Say Hello to Yellow: State-Sponsored Healthcare in Denmark

by Brittany Shoot
– Denmark –

Danes are often dubbed “the happiest people in the world” by the U.S. media, and this may be due in part to Denmark’s advanced state-managed, single-provider healthcare system. Every citizen – as well as every refugee, immigrant of temporary or permanent residence, temporary worker, and international student – has full state healthcare coverage. Everyone carries a sygesikringsbevis – a plastic yellow card imprinted with a personal identification CPR (centralized persons register) number.

A system surprisingly lacking patient paperwork and bureaucracy, the Danish set-up efficiently tracks everyone’s medical history using their CPR number. Showing up in a physician’s office only requires a swipe of the card to pull up all medical records. Every doctor’s visit is covered in full, as is prenatal care, hospital births, major surgeries, and many cancer screenings. Some elective surgeries like tubal ligation are also fully covered.

Unlike private insurance providers in the U.S., state-managed Danish insurance policies never exclude anyone based on pre-existing conditions. However, they do not cover the cost of dental care, glasses, holistic treatments, and elective plastic surgeries.

Prescription medications are subsidized – the more you spend, the more your discount increases. People like me – who take several daily medications and require expensive prescriptions for pre-existing conditions – never have to experience the stress of paying inflated prices for medicine. Since moving to Denmark, my migraine medication cost has decreased – both due to state subsidies and less patent restrictions – from $45 a pill to roughly $2.65 per pill.

Under the Danish system, it is always a patient’s right to choose his or her own doctor, and one may switch physicians in their area for a small fee of 165DKK (roughly $30USD). Since medical records are in an electronic database, it’s simple to change providers and get referrals, though waiting times for appointments vary much like they do in the U.S. But in Denmark, when one’s primary doctor is unavailable, you can choose to see any other convenient physician for no additional fee.

Denmark’s system is funded by high state taxes – anywhere from 45% to as high as 62% for wealthier citizens – which are automatically deducted from one’s paycheck. Many people believe that despite high taxation rates, the state healthcare system – and other state provisions and subsidized programs – are cheaper and easier than personally paying outright for services and haggling with insurance companies. Salaries are much higher here, due in part to strong unions and protective labor laws, thereby balancing the high-taxation system and leading to increased savings for everyone.

And if you’re unsatisfied with the state healthcare coverage and facilities, private insurance can be purchased at a premium. Private physician and hospital care is available for an additional fee if reducing the wait time for non-emergency surgery seems worth the extra payment.

The one major drawback to Denmark’s system is that unlike the “pharmacy culture” of the United States, 24-hour pharmacies – apoteker – are spread few and far between. Most pharmacies are only open Monday through Friday until 5:30pm. At least one select apotek is open 24-hours in every region, but that may mean driving 50 kilometers to pick up a prescription – and that’s assuming you have a car. While most are stocked with over-the-counter basics like toothpaste and vitamins, anything stronger than ibuprofen and children’s cough syrup can only be obtained with a prescription.

However, in after-hours emergency situations, a rotating base of on-call physicians answer a nationwide phone service and advise whether emergency care should be sought. Unlike the difficult choices I’ve previously made in the U.S. about whether or not to go to the emergency room and face the financial aftermath, emergency visits are just one more state-funded service that keeps anxiety low—and care accessible to all.

In an ethical system that strives to protect every person equally, Denmark’s single-provider system places greater emphasis on preventive care, leading to less fear of becoming sick or injured. There is no bickering with insurance companies unless one opts for a private plan. No one has to make tough, unnecessary choices about which prescriptions to fill or whether to seek care based on cost.

For my Danish partner and me, it’s been a dilemma to decide where to live. He’s never lived without a medical safety net, and has seen firsthand my negative experiences living without healthcare in the United States. When looking at the advantages of the Danish system, I know I’m not alone in thinking that an inclusive state medical plan would count more Americans among the happiest people in the world as well.

Brittany’s article is the first piece in our series that examines the benefits and drawbacks
of various healthcare models around the world. – Ed.

About the Author
Brittany Shoot is an American writer living in Copenhagen, Denmark. A longtime member of the Feminist Review blog editorial collective, her writing has also appeared in a variety of print and online publications including Bitch, make/shift, WireTap Magazine, and Religion Dispatches.
Brittany earned concurrent Bachelor’s degrees in Women’s Studies, Communication, and Psychology, and has a Master’s degree in Visual and Media Arts. She likes to think of herself as a recovering academic but suspects that another degree in animal ethics might be in her future. A vegan and empathic animal advocate, she hopes to eventually operate her own farm sanctuary. When she isn’t taking photos with vintage film cameras and eating avocados, Brittany can be found moonlighting as a teacher, pet sitter, and farmhand. Visit her website at www.brittanyshoot.com.