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'Unlike Sweden, when you call an ambulance in the US, it comes'

'Unlike Sweden, when you call an ambulance in the US, it comes'

Published: 03 May 2012 12:08 GMT+02:00
Updated: 03 May 2012 12:08 GMT+02:00

Recently, I have read a chain of stories about a health care crisis that, until I moved to Sweden, was barely on my radar. And coming from the US, a country mired in health care woes, I thought I had heard it all.

In recent months, newspapers around Sweden have reported a slow trickle of deaths connected to the slow or lack of response from ambulances.

On March 27, The Local reported that a young woman in Timrå died after being denied ambulance services even after her third call begging for help. And just two weeks earlier, on March 14th, The Local ran a story about a man in Stockholm for whom, after three calls and thirteen hours, the ambulance arrived too late. There are two similar articles from the month of February as well. And these are just the deaths.

While an emergency operator undoubtedly has a tough job, one piece of it sounds fairly straightforward: if someone asks for an ambulance, in most cases, they probably need it.

So why are these people being denied?

I wondered this to myself when I first moved here, and the question stayed in the back of my mind until we ourselves had to call an ambulance. After that, it was clear to me where things can go wrong.

Our son Erik has the unfortunate distinction of breaking his arm in two countries. And in neither of these cases was there any doubt that his arm was really, horribly broken.

About a year ago, Erik was playing on top of a built-in bunk bed (a piece of furniture we never would have chosen ourselves) when his friend accidently knocked down the curtain covering a skylight. This skylight sits about a foot away from the bed, and Erik reached up to fix it. He then returned to what he thought would be the side of the bed, but his guess was a little off; he fell straight down, directly on his arm.

From across the house, we could hear these were no ordinary screams. One look at him confirmed my suspicion—the bottom half of Erik’s forearm was pointing the wrong way. Anyone who had ever seen the sight of a limb so clearly broken will never forget just how terribly wrong it looks—the image is forever imprinted in my mind.

It was at this point, as I was standing over my son writhing in pain and fear, that I realized I had never bothered to find out what the Swedish emergency number was. I’m sure I had seen it somewhere before, but it hadn’t registered. Luckily, I wasn’t the only one at home.

My husband tried to comfort Erik while holding his own fright at bay. Meanwhile, I dialed 112. The conversation went something like this:

“My son fell off our bunk bed and broke his arm. We need an ambulance.”

“Is he conscious?”

“Yes.”

“Does he have any other injuries?”

“I’m not sure. We haven’t really checked.”

Did he break his back or neck as well? I hadn’t considered this possibility. This thought is not calming me down.

“How high is the bunk bed?”

In my panic, the question stumps me. This sounds ridiculous now, in the quiet of my now-peaceful home, but I blanked. After less than a year in Sweden, I hadn’t entirely gotten used to the metric system, so in the panic of the moment, I couldn’t come up with an instant estimate.

“Um… one meter? Two meters?”

“Well, which one is it? There’s a big difference,” she snaps at me.

“I’m not sure. The regular bunk bed size?”

She is silent.

As Erik’s screams carry through the house, a new thought dawns on me.

“You haven’t asked for my address yet. Aren’t you going to send an ambulance?”

“No,” the operator patiently explains—that’s not how this works. First, she needs to decide if we need an ambulance. Then, she needs to decide how to prioritize our call if someone else in our area happens to call when the ambulance is on its way.

I can hear my Swedish is getting worse by the minute, but experience tells me that switching over to English isn’t going to make things better.

“My son’s arm is pointing the wrong way, and it’s possible he had other injuries we didn’t notice immediately. I’m sure he needs an ambulance. And it’s really hard to concentrate on your questions when he is in so much pain and I know the ambulance is not coming.”

But she continues.

Even in the midst of this crisis, I’m incredulous.

Do I have to convince this woman that I need an ambulance? Is the burden of proof on me? That is to say, is my son’s care resting on my persuasive abilities…in a foreign language?

Now, there are a lot of things wrong with the US health care system. After lengthy wait lists, coverage denials and nurse strikes (including on the day of my daughter’s birth), I wasn’t sorry to say goodbye to that system.

