3 things that could be improved in Danish health care

May 17 Written by

The Danish health care system has a great reputation and is widely known as being one of the best in the world. And don’t get me wrong, any system that provides even the most basic care for all of a country’s residents is a good system in my eyes. Denmark, and especially Copenhagen, has a high density of doctors and hospitals, and nobody needs to worry that they won’t be treated or that the treatment for a longer-term illness would cost them their live savings. There is emergency care, everyone has a general practitioner, and there are specialists available for every area of health. If you need advanced diagnostics or even surgery, there are a number of very good public hospitals, and aftercare in will be provided, for example in the form of physiotherapy.

This is “sophisticated whining” – I know that there are many, many places in the world where people can only dream of having a health care system and coverage like we do here. But after living here for a couple of years, during which I’ve been unfortunate enough to have a number of run-ins with the Danish health care system, I’ve noticed a couple of things that I think could be handled better. In short:

The Danish health care system is good, but not perfect. Here are three things that I think could be improved:

Inrease the focus on prevention

This is probably my biggest issue with the Danish health care system as a whole. Basically, as soon as there is something wrong with you, everyone will jump through hoops to take good care of you – but not a second earlier. I’m used to going to different specialist doctors for regular check-ups, like once a year or so. But here, that seems to be considered completely unnecessary (I think my GP probably thinks I’m a hypochondriac). The first question when asking for an appointment is always, “what’s this about?” – and my reply that it’s just a check-up is met with skepticism and dismissal. As an example, a couple of years ago I had to get a birth mark removed because it was considered to be at risk. Ever since then, I’ve gotten preventive skin cancer screenings at the dermatologist on an annual basis. The first time I mentioned this to my doctor, he said that he didn’t think that was necessary – I should just check my birth marks myself, and if I see anything odd, I could come in and have him look at it. This was despite me mentioning my history of having a suspicious birth mark removed.

Everyone gets basic insurance in Denmark (you’re covered if you’re a legal resident and have that yellow insurance card), but you can buy extra insurances with better coverage, which many companies do for their employees. Through my work, I have an excellent insurance, which allowed me to get my back surgery last year at a private hospital and avoid the long waiting times in the public system. But even this amazing insurance does not cover any prevention! It’s completely mind-boggling to me. I haven’t compared health care system costs for different countries, but I simply can’t imagine that it’s more expensive to do a 15min skin cancer screening on a bunch of people than to treat one person who actually has skin cancer.

Don’t give the “own doctor” all the power

Once you register in Denmark with a CPR number, you’ll get your yellow health insurance card and will be asked to choose your “egen læge” (“own doctor”) – a GP who will be your first point of contact for anything health-related. The GP also refers you to specialists, if and when deemed necessary. Generally, I don’t think there’s something inherently wrong with that. A certain level of screening is smart to ensure specialists aren’t flooded with non-cases and can spend their time on those patients who really need their help. But, and this is a big but, it all depends on your GP. Some GPs will write you a referral if you request it by email (I’ve heard). Others, like mine, unfortunately, apparently suffer from a little bit of a God complex and will not refer you, because they think they can do everything themselves. See for instance my earlier example about the dermatologist, where my GP suggested that I come in to see HIM when I see something suspicious, and HE would then determine whether I need to see a dermatologist. So in that case, my health depends on two people who aren’t dermatologists noticing an irregularity. Sounds super safe!

For us women, it gets even worse, as apparently it is totally common to do your gynecology exams at your GP’s office. Say whaaaaaa?! First time I heard that, I was completely in shock. When I asked my GP for a “henvisning” (referral), he dismissed me and said, “no, we can just do that here”. Eeerm – I may be in the minority here, but I’d much rather get checked by an actual gynecologist, thankyouverymuch. I ended up talking him into giving me the referral, but that experience was very humiliating – I think that doctors should just respect my right to be treated by someone I feel comfortable with, especially for such a private matter. A word of advice for fellow expats – you can look for gynecologists that accept “selvbetalere” (self-payers), which means you can opt to pay for the check-up, if your GP refuses to refer you.

The best bit about this whole thing is the following. When I needed a referral to a specialist, I called my GP’s office and asked if they could give me one. The nurse said I had to come in and see the doctor, otherwise they couldn’t. Then, the GP gave me this whole spiel about how it costs the Danish state DKK 110 every time I ask for a referral – erm, yes, and who do you think pockets that, my good sir? It’s YOU, because you make me come in and see you before! I found that pretty hypocritical.

Improve dental care coverage

Finally, Danish basic insurance doesn’t cover dental care. Well, it does pay a little bit of a “subsidy”, but be prepared to pay up every time you get your teeth checked. Again, I might be spoiled by the German system, where you can get an annual check at the dentist for free, but I still think a first world country should care about its citizens’ teeth! I go twice a year to get a check and dental cleaning, and every time I’m out of pocket about DKK 600. I’m happy to pay that, because I care about my teeth, but not everyone can afford it (or wants to pay) – I’ve talked to Danes who haven’t been to the dentist in years! I’m pretty sure more people would go if they could get a free check every once in a while.

What are your experiences with the Danish health care system? What do you like and dislike about it? And what would you like to see improved? Share in the comments below!

Typical Danish times two: Store Bededag and 1st of May

Apr 30 Written by

Here in Denmark, we’re preparing for a nice, extended weekend, as tomorrow is Great Prayer Day (“Store Bededag”) and thus a day off. Incidentally, Great Prayer Day coincides with the international workers’ day on the 1st of May this year. So I thought, why not take a look at these two holidays and their traditions?

