MS Versus the Swedish Healthcare System

By Fredric Andersson

3 min read

In this article, I'm talking about the Swedish healthcare system in general terms.

The cost of MS care

Denied insurance, medical debt, flare-ups due to financial stress, or getting approved for disability. These are just a few of the topics I've encountered when reading about financing MS care. It's unfair that anyone would have to compromise their healthcare because of expensive hospital and medical bills. For the ones not being able to hold a job because of their MS or switching careers to manage, it can be even more challenging.

I am fortunate to be born in a country that affords its citizens universal and reasonably priced healthcare. Living in Sweden allows me tremendous freedom and privilege to not worry about the financial aspect of living with MS. As a whole, I trust the Swedish welfare and healthcare system. The quality of care is generally high. Many of our research hospitals make incredible medical advances. Sounds too good to be true? Well, let's talk about it.

How the Swedish system works

First, let's start with a short rundown of my MS (outpatient) treatment costs.

When I see a primary care physician, go for a check-up, lab test, or get my twice-a-year Rituximab infusion, I pay 100 SEK for every visit. That's roughly 10 USD. When I see a doctor or MS specialist, I pay 300 SEK. A cap known as "högkostnadsskydd" (high-cost protection) prevents patients from paying much out of pocket for their care. So for every visit, what you paid gets tallied. This is cumulatively calculated year-to-year, and if you reach approximately 1300 SEK for that calendar year (125 USD), you've reached the cap. If you go to the doctor again that year, you don't pay for the visit or treatment (terms apply). There's a similar cap for prescription medication (of course, terms apply).

There are exceptions, such as in-patient treatment, most private practices, certain specialists, or emergency care, that generally cost more. But for most people, the above are the prices we pay for healthcare. The cost of care is an important issue, but even universal healthcare at low prices comes with challenges. This issue concerns more than what is (or isn't) left in your bank account. There are plenty of reasons, but here are a few I've encountered when seeking and receiving care for my MS.

Challenges I have encountered

Availability

While the standard of care is high and the price is low, there are issues with availability. Many people, especially those in desperate need of care (treatments, surgeries), may wait many months to see a specialist or be scheduled for surgery. Many ask why they should bother waiting so long and risk being sent home without help. They risk being referred to another doctor, and back on the waitlist. It's a slow-moving system with bottlenecks and frustrating bureaucracy. It can take a real toll on the patient. We even have a saying for it in Sweden: "You have to be healthy to cope with being sick."

Getting inside the walls of the system

Because of issues with availability, many people will know the long-winded dance with your primary care provider. Being referred to a specialist can be lengthy, and even then, you might have to wait a long time for appointments. Primary care was my first stop when I tried to get help for my MS symptoms before the diagnosis. I went countless times and saw numerous doctors but got nowhere closer to an answer. Once my MS symptoms became too much, I was luckily catapulted into the healthcare system with resources and specialist care.

Options for specialist care

The Swedish healthcare system is decentralized and funded by taxes. Finding an alternative specialist care at private practices can feel like an alien concept. Trust and price can be an issue. Because of the high demand for care and comparatively few specialists, some people settle for what they might not be happy with simply because of the limited options and long waitlists. Therefore, some people feel disconnected from their doctor and uncomfortable discussing their questions and worries freely. Building a trusting relationship with your healthcare provider can be challenging.

Finding quality care

When I sought care and diagnosis for my MS, I was reminded of all the challenges with Sweden's healthcare system. Despite the difficulties with universal healthcare, I remain grateful for living and receiving my MS care in Sweden. But I also know that time is of the essence when diagnosing and treating MS. The long waits can feel frustrating and provoking. Regardless of the care you receive, price should not come before quality, but quality should also not be unreasonably priced.

As mentioned, I talked about the Swedish healthcare system in general terms. You can also read more about Sweden's healthcare system.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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Therry Neilsen Moderator & Contributor
Fredric, it's always good to hear from you. It's interesting to hear from a country with universal healthcare coverage. One of the frustrations with Multiple Sclerosis is that paying for care can get brutal. And of course, we do have to wait to see specialists, but at least with a retail health care system, you tend to be able to get care in a fairly timely fashion. The difficulty is that getting that care can completely bankrupt you, and in the end, you still die. We had a very ill cat, and were referred to a specialty cat hospital about an hour away. Max was treated very well, and took all his medicine like a real trouper. but six month and about $5000 later, Max still died. He didn't suffer too long, and we felt good knowing that we did our best for our beloved Max, but looking back on it, we might need that $5000 for our own care one of these days. In some unspecified universe far far away, people recieve the care they need regardless of the color of their skin* and the state of their pocket book. But it's not here now, and I have to admit, I don't see it anywhere on the horizon. *In the United States, people of color receive inadequate care, and women of color die in childbirth at about 2.5 times the rate of white women, and it doesn't matter who or how famous you are. Tennis great Serena Williams almost died in childbirth.
1. Fredric Andersson Member
 <inline-mention username="Therry Neilsen" user-id="4095618"/> Thanks for reading Therry! Getting adequate care should never leave a person at risk of having to empty their pockets. Sorry to hear about Max!
Kim Dolce Moderator & Contributor
Fredric! I was positively breathless with anticipation at learning details of your experience with Swedish universal healthcare, thank you so much for telling us. I even clicked on your link to learn more about Swedish healthcare. It was so interesting to read your particular experiences with the system, and then get a bonus perspective by learning even more. Now that I know PLwMS in the UK, Australia, Netherlands, Sweden, and Canada, and read about their universal healthcare experiences, I see similar pros and cons, including a private tier of healthcare. Here in the US we have socialized medical coverage in the form of Medicaid and Medicare, plus commercial insurance. if we went to universal healthcare, I think it would at once resemble that of other lands but be unique to us. It can be done successfully, but it is such a political hot button topic that I doubt we'll see it happen in my lifetime. 
1. Fredric Andersson Member
 <inline-mention username="Kim Dolce" user-id="4084112"/>, I'm glad you liked the article! Please let me know if you have questions about the Swedish healthcare system. It's such a complex system and virtually impossible to fit into one article.
Gary Chester Member
Great topic, Frederic! It was good to get a glimpse of one European-style healthcare system as it relates to MS. Not comforting to know that your system, like ours in the U.S., has some major flaws (but at least skyrocketing cost for individuals is not one of them). I agree with Kim that we will not have universal healthcare here; the best hope is to make Medicare available at a younger age.
1. Fredric Andersson Member
 <inline-mention username="Gary Chester" user-id="3993319"/> Thank you for reading! I'm sure there are pros and cons to every system, but I think good, effective healthcare should be available and accessible to everyone who needs it, no matter what.