But here’s one thing that, for the most part, I could rely on: if I call an ambulance, it will come. In fact, if I call them by mistake and hang up, they’ll call me back just to make sure I don’t need help. No convincing necessary. This was true when I lived in suburban Michigan, rural New Hampshire, and New York City (not the nicest part), and it was true in San Francisco.

Here’s the beginning my conversation with the US emergency medical services for Erik’s identical arm injury, two years before:

“My son fell off the monkey bars and broke his arm. I need an ambulance.”

“Where are you?”

“Golden Gate Park, the playground by Fulton Street.”

“An ambulance is on its way. Please stay on the line.”

No convincing involved.

Don’t get me wrong; I’m not making any broader suggestions that Sweden’s health care system should look more like the US’s. My point is just the opposite: if a country with such a fractured health care system can make ambulance services work, shouldn’t Sweden be able to as well?

After experiencing the same injury in both countries, it seem as though a system which provides more ambulances, more often would benefit the health of all people living in Sweden. Yes, this solution costs more, but isn’t this particular cost worth it?

By the end of our ten-minute-long conversation, the Swedish operator couldn’t promise me an ambulance any time soon. And in this case, there was no doubt that Erik needed a hospital, not even in the operator’s mind—she just wasn’t sure about our ambulance status. I hope I never have to find out what happens when the symptoms are more fuzzy.

The intentions behind the Swedish process are good: a more careful screening of emergency victims is intended to cut down on wait times and guarantee care… and possibly save money. But in a twist of irony, instead of feeling as though the care I need is guaranteed, the current model has undermined my confidence that I will get that care at all.

As an immigrant with imperfect Swedish, I felt especially vulnerable. After Erik broke his arm, my conversation left me with the feeling that our emergency care rests on a decision made by one bureaucrat behind a desk, not a group of people concerned with my son’s safety. In a new country that I’m still figuring out, I don’t want to be concerned that an ambulance might not come, despite my protests.

The Swedish model of care gets so many things right. Having experienced both systems with kids, overall, Sweden’s has been a huge relief for us.

I hope that, with all the recent publicity, Sweden can re-think the current emergency care model so it can get this right, too.

Rebecca Ahlfeldt is an American ex-pat writer, translator and editor currently based in Stockholm.

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Your comments about this article

14:26 May 3, 2012 by Cze
I still wait until somebody explains to me what the Swedish "welfare" consists of? The public service is typically very slow and the encounter with the health care system is really a fight or begging for the treatment depending on your situation.
14:41 May 3, 2012 by rufus.t.firefly
I read your story. As another American ex-pat, I have realized over time that the kind of official behavior you are describing is not an aberration, it is the norm, especially when Americans are the ones in need of assistance. I have wracked my brains trying to "understand", but I can't. Swedish people will attempt rationalize this kind of conduct in various ways. To me, it appears to be a deep antisocial streak that permeates society here. It frightens me.
15:16 May 3, 2012 by Eagle63
mmm.., glad I chose Canada as my native country, if needed they even pick you up there by plane!
16:32 May 3, 2012 by bronc
I'm also an American-expat, but I'm over in GBG. I came back to my girlfriends home to have our first baby, and it was a pretty complicated pregnancy. We took 3 ambulance rides to the hospital before the birth, and all 3 times it was me calling and talking to the dispatcher. While I've continued to hear these kinds fo stories, I've been lucky enough to not experience it.

All 3 times they picked up, I told them what was going on, and they dispatched an ambulance right away. I was actually surprised how fast they showed up, within 5-10 minutes each time, compared with up to an hour back in San Francisco.

Maybe it's because I'm in Gothenburg, I don't know, but I'm just very thankful I haven't run into this situation. I don't even know what I'd do if they asked me 10 minutes worth of questions or refused an ambulance while I was freaking out.

