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Health Service

Norway - Health Service

Norway’s government was living in exile in London during the 1940s, and watched the formation of the UK National Health Service. At the end of the Second World War, the returning politicians were inspired to create a universal healthcare system in Norway. The system is mostly still in place today, costing 9% of Norway’s GDP, which means the amount spent per head in roughly twice that spent in the UK. Since the 1970s the central government has provided almost all the public funding rather than devolved Local Authorities. By the end of 2002, the Norwegian Government owned and ran all the hospitals in the country.

Norway’s health system is not entirely free at the point of care, however. There are no medical, dental or optician charges for children under the age of 16 if they are Norwegian citizens or permanent residents. Pregnant women will get free treatment if it directly relates to their pregnancy and childbirth, and if they satisfy the citizenship or residency criteria.

For everyone else, the system works a little bit like other insurance policies. The excess is paid by the patient, and once that excess limit has been reached then the insurer covers the rest of the costs. So Norwegians will pay to see their GP, dentist and other local services, to have tests (including smear tests) done, and they have to pay for bandage and equipment costs for emergency care. Once they have paid up to the limit, they are issued with an exception card, and this will allow them to receive routine medical treatment free of charge for the rest of the financial year. Once the new year starts, they will be required to pay again.

There is a second tier for specialist services which is also paid by the patient, until the excess limit is reached and the state funding steps in. This would include certain dental treats and physiotherapy.

Some people are entitled to the ‘blue prescription’ scheme. They have excess limit of charges that they have to pay for, and then the state pays the prescription charges above that for the rest of the year.

Routine dental treatment for adults does not form part of the government health system and so all the costs must be paid for by the patient.

Larger employers may pay for the services of a GP, so their employees can have free checkups, but this is by no means universal.

To sign up with a GP, you must be registered on the government’s central IT system. You can ask to be registered with a particular GP if they have space on their waiting lists. If you want to change GPs, you must apply to do this via the IT system and then wait for a confirmation letter. You need to be registered with a GP to access primary healthcare and receive a referral to secondary and specialist levels of treatment.

Like many European nations, Norway’s population is ageing. Combined with advances in medical treatments, there are increasing numbers of elderly people living longer with more health issues than at any time in history. Norway has a large country with a small population, so it has needed to respond to the rise in demand for its health services.

Norway’s recent health policies have championed centralisation. A number of smaller hospitals and health facilities serving small populations have been closed. Meanwhile large central hospital services have been expanded to serve the populations of a larger area. The medical profession has welcomed this approach, citing increases in treatment success rates as professionals specialise in a particular area of expertise.

The policy has been controversial because populations living in rural areas have watched local services disappear. Central treatment centres can involve a round trip of over a hundred kilometres.

However, Norway’s health system is held in high esteem under global comparison models. Many major treatments and conditions have better outcomes than in other westernised countries.

For anyone visiting Norway who ordinarily resides in a European Union country and holds a European Health Insurance Card (EHIC), essential and emergency medical treatment will be offered on the same terms as provided to Norwegian citizens. You must take the card with you for the trip. Additional medical insurance cover is always advisable as the EHIC services are limited. Anyone without the EHIC should purchase an appropriate level of medical insurance cover to deal with all medical emergencies.

If you are living in Norway and are not a permanent resident paying into the health tax system, then you will have to pay all medical costs yourself. Your EHIC is not eligible because you are living in Norway and not in the country which issued the card. You must, for example, be living in the UK to access NHS services, so the NHS will not fund treatment for you whilst you are living in Norway.

If you need emergency medical assistance in Norway, dial the international emergency number 112 and ask for an ambulance.

Norwegians are educated and have an enlightened view of the world, so mental illness and depression are seen as serious illnesses for which the sufferer needs treatment and support. For those in desperation the Norway Suicide Hotline can be contacted on +4781533300

Just under a third of the Norwegian adult population smoke. It is illegal to sell tobacco products to anyone under the age of 18. Smoking indoors in a public place is also banned.

