Anyone who has drawn a breath since the beginning of the Clinton Administration is likely aware of the political minefield that is health care. (If not, may I remind you of the fate of Hillary Clinton's health plan??) As our nation ages, the difficulty in providing quality, affordable health care will only become more vexing. The weakness of the American health care system is that those who have money and/or health insurance get good health care. Those who do not, well, do not- and that is a travesty.
Some countries have recognized this and have gone to a more socialized system of health care. Unfortunately, as Sweden is demonstrating, socialized medicine is not a perfect system, either.
Sweden exudes good health and well-being in summer. The air smells of pine trees and people of all ages bicycle and stroll well after dinner under the late-setting sun.
But as Swedes return from country cottages and Mediterranean beaches and prepare for an election September 15, they are grappling with a vexing problem: one of every six working-age Swedes is off work because of illness or injury.
The number of people on government-paid sick leave has doubled in five years, and welfare benefits for the sick and disabled now exceed the government's military and education budgets combined.
In all, about 340,000 Swedes -- one in every 26 of a population of 8.9 million -- are getting sick pay from the National Social Insurance Board, a third for longer than a year. An additional 470,000 are on disability pensions -- early-retirement benefits paid by the government to those who stop working before the retirement age of 65. These often are bigger than regular pensions.
Sick Swedes -- and what makes them sick -- are one of the main election issues.
The governing center-left Social Democratic Party, seeking to extend an eight-year spell in office, has commissioned studies and written reports saying job conditions are getting harder and more stressful.
Opponents, led by the center-right Moderate and Christian Democratic parties, say the government is looking for a cure in all the wrong places. The problem, they say, is not workers' health but cushy welfare policies that are eroding the work ethic.
Whatever the explanation, the cost -- about $12 billion a year, or 16 percent of this year's national budget -- worries officials.
"I don't think we can accept any higher costs. Then we risk having to change compensation levels and the sickness insurance loses its function and legitimacy," said Rolf Lundgren, chief economic analyst at the National Social Insurance Board, which picks up the tab from the employer after a worker's second week of absence due to sickness.
Sweden has long been viewed by many as a model welfare state, characterized by high taxes, extensive government benefits and a relatively small gap between rich and poor.
Although social benefits were scaled back somewhat during a recession in the mid-1990s, subsidized health care and compensation pay for unemployment or parental leave. The system is financed by some of the highest taxes in the world on income, wealth, property and purchases.
There are some hard choices to be made here. While most Swedes would no doubt be loath to give up the benefits they currently enjoy, the question becomes how much longer the system can continue before it implodes.
In the US, you have HMOs and drug companies making undefendable profits. In Sweden (and other countries with socialized health care systems), you have a system supported by a heavy-almost-to-the-point-of-being-unreasonable tax burden.
I don't pretend to have an answer. All I know is that the system is broken, and no one seems to be doing anything to fix it. After all, it's all about the Benjamins, and when it comes to health care, there are a LOT of Benjamins that will be thrown at those willing to maintain the status quo.