But two things I can confirm, their health care system is much better then the one in the US, and that there does exist some bias or racism against non-Swedes, especially when dealing with people not face to face.
16:40 May 3, 2012 by hipersons1
IDK, I'm american, too, and in general I don't think one needs an ambulance just because one needs to go to the hospital. Ambulances should be for when there are no taxi's or other cars available and immediate medical attention is required, or of course when there is no physical way to transport the person in a car of some kind to the care he or she needs.Howerver, I agree that if they are not going to send an ambulance that they should at the very least offer to send a taxi to your location.
17:50 May 3, 2012 by gpafledthis
Good ol american self-reliance seems to die quickly in sweedie air !! What do they the do - declare it a banned substance at customs !! TL name and shame the above who wrote !! If you really want service - get arrested !! go to prison - there every want will be met !!
20:09 May 3, 2012 by Reason abd Realism
The worrisome element with regard to this particular story would be the prospect of moving an injured person who potentially has a neck injury, and/or of making the broken arm a lot worse by improper movement (maybe CPR courses cover these topics).

I am a bit surprised that the author did not switch to English, as everyone under 45 speaks it so well, when explaining the height of the bed ('head height', if she had forgotten the conversion to meters), and which would have been critical in assessing the risk of a neck or head injury, to assist in assessing the urgency of sending an ambulance.

The author might have deemed a switch to English as a move that might have lost time, but my own impression is that a switch to unaccented English is almost always helpful for a client within the Swedish 'service' industry (have only seen this out in restaurants and furniture shops, but presume that it may carry over even into medical services, although it should not).

Anyway this particular situation turns out to have been non-life threatening so the absence of an ambulance was disappointing, but not criminal negligence. But with the other headline grabbers of the past year, there should be some pressure to make changes to emergency response services, and any sensible politician would insist on at least some binding recommendations.
20:26 May 3, 2012 by Solith
Get a car ride to the hospital myself (for a non-lethal injury such as say a broken arm) in Sweden or be charged an arm and 2 legs for an ambulance plus massive fees for emergency care, then any aftercare in the US. Forgive me for preferring to stay here.
20:40 May 3, 2012 by HelmiVainikka
@Solith:

I am sure she would agree with you, if she was alive:

http://www.expressen.se/nyheter/jill-22-dog-i-sitt-hem---fick-ingen-ambulans/
21:25 May 3, 2012 by 0007
well..if you dont like here best thing do is go back to usa....so u get better service...
02:57 May 4, 2012 by Smiling Canuk
In the US they'll pick you up and then ask you to pay by cash or credit card. :-)

Have no idea about Sweden but I've got no complaints against the Canadian ambulance system. When my mother suffered a stroke they had her to the emergency department in less than half an hour. When I lived in Northern Ontario they would send serious emergencies out of the area by helicopter ASAP. Fortunately the government pays for it, or at least we do through our taxes.

I would have thought the Swedish ambulance system would be at least as good as ours since they are a much smaller country and have less distances to travel.
04:28 May 4, 2012 by soultraveler3
Reason abd Realism, I'm surprised she didn't try as well, especially if what it says in the story is true. She'd been in Sweden less than a year, didn't know to dial 112, but spoke Swedish well enough to have (what appears to be) a quite in depth conversation while stressing and listening to her son screaming in pain? Unless she studied Swedish before moving here that doesn't seem right. Anyways...

Switching to English might not have made it easier. I've never had to call an ambulance but have tried to call the police twice and it was horrible both times. The first time the police office was closed, no answer, no transfer to a call center, not even a machine to take a message. Found out later that there's a different local number you're supposed to call when they don't answer there.

The second time two older boys were beating a younger and much smaller boy and kept dragging him off his bike when he was trying to get away. Again, nobody answered at first, but after about two mins I was transferred to a call center in Stockholm. The first operator couldn't understand what I said in Swedish or English and it took 10 mins and being transferred 3 times before I got someone. My Swedish isn't perfect but that's all I speak with friends, the sambo's family, at work etc. and they understand me just fine. The police finally showed up over an hour later but by then the kids were gone. I'm really glad that someone wasn't having a heart attack or getting stabbed.

