3 things that could be improved in Danish health care

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!

Comments

  1. Natalia says

    Hi Laura !
    I totally agree with you about that Danish system is one of the best. Around month ago I signed up for a small surgery. It was about varicose veins. I waited two weeks for it. For me it was super fast. In Poland from where I come from, it’s about 3-4 months to do it, if you want to do it for free. I am very satisfied with the DK healthcare. But I also agree with your 3 points, how to make it even better :-)

    • says

      Hi Natalia - glad to hear that you had such a good experience! And I agree, it is generally a quite good system. It could just be even better! :)

  2. sal says

    Hi,
    Totally agree with you. Especially on the prevention side.

    I used to do a blood check up once a year in Belgium. Precisely to react proactively in case of anything.
    When I went to see my doctor the question he raised was “what for” ? and when I told him it was just to be proactive and react if anything wrong the answer he gave me made me speechless. He said “it will cost money to the social security whilst you have nothing”. It was the first time I heard about money consideration from a doctor (at least in Belgium the country I come from). I explained him that on the long run the prevention might precisely decrease the final social security cost by being able to react quicker because things get worse (and more costly). But no way. No blood test for prevention…..it costs ! Amazing…

    • says

      Hi Sal,
      Thanks for your comment! I have a hard time understanding this, too. Of course prevention does cost money, but it also helps to catch potentially critical conditions that may be much more expensive to treat afterwards (not to mention the factor that you can actually prevent people from getting sick!). I hope you can convince your doctor to let you do a checkup every once in a while!

  3. says

    I totally agree with your points! I asked if I could get some bloodwork done a few years ago here and my doctor said I didn’t have any reason to whereas at home, it is almost a yearly routine to get one and check that immunizations are up to date, check cholesterol levels, etc. with a blood test. (So I got one done at home while I was on vacation!) And I totally agree, being preventative rather than reactive seems like a better approach to me.

    • says

      Hi Karen, sorry to hear that they wouldn’t let you take that test! Unfortunately, I don’t have insurance coverage in Germany, so I can’t go to the doctor there (unless it’s an emergency, of course!). Danish health care has a long way to go in terms of prevention!

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