Thursday Again??

• How is it already Thursday?!  Time is really flying and sometimes I feel like I only do half of what I want to get done.  On the other hand I'm not the kind of person who gets stressed.  It will all be fine in the end.  No use worrying.  That's my mantra.
• Isolde is well again except for a persistent cough, and has been at preschool all week, but Harald has been very miserable, poor thing.  He doesn't have any fever anymore, or very little, but his nose is still very clogged up and he coughs a lot, so he will probably need another few days to get well.  None of us have been sleeping very well since last weekend, and this week I have only slept 4-5 hours per night *yawn*.  Can't wait for the weekend to come so that I at least don't have to get up at 7am and go to work.  I have also started coughing a little bit, and my throat is a bit sore, but hopefully I won't get it bad, fingers crossed.
• Tomorrow we're hoping to meet up with one of my cousins who's in town on business, depending on his schedule.  We plan to have fika in the afternoon somewhere in town, and afterwards, when he has to head to the airport, we will go to the Swedish church's annual Christmas market.  Looking forward to it!  A bit of a start to the holiday season!
• Almost every day on my way to one of the lunch places I pass two beggars.  At least one of them is Roma, a woman who sometimes has her baby with her, and the other one is an old man, maybe also Roma?  I never give them any money, as I'd rather help in some other way through an organisation (or if I would give them something directly, perhaps some clothes or items for the baby), but I feel sorry for them and I feel bad every time I pass by without doing anything.  I really hope that the Belgian authorities could do more for them.  In Sweden they are not allowed to beg accompanied by their children; if so the authorities steps in and remove the children, which perhaps helps, at least the children and hopefully also the parents (but I'm not at all an expert on this issue). 
• I'm very disappointed in the level of recycling here in Belgium.  For some reason I thought it was one of the more advanced countries, and as all is relative perhaps they really are, but compared to Sweden they are well behind (and apparently Belgium didn't even have a functioning waste water system until the mid-2000s...).  In Sweden we can recycle most plastic (and in soft/light plastic bags and covering where my parents live) but here it is only plastic bottles or other drink containers.  So plastic boxes/hard packaging for minced meat for example is a no but I assume a schampoo bottle is a yes, even though it is not a drinkable fluid.  Also, there is so much packaging still in this country!  Toothpaste comes in a paper carton.  Same with a tube with tomato paste.  Teabags are always individually wrapped, and often in plastic, not paper.  All bisquits and cookies come with several layers of packaging (but we have noticed that it has benefits - the humidity in this country makes cookies go soft very quickly otherwise.  I could go on but I think you get the gist of it.  At least most paper and metal can be recycled.
• We are starting to plan our two weeks in Sweden at Christmas!  So far we have New Year's Eve planned, and a brunch with my group of girlfriends (childhood friends) and their families on the agenda, and an appointment with the Swedish children's health centre (BVC) booked (3-year-old check-up for Isolde and regular check-up for Harald).  I also need to book a hair salon appointment and I also want to use some gift vouchers at a beauty salon near our Stockholm flat.  Peter and I are also planning to have either set of grandparents babysit for a day so we can go to Raison d'Etre spa (at Grand hotel, best spa in town!) and to a restaurant for dinner.  We may also take Isolde for her 3-year-old dentist check-up (first ever dentist appointment!), but it could also wait until our next home visit in March or April.  And then there is Christmas and hanging out with family of course.  And see more friends.  Can't wait!
• But before then I'm looking forward to my dear friend H. visiting this weekend!  She's coming on Saturday and in the evening we're going out for dinner, something I haven't done since we moved here!  The rest of the weekend is not planned yet, but suffice to say it will contain eating and drinking, talking, seeing some other friends, maybe doing some shopping (I need to start my Christmas shopping soon).

Healthcare or Sick Care?

Helena argues really well for more European healthcare co-operation! Some people think the EU should stay away from healthcare issues but like Helena, I think we can only benefit from more co-ordination and more patient influence.

Helena has a personal story to tell - you can read it here. In brief, she has moved back and forth between Stockholm, London and Brussels over the last five years, which has caused some difficulties for the Swedish health service, mainly as a result of the procedures in place for GP appointments, referrals for tests, waiting times, IT systems and ultimately, her living abroad. Even though she had a letter from her doctor in London stating that she needed to have a certain test taken, the Swedish health service could not set up an appointment unless she went through the normal routes within the Swedish healthcare system (details on her blog).

Her point with the post is to:

ask the question how the Swedish health service manages increased internationalisation? If they could not manage my needs, despite me being registered in Sweden, because I had taken a test in another country, how would they then meet the needs of persons who live in Sweden temporarily, persons who have just moved to Sweden, or person who do not speak Swedish?

The need of the patient must always be more important than the system. If something does not fit into the system there must exist a culture within the health service that encourages flexibility and initiative. But all too often governance through quantitative evaluation and budget goals makes it more profitable for divisions and units to stand on the side of the system when it collides with the needs of the patient.

