for Kevin Steinman, so he's moving to Norway
Kevin Steinman says farewell and thanks to the Twin Cities
Kevin Steinman's farewell show at Bryant Lake Bowl, 7/23/12
Hege, my nurse, explained on my first visit that everyone at her hospital works very hard to make sure patients feel well, and that I was "heartily welcome to continue to receive my therapy there now that I'd moved home" to Oslo. During that first infusion, she asked if I'd like some salmon, since the two-hour treatment was over lunchtime. I automatically declined her offer at first, because I didn't have any money with me; but then it dawned on me that it was probably free, so I said yes, thanks. The lunch was free.
The plate of tasty salmon, salad, and bread which arrived a few minutes later caused me to blink back tears of gratitude, as I reflected on the Saltine crackers I'd always been offered in Minnesota during my infusions. Though no one understands the cause of Ulcerative Colitis, if I were a betting man, I'd wager that preservatives such as the ones in Saltines probably can't help chronic digestive disorders like mine. Here in Norway, I've been served a free hot lunch during every infusion so far.
I should note that I have not bought health insurance here (despite the fact that health care is offered publicly, some people choose to do so in Norway). Still, after each infusion, I pay only the equivalent of around 50 dollars, which covers my co-pay for the Remicade, blood tests and nursing services. This compares favorably to the $5,000-per-dose uninsured cost of the same treatment in the U.S.
After leaving behind the health insurance and out-of-pocket costs per eight weeks in the U.S., my total health expenses are down 97 percent. But that staggering difference in health costs between Norway and the U.S. will only grow larger in August, once I hit my yearly out-of-pocket maximum of $300. (Everyone living in Norway has a yearly medical expense cap of roughly $300 USD, so after August, all the rest of my infusions in 2013 will be 100 percent free for me.)
At no point when I check in for treatment here in Norway does anyone ask whether I am insured, or how I plan to pay. It's a small detail, really, but for me it frames the whole hospital experience here in a radically different light from my treatments in the U.S. Everyone I've met in the health system here has been infinitely more concerned with how I feel, how my treatments are working, and my infusion schedule than with the business questions that seem to crowd the beginning of American doctor visits with a sense of impending doom. To be sure, there are also people in Norway who just handle payment. But here they don't seem to be a part of the problem. They seem, rather, to be a neutral part of a relatively smoothly working system, designed to offer the maximum benefits of health care to all people.
Another glaring difference: here in Norway there is no paperwork for patients. Save for the odd result in which my most recent blood test shows a low level of some vitamin, I get nothing in the mail from my hospital. I see nothing in written form about the costs related to my care. Romney had his binders full of women. In America, I had binders full of health insurance documents, explanation of benefits forms, and bills, not to mention the odd collections notice. On the psychological front I'm feeling blissfully recovered from the onslaught of pressure to pay for my treatments while living with Ulcerative Colitis in the U.S. Incidentally, since selling my car and buying a monthly bus pass, my overall stress level has also gone down significantly.
Now, the fact that I have a chronic disease is a thought that very rarely occurs to me. In America, it seemed as though the whole system was geared toward reminding me on an almost daily basis that I was suffering from something very serious and very expensive.
Meanwhile I've been observing on social media as fellow musicians and friends in Minnesota have struggled through their own health issues, prisoners of the system I left behind which seems to demand a pound of flesh before offering service. I was particularly moved by P.O.S's fans raising $40,000 for his treatments after he was forced to cancel a tour; and the success of Erik Hess's fundraiser concert, which was necessary for him to continue getting treatment at the Mayo Clinic.
Still, these victories should be seen for what they are -- bandages on a broken system, not models for future health. I am disheartened when I read reports of U.S. Congress members trying to overturn the Affordable Care Act, parts of which are scheduled to take effect next year. Far from overreaching, I contend that the changes the ACA is slated make in 2014/15 won't go far enough to protect patients of chronic diseases from risking financial ruin just for embarking on a course of cure.
When I speak with people here long enough to divulge my health history, they are all so pleased by the improvement of my situation that it evinces feelings of pride in a system they otherwise might take for granted. One person I met told me he thinks I should be a spokesperson for immigration in Norway because of how much their system has benefited me. And I guess in a way, I already am. I've noticed that Norwegians complain a lot about their country, and whenever I hear such talk, I share a bit about where I've come from, and just how positively I've experienced their country's health care.
I understand that Norway's not a perfect place, and that even in terms of health care they have their own challenges yet to meet. But I think Norway deserves to be damn proud of the perks its won for its citizens over the last century. It hasn't always been this way -- Norway has consciously prioritized the universal health system that is now in place, just as we in America must do if we are to make similar changes.
For the record, my specialist doctor at Minnesota Gastroenterology sweetly asked me to email him to confirm that I was receiving the treatment that I need. His, and my American nurses' many kindnesses cannot be overlooked. In this discussion the caring workers in the American health industry ought not be made out to be enemies of public health. They are in many ways victims of this tragic injustice as much as chronic disease sufferers are.
No, it is clearly the model of for-profit health care in the U.S. that fails us morally. Everyone ought to be able to afford and have access to the treatments they need to survive. It's as simple as that. America, like Norway, has the resources to accomplish this goal. Can we find the collective will to make it happen? Here's hoping.
Kevin Steinman is back in Minnesota for some shows! Coming up:
7/11 Rochester // Americana Showcase Summer Series @ Legends // 8pm // with Adam Levy, Brandon Sampson
7/12 Northfield // House Concert with Chris Koza
7/18 Minneapolis // Live Letters
7/19 Excelsior // 318 Cafe // 8pm