Health is about responsibility

Health is about responsibility. I am not sure of the situation in other countries, but in Sweden I get the feeling that people in general have given up their responsibility for their personal health. They expect someone else to be liable if their health fails them.

Of course, there might be more or less reasonable explanations for this and the Swedish well-known high taxes does give us citizens a lot of valuable benefits. Our schools are completely free of charge, including higher education like universities. In fact, the government actually gives university students an allowance of around 1,000 USD (7000 SEK) per month to support higher education.

When it comes to healthcare in Sweden, we are fortunate to have a reasonably good access to high quality healthcare at a very low cost. Swedish citizens pay no more than about 130 USD (900 SEK) per year for primary and secondary healthcare and for tertiary care the fee is not very high either. For prescription medication, an individual pays no more than 260 USD (1800 SEK) per year, regardless of the price of the drug. The balance up to the actual cost for the care and medications is covered by the social security system.

I have absolutely no reason to complain, this system really benefits me personally, since I take medication at an actual cost of approx 15 USD (100 SEK) per day or over 5000 USD per year. Of course, to me personally, this system is a life-saver, since I would be more or less completely unable to move without my medication. But I definitely think that this system also gives Sweden a reasonable ROI, since this investment actually enables me to work and contribute actively to society as well as reduces my use of other healthcare resources.

Naturally, this system also has downsides. In my opinion, a healthcare system where the individual pays practically next to nothing of the actual cost for care directly, makes people a bit spoilt. Services that are free of charge are not really valued in Sweden. But this is to me a very light burden to bear, since it provides us Swedes with an usually equitable healthcare system.

The other major problem I see with the “Swedish model”, where the government basically has taken a very large responsibility for its citizens, is exactly that; responsibility. In my opinion, most people in Sweden have actually, more or less consciously, given up the responsibility for their own health and expects someone else to take it for them. To me, health is about responsibility, responsibility for your body, responsibility for your wellbeing, responsibility for your life. I am not saying that I have the responsibility to heal myself, but I definitely have the responsibility for acquiring the necessary knowledge for my own health issues and manage them accordingly. To me, health is about being responsible for knowing when I can manage a health issue myself and when I need professional help.

I have the responsibility to take care of myself, because no-one else can be expected to and that is the way it should be. I am fully aware of my responsibility, but that doesn’t mean that I can always manage by myself. I need help, but it is my responsibility to seek it when I need it. And in my opinion, healthcare has the responsibility to meet my needs. But not necessarily in full.

There has to be a balance between 1) my expectations or hopes for improvements in my personal health, 2) what is medically and technically feasible and 3) what is economically reasonable.

To me, this forms the basis for Shared Decision Making in healthcare.

Method description

To evaluate the effects of my medications, I use an app on my iPhone.
I don’t have the tremor that most people (including myself) associate with Parkinson’s, but instead I have bradykinesia (slowness of movement) and rigidity with a bit of balance and gait problems, just to make it more interesting.  
I did know that tapping tests are used to evaluate Parkinson’s clinically so I looked for a tapping test on my iPhone and found “FastFingers”. The app has a window divided in two halves and I think that you are supposed to alternate the tapping between the two halves, but I only use one side. I make sure that the lower part of my palm, thumb, ring finger and little finger are resting against the table, see photo, and tap with my middle finger as fast as I can for 30 seconds. I do this with my right and my left hand a number of times throughout the day and record the results (time and number of taps).

I started collecting baseline data a number of weeks ago and actually found it more difficult than expected to capture enough data in a day to be able to find meaningful patterns. I was able to record enough data for two days, 12th and 13th March, and the results are plotted below with number of taps in 30 seconds on the y-axis and the time for the test on the x-axis. I also included a control, a.k.a. hubby 🙂