Thus I cringe when I hear Swedish politicians saying that EU initiatives in the healthcare sector threatens the Swedish healthcare system. Defence of systems and models is seldom a very good political starting-point.

What I would add is that - which probably Helena would agree with as well - is not that we want the EU to start deciding the financing or the content of the healthcare provision, but to facilitate for patients in an increasingly global world.

Childhood Poverty and Family Policy

Anne, a Swede currently residing in Oregon, writes about the cost of childcare in the US and the (negative) consequences for families and especially women. A job may pay $9 / hour but (licensed, authorised) childcare costs $15 / hour so you're better off just staying home. Even if you have a more advanced and thus higher paid job, $15 / hour doesn't make a huge difference when it comes to an incentive to work. Anne says that "You get what you pay for is something you often hear, in different contexts. It is considerably greater differences between what's good and what's bad [quality] so you'd better be careful. [sic] USA is the country with the best, most modern and luxarious but also the worst you can find. Everything is about money, no subsidies, discounts or support systems exist. Everything depends on how much you are willing to pay, you get what you pay for."

This week I attended several really interesting meetings on this very topic (at research institutions SOFI, CHESS and the Institute for Futures Studies). Some of the findings of international studies:

• There is a strong correlation between poverty rate and generosity of family provisions*

This means that countries with generous family policies have lower child poverty rates. And especially family policies that support dual earner families (i.e. families where both parents are working).

• Support promoting dual earner families is more efficient than support promoting traditional family patterns

This means that

• The poverty relieving effect of dual earner support works both via benefits and market income. I.e. the contribution may be direct through the amount of benefits paid, or indirect by supporting two earners and thereby raising the market income of the household.

While

• The support to traditional family patterns works only via benefits

Other important factors are

• Access to childcare

This includes extensive, accessible, affordable and high quality childcare (pre-school).

Another interesting - and strong - correlation is that between family policy generosity and infant mortality, i.e. generous family provisions lead to low infant mortality.

• What drives this development is strong dual earner support (e.g. childcare provisions).

I'm not going to bore you with all the tables and graphs but I think you get the gist from the above bullet points!

* Family provisions are policies such as tax deductions for families/parents (double or single parent households), parental leave/allowances, child allowances, right to and compensation for staying at home with a sick child, etc.

A Bit of Sicko in the Swedish Healthcare System

Johanna Graf is always so spot on! I agree with her completely so I have translated her post:

"Unfortunately I have to throw up...
...because this is one of the most tasteless things I have heard. A private children's hospital is opening at Sophiahemmet in Stockholm [where] children of parents who have paid into a private child insurance can receive care. In a web survey carried out by [the tabloid] Aftonbladet it is admittedly a majority who thinks it is wrong with privately financed [through insurance] children's healthcare, but alarmingly many who still think it is a good idea. Maybe they have fallen for the insidious talk that is always brought out when private care is the topic; "But, if more people pay for their care themselves, the pressure on the public health service will be relieved and it can work better".

But think one step further! What do you think happens to the private caretakers' willingness to pay for care they no longer need, or need less and less often? What happens with the strength of a tax system where some, often those who are less willing to pay, do not think that the quality of the service that they are getting for their money is good enough, och therefore join another [health] insurance system?

In the particular case with private children's hospitals one can also quietly ask oneself what will happen with children who are born sick and in all likelihood have not yet been - or would never be - granted a private insurance?

This with private children's insurances is already today a chapter to itself. My middle son gave the wrong answer during a hearing test at the children's health centre and is still to this day, at age 16, not granted a full child insurance with our insurance company. And I have heard a lot worse stories. NO to such a society!

In the long term one could ask why all of us together must pay for their expensive medical training if many doctors only devote themselves to help those who pay the most for their services?

To be very clear, so that no one goes mad now: What I'm criticising is NOT private care, but private insurances. (It is the same thing with the education system: It is not the free-standing schools that is the problem, it is the financing system that moves tax money around in an eternal moving merry-go-around that is very financially unsound.)

It makes me happy that it is not only Social Democrats who criticise these systems. Also the Swedish Association of Health Professionals is a warning voice: "The risk is that the cleavages in society increase, that those who cannot afford to pay receive worse care and that the public health service cannot be financed at the same level as today."

Less that three years to the election, but there are unfortunately a lot that can be destroyed before then."

Just a Thought

It seems to me that people (read: the government) think that the worse thing you can ever do is to misuse welfare benefits (e.g. staying home from work even though you're not that sick or getting payments for caring for a sick child in the home even though the parent is the one sick as it pays better) while to cheat the system by not declaring (paying) taxes on labour and services (e.g. building work or cleaning services in your home) is permissable and in fact quite understandable and normal*.

But isn't the latter as bad since both scenarios in effect mean that you cheat the taxpayer? Either by trying to milk the system or avoiding to pay taxes you are supposed to pay.

* Especially among the centre-right government ministers.