Chicago’s Mary Robinette Kowal is an award-winning historical fantasy and science fiction author, a 25-year professional puppeteer who has worked with Sesame Street, LazyTown, and her own company, a narrator, and a proud owner of two adorable cats. She’s also had her fair share of health scares.
While living temporarily in Iceland, Kowal approached her medical care provider with a concern about a new lump she found in her breast.
She expected to deal with a lengthy ordeal that would shuffle her from one doctor’s office to the next while she managed a growing anxiety about her health.
She expected to fork over a small fortune to find out (hopefully in time) whether her concerns about a cancerous tumor were warranted.
She expected to spend the next several months hoping to stumble across clues online that could tell her if she was going to be alright.
But none of those things happened.
Kowal shared her experiencing navigating Iceland’s medical care system on her Twitter page, and her story has since gone viral among Americans who are nothing short of shocked about the differences between the two countries’ systems.
What Iceland’s Healthcare System is Really Like
“When I lived in Iceland, I found a lump. I had no idea how to navigate finding a doctor, so I went to our show’s production manager. Me: I found a lump. Can you help me find a doctor?
PM: Just go to the cancer center.
Me: Okay. How do a get a referral?
PM: What’s a referral?
After I explain what a referral is, he looks baffled.
PM: Just go to the cancer center. Me: But…referral? He shrugs and hands me the phone number to the cancer center. I call and explain.
CC: A lump, ah yes. You should come in.
Me: Don’t I need a referral?
CC: A what?
Having accepted that I don’t need a referral, I say, “How do I make an appointment?”
CC: An appointment? Yes, we can do that if your schedule is very busy, otherwise just come in.
Me: I don’t need an appointment?
CC: You found a lump! You know your body, yes? Come in.
So I go. The nurse checking me in apologizes because, since I’m not Icelandic, I’ll have to pay for the visit. It’s 300 krónur. That’s 3 dollars at that point. I pay and sit down to wait.
CC: You found a lump.
She escorts me into an examining room and palpates the area.
CC: Yes, that does feel like a lump. Let’s do a mammogram. I prepare to hear about making an appointment for that.
CC: I’m sorry, but it’s across the hall. Do you mind following me?
I’ve been in the building for about twenty minutes at this point when I’m strapped into the mammogram — WHICH HAD WARMERS — and she does her thing.
CC: There is something there, you are right. I want to see it with an ultrasound. And then she leads me next door.
She does the ultrasound and when we’re finished, she tells me to get dressed and to meet her in the waiting room. I head out to the changing room, put my top back on, and walk out to the waiting room. I sit down to wait.
CC: It is only a cyst.
Forty-five minutes after walking into the Icelandic Cancer Center and 300 krónur poorer, I had the answer. In the US, a similar lump took two weeks and three different office visits. I think about this every time I have to fight with medical insurance in the US.
PS for clarity, I used my surname, but I’m pretty sure it was my first name the entire time, because Iceland. PPS Why don’t all mammograms have warmers?”
… Compared to the American Healthcare System
A 2017 research study published in the Lancet found that by comparing the mortality rates of illnesses that could otherwise be prevented or treated with a good healthcare system, Iceland’s healthcare ranked number two in the world, second only to the European microstate Andorra.
Meanwhile, a 2018 research study published in the Lancet ranked the United States’ healthcare 27th globally, compared to its 1990 rank of 6th globally.
Kowal is no stranger to the complications, delays, and sheer adversity caused by the broken American healthcare system. After many people responded to her Twitter story with their own bad healthcare experiences, she shared another example.
This time, she and her husband were living in the USA, and as you might guess, the outcome was not a positive one:
Yeah. When my husband had carpal tunnel, the surgeon said that it was so severe that he wanted him in immediately or risk nerve damage.
Six months later…the insurance finally cleared it. Spoiler: he has permanent nerve damage.
— Mary Robinette Kowal (@MaryRobinette) June 3, 2019