America has a lot of problems with it's medical system, but one thing you can always count on is the police, ambulance, fire trucks etc. showing up when you call. Living in multiple mid-sized cities (3-7 million) in the states, the longest I've ever known it to take to emergency personal to scene was about 10 minutes. There's no reason Sweden shouldn't be able to do the same.
06:20 May 4, 2012 by Reason abd Realism
@ soultraveller 3

Hiring emergency response operators who are not relatively fluent in English in Sweden is ridiculous, particularly given the high degree of English fluency/literacy in Sweden, and the emergency needs of tourists or newly arrived Swedes. Makes about as much sense as hiring an air traffic controller who can only speak Swahili.

In Canada they send out the police every time there is a 911 call, even if no one says anything on the phone, in case that person is unable to speak, or too afraid to speak because of an intruder in the home. A friend arrived home one day to find the police in his driveway, simply because his old style cordless phone began dialing numbers at random, including the sequence 9-1-1, when the batteries were low (a common flaw apparently).

The tragic death of a young woman who was not sent an ambulance when she was asking for one, literally 'because she was still able to speak' is one of the most idiotic examples of criminal negligence and incompetence that I've ever heard of. Sweden gets most things right, but the emergency response system, and the staffing of that system, is not one of them. In principle this system can be much improved, and the obvious question is whether or not any steps will be taken to improve it.
08:08 May 4, 2012 by rise
Well Moderaterna have lowered the taxes by a hundred billion kr per year (for working people, not pensioners). Health care including ambulance service doesn't come cheap. I'd say voters have got what they asked for. Too bad people have had to pay with their lives! :(

Sweden now has an inadequate defence, inefficient police, a scanty health care, trains that aren't working in the winter et cetera and so on. So, one can only exclaim "heja Moderaterna!!". :P

Use of the word "welfare" has become just an other political tool in the world of political liars.
10:44 May 4, 2012 by Pojken
It is called "triage". Not everyone warrants the same treatment.

Imagine this scenario - your child breaks his arm. You called an ambulance. At the same time, your neighbor's child goes into seizure and is turning blue. Both of you rush out and discover both have medical emergencies.

What do you do? Push your neighbor aside? No, that would be cold. Likely, you'd let that take priority.

Same same. S.omewhere in your city, people are dying or are more seriously injured. Likely, the operator is aware of their resources and must make that decision. Sure, sometimes they make the wrong decision, but it is likely never done to willingly withhold medical attention. Sometimes it is done due to poor training and yes, those need to be addressed.

However, reassess what you wrote. Don't criticize based purely on emotion. You obviously made it to the emergency room. Realize that an ambulance is not a state-funded hospital cab. It's meant to save lives.

(Oh, and when I was a kid, I was riding on the handlebars of a bike and my leg got caught in the front tire spokes. I fell off, messed up my ankle, and passed out. My parents immediately put me in the car and drove to the hospital. An ambulance would have been pointless and expensive.)
11:15 May 4, 2012 by hunnysnowbee
I get that some people may think, "Oh, it's only a broken arm. It's not that serious, you could go by car or bus, you don't need an ambulance". But in actual fact a broken limb can be serious, and in this ladys case, where her sons arm was evidently pointing the wrong way, it was a potentialy serious break, requiring emergency attention. A bone can shift when it breaks and cause presure on an arterie, cutting off vital blood supply to the limb. In thise case, immidiate medical attention can mean the difference between the normal healing of a bone by means of the limb being put in a cast, or amputaiton of the limb due to tissue death, caused by lack of bloody supply that has been left in that way too long.

Also, a broken bone can be very painful for even an adult. At least taking a child by ambulance they can get pain reliefe en route to the hospital. 1, Who wants to see a child in any sort of pain, let alone severe? 2 How are parents supposed to concentrate on driving, with their child screaming in agony and they're worried about how bad the injury is. 3, most people do not have the medical knowledge to properly assess how serious injuries can be, and in a hightened emotional state, especialy if you have an injured child, may miss something vital to pass on to the phone operater.