Store Bededag

Great Prayer Day was introduced way back in 1686 by Bishop Hans Bagger, who decided to bundle some of the smaller prayer days into one big day dedicated only to praying. It’s held each year on the fourth Friday after Easter, and is a public holiday in Denmark. Historically, nobody was allowed to work, so that everyone could concentrate on their fasting and prayers. It’s apparently also the only non-weekend day where Danish children can celebrate their “konfirmation” (we are invited for one, for instance).

Lune hveder

It’s become a tradition to eat warm wheat buns (“lune hveder” or “varme hveder”) on the eve of Great Prayer Day. This tradition started because – like everybody else – bakers were not allowed to work on Great Prayer Day. But people still had to eat, so the bakers came up with the idea of baking buns on the day before, which could then be reheated on Great Prayer Day – and so, the warm wheat buns were born. But we all know that bread and buns taste much better fresh out of the oven, so legend has it that people just couldn’t wait and instead ate them on the eve of Store Bededag instead, which is still a tradition today. So why not grab (or bake) some lune hveder and enjoy them with some butter and jam tonight? Although I’ve heard people say they are “literally the most boring type of bread out there”, I actually quite enjoy them - warmed up, with some nice cold butter, and maybe a bit of jam. They typically contain cardamom, but there are all sorts of different varieties out there, so you’re free to pick your personal favorite!

1st of May

The 1st of May has historically been a special day in the Northern Hemisphere, for various reasons. In some countries, such as England, it is celebrated as a spring fest, whereas Germany and other Northern European countries know the celebration of “Walpurgis Night”, or “witches night” from April 30th to May 1st, often with bonfires and the like. 1st of May was declared International Workers’ Day back in the 19th century, and is a national holiday in many countries, Denmark included – at least for traditionally more “blue collar” jobs. The Financial Services Union has negotiated a compensatory day off for those employed in the financial services industry, who traditionally don’t have May 1st off.

In Denmark, political events and speeches are held on May 1st, but they often resemble festivals rather than political rallies. The largest event in Copenhagen is held in Fælledparken, where people come out to enjoy the sun and maybe a picnic with a couple of beers.

Do you have any plans for the day? And are you eating some hveder tonight?

Typical Danish: Fastelavn

Feb 12 Written by

This week, in addition to most kids being off from school for “vinterferie” (winter vacation), we’re also celebrating Fastelavn in Denmark. Fastelavn is basically the Danish form of carnival, which exists in many more or less similar forms across the globe (from the famous carnival in Brazil to Mardi Gras in New Orleans all the way to Fasching in Germany). In Germany, we even call it the fifth season. Carnival or Fastelavn marks the transition from winter to spring - even though this week feels like it’s still the middle of cold, dark winter! - and, in the Christian calendar, also means the beginning of Lent.

Fastelavn is a colorful, fun time for kids and grown-ups alike, with dress-up parties and fun games to play - and of course my beloved “fastelavnsboller”, pastries filled with delicious cream. There are some special traditions and customs surrounding Fastelavn in Denmark - here’s a quick overview.

 

Slå katten af tønden (literally: “beat the cat out of the barrel”)

Photo via fuglsang.biz

This is a kids’s game which resembles a pinata - a wooden barrel is filled with sweets and hung for kids to hit with sticks until it breaks and the sweets come raining down. Whoever manages to break the barrel is “king of cats” (kattekonge) or “queen of cats” (kattedronning).

 

Fastelavnsris

Photo via blaamejsen.blogspot.com

 

Another tradition says to decorate birch twigs, often with ribbons or little figurines. It’s the exclusive right of children to wake their parents on Sunday morning by hitting the bed (or, hopefully softly, their parents) with these twigs.

 

Fastelavnsboller

My absolute favorite part of Fastelavn! If there’s one thing the Danes love, it’s to assign special food/ drink items to different occasions and holidays (I’m thinking about lune hveder for Great Prayer Day, kransekage for New Year’s, and of course all the Christmas food). Of course, Fastelavn is no exception: we get delicious buns! There’s even a poem/ song about them:

“Fastelavn er mit navn,
boller vil jeg have.
Hvis jeg ingen boller får,
så laver jeg ballade.
Boller op, boller ned
boller i min mave.
Hvis jeg ingen boller får,
så laver jeg ballade.”

This basically translates to: “My name is Fastelavn, and I want buns. If I don’t get buns, I’ll cause trouble. Buns up, buns down, buns in my tummy. If I don’t get buns, I’ll cause trouble.” A perfectly understandable sentiment in my opinion! (Quick poll: am I the only one who’s immediately reminded of a certain quote from Sir Mix-A-Lot’s Baby Got Back?)

Top left: with raspberry cream and icing from The Royal Smushi Cafe; top right: gammeldags version from Emmerys; bottom left: with raspberry jam filling and pink icing from Emmerys; bottom right: with butter cream filling and confectioner’s sugar from my awesome cantine at work

There are two different types of fastelavnsboller: “gammeldags” (i.e. old school) buns are made of a yeast-based dough and filled with buttercream and topped off with chocolate. The modern version is closer to a classic Danish, with a puff pastry-like dough and a lighter cream filling, often topped with confectioner’s sugar. There are also some varieties with jam filling (or a mix of jam and cream) and icing (third picture above). In my opinion, they’re all pretty awesome, but you decide which is your favorite! If you need some inspiration, here’s a taste test of Copenhagen’s best fastelavnsboller, and if you’d like to try and bake your own, try this recipe for the old school version (in English).

Are you dressing up for Fastelavn? Or are you - like me - just all about the boller?!