Here’s how it works.
All legal residents of the country have full access to the national health care system. Shortly after arrival newcomers like me are sent paperwork to fill out. They are asked for some of the details of their medical history and asked to select their preferred primary health center. There is also a central web interface where you have access to your medical records, billing information, the clinics and practitioners who you are seeing. You can use the interface to request an appointment and to reschedule or cancel appointments. Luddites can do all of this by phone too but, seeing as Sweden is the most online country in the world, having all of this web-based makes a lot of sense.
Once you are in the system, any routine health care is scheduled automatically. You receiveda letter with the time and location of your appointment. The understanding is that you will go if at all possible. Leaving work for such appointments is routine and of no cost to you (i.e. you get credit for the time as work time) but you also have to go back afterwards (it is not a day off).
There is often some minor cost associated with your visits to the doctor (between 20 and 50 USD) but once you hit the cap (deductible if you like) of about 250 USD in the calendar year, you get reimbursed for your expenses.
For non-routine medical care it goes like this. If you’ve got something minor (say, a rash), your first stop is the pharmacy because pharmacists can dispense many drugs (steroid cream, for instance) without a prescription. For something requiring a doctor, you can use the online interface to identify the relevant doctor (say dermatologist) and submit a request for an appointment in which you describe the complaint. In 2 or 3 days you will hear back (I set the system to send notification to my phone that I need to log in and see the reply). If it is more pressing you can call and they will get you in right away. Once I requested an appointment with the wrong department and they responded right away to tell me what department I should be seen in.
So that is the system. Really, if you have good insurance in the US the only real differences are the efficiency of the centralized record system, the fact that you select departments instead of doctors (although you can specify your doctor even if it is not typically done and they do keep you seeing the same person for the most part), the fact that you have a very low deductible and you are paying for your health care with your taxes instead of expensive monthly payments. If you are in the US without good or any healthcare, the Swedish medical system offers a completely different level of access and care.
When it comes to appointments, it works like this. You show up on time (no need to come early) and wait for a few minutes until they call you. There are signs around saying that your rights as a patient are such that you shouldn’t have to wait too long. I think you are supposed to complain after 20 minutes but, truth be told, I am never sitting long enough to really pay attention to the signs. The hospitals and clinics are clean, quiet and comfortable. They are not overcrowded with people waiting around for care.
Then the doctor comes to get you. And here is the big difference. You spend the whole appointment with your doctor – not with a nurse getting you set up, etc. First they collect you and take you to their office, not an exam room. You sit at their desk and talk about whatever the issue is. If necessary, they consult the computer for information about diagnostics, recommended procedures, etc. If a prescription or labwork is required they put the orders in the system right there so all you will have to do is show up at any pharmacy or lab. Then, if you are having an exam, you head into the adjoining exam room. The room includes all the necessary equipment. So, say, if you need to have an ultrasound, the doctor performs the ultrasound right then and talks about what they are observing – no sending you to some other place where a tech who isn’t supposed to say anything definitive does an ultrasound which is read by someone else who then sends the report to your doc who then decides what it means.
After the exam, you return to the office to finish up any final business and then you are on the way. I’ve had 2 appointments and in both cases the appointments lasted an hour. I was with the doctor the whole time and never felt rushed, etc.
So, there you have it. I have good insurance in the US so the Swedish system doesn’t really feel too different to me. In terms of the few differences I have observed, however, Sweden comes out on top.
Sometimes I find it completely insufferable that this country perpetually comes out on top!