Obesity levels have risen dramatically in Norway over the past few decades, though there are signs the increase appears to be levelling off. Just under one in five Norwegians have a clinical obesity rating of Body Mass Index (BMI) rating of 30 or above; there is little difference in occurrence between men and women. However, this rate is significantly lower than in the US, where more than a third of the population are clinically obese.

Norway has very strict laws about recreational drug use. If you are caught with only small, personal quantities of any illegal drug substance, you will face a heavy fine or imprisonment.

You can legally drive in Norway using your EU/EEA driver’s license or an International Driving Permit. You must have valid car insurance and your car must be in good condition. When driving, your car headlights must be on at all times, in all conditions and at all times of the day. Drivers are given heavy fines if they are caught speeding. All vehicles must be fitted with winter tyres from November to April each year to cope with the winding, hazardous roads in bad weather. Large vehicles must also be fitted with snow chains. There are an average of 2-3 road deaths per 100,000 of population in Norway; this is similar to the UK but well below the average of 10 per 100,000 of population in the US.

You will normally find it a safer option to not drink any alcoholic beverage before driving in Norway. Drink driving laws are strict, with severe punishment for offenders, and roadside checks are common.

If you just have .20-.49mg of alcohol per litre of blood, you will receive a heavy fine. This is likely to be much more than a month’s salary. Above .5 mg of alcohol per litre of blood, you will be face a three week jail sentence to be served in Norway; for repeat offenders that could be as long as three months. You will also have your driver’s license revoked for up to two years.

To put this into context, the legal limit for driving in England, Wales and Northern Ireland is .8 mg of alcohol per litre of blood. This is the same as most US states allow. In Scotland, France, Belgium and the majority of European countries the limit is reached at .5 mg of alcohol per litre of blood.

Norway’s crime rates are low. Assaults are muggings are rare but increasing. Petty theft occurs around the railways stations and airport in Oslo, with tourists a particular target. You can help reduce the risk of it happening to you by being aware of your surroundings and belongings and taking sensible precautions.

Norway’s mountains, lakes and glaciers are a big draw for outdoor enthusiasts. But venturing into these remote areas can bring you into contact with much higher levels of risk than you are used to. Plan ahead, give others some clear information about where you are going, bring the correct equipment, and keep alert to the dangers around you. A warm sunny day can be cold and stormy within hours, and in the wrong conditions you can easily fall prey to frostbite.

Glacier accidents happen regularly, with tourists sometimes dying. If climbing a glacier, employ the services of an experienced guide who knows the local conditions well, and hire the appropriate equipment. Do not stand too close to the side of a glacier for a photo. The ice is constantly melting and shifting, so weaknesses can cause the collapse of lumps of ice at any moment.

If you are travelling to the Svalbard archipelago, local environmental laws mean you must take precautions against the possibility of a polar bear encounter. It is a sparsely populated area with significant polar bear numbers. If you are camping, you must place someone on watch, so they can wake everyone up if a polar bear appears nearby. A tripwire must be set at the right height to stop the polar bear walking into the confines of the camp.

Increasing numbers of tourists are arriving in the area; at the same time global warming means polar bears are losing territory. There has been a dramatic rise in the number of polar bear encounters, and in 2016 four polar bears were shot during the year rather than the usual annual toll of one or two.

In June 2017 a group of campers were given a heavy fine for shooting a polar bear which had started to maul a sleeping camper. A four month investigation concluded that the group had not taken appropriate measures to avoid the incident which resulted in the death of the animal, hence the fine was imposed.

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Expat Health Insurance Partners

Bupa Global

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Cigna has worked in international health insurance for more than 30 years. Today, Cigna has over 71 million customer relationships around the world. Looking after them is an international workforce of 31,000 people, plus a network of over 1 million hospitals, physicians, clinics and health and wellness specialists worldwide, meaning you have easy access to treatment.