I do not understand this system at all. In the UK an ambulance is always sent, because you just never knnow when it may be more serious than is first thought and it's better to be safe than sorry!
11:23 May 4, 2012 by rise
In the middle of the 1990's my car was hit by a truck, leaving me clamped inside it. It took the rescue team ten minutes to arrive to cut open the roof of the car to get me out of it. The team had raced 12-13km to reach the spot and the ambulance then took me to the small hospital in my small hometown. That hospital lacked resources to help me since I was too severely wounded. Therefore they flew me to a bigger hospital 600km farther south. Otherwise I would not have survived.

If the same accident would occur today I don't think I'd survive at all. Public services have been cut down too much. But hey, at least people now are having slightly lower taxes! :P
11:35 May 4, 2012 by frenchie56
I have lived in sweden now for 22 years (stockholm) twice i have call for a ambulance both time the person aked me if i was breathing ? the first time i could not move because of a back problem 45 mins i waited for the ambulance they had to give me 3 injections of morfin before i could get to the ambulance ´the second time i had a neck problem they told me it would be quicker to take a taxi
13:02 May 4, 2012 by karex
#5

The problem with not calling an ambulance is that then prioritization is shifted from the call for an ambulance to having to go through this in the hospital emergency room. If you arrive by some other means than an ambulance, chances are they will first ask you if you have booked an appointment and try to send you home to come back another day. A friend of mine (he's Swedish BTW) had to sit and watch his wife die (also Swedish) in front of his very eyes while they waited more than 10 hours in the emergency room for the doctors to treat her heart attack. If you come in an ambulance they HAVE to prioritize.

My friend has since left Sweden, never to return. decades later he is still bitter and claims "that accursed country murdered my wife".
14:37 May 4, 2012 by gdoolan
The ambulance system does have a very bad reputation here. And it has lost the confidence of those it is supposed the serve. I have been on the receiving end of patients who have caught taxis to hospital, rather than call an ambulance, as rightly or wrongly, they are worried the ambulance won't come. This needs to be addressed. Screening people over the phone by talking to an operator and a nurse is, in my view, totally inappropriate. And in a system that wastes large amounts of money on all sorts of things in the hospital system, increasing the size and reliability of the ambulance service is small fry.
15:24 May 4, 2012 by Pojken
Do you people know what an ambulance is for? It isn't a portable hospital. It isn't your ride to the hospital because you're freaking out. It isn't a triage station.

Pure and simple - it's a tool that extends life for the precious seconds that is required before required medical attention. It is ultimately quite selfish of people to assume otherwise.

It seems to me that the author was sent through triage correctly. Her son was NOT in a life and death situation and she eventually got herself to the hospital fine. Sure, you could argue the chances that it could have been worse, but in most broken arm scenarios the children survive. Please, correct me if I am wrong.

If this was a severe case in which the child's life was in danger and no ambulance is sent, then by all means, feel outrage. For a broken arm?

I name this molehill Mt Everest II.
16:03 May 4, 2012 by David S
I've had both parents-in-law need ambulances (in Stockholm) and have no problems getting them. More recently up here my sambo fell of a horse and was knocked unconscious for a few moments, but with risk of neck injuries we kept her still and an ambulance was there (20km out in the countryside) in less than 10 minutes.

13 years ago I was involved in a bad car accident, around midnight in the middle of nowhere, an ambulance was there in minutes.

So we've had nothing but positive experiences so far, thankfully.
16:20 May 4, 2012 by cogito
@ Pojken (22) and all defenders of shabby Swedish healthcare pulling the old "triage" excuse. Here's the news: Triage (prioritizing) is routine practice in all healthcare systems everywhere. But somehow in the U.S., in France, in Italy and in Spain, they manage to get an ambulance there before the caller dies.

On the language issue: Can anyone explain why the Vårdguiden (the official healthcare information publications) announces a special telephone number for speakers of Arabic, Serbo-Croation, Bosnian....

But no special number for speakers of English.

They would claim, I suppose, that Everyone Speaks English.

Well, they don't.
16:58 May 4, 2012 by zeulf
I dont wonder that she has too much spare time to write about all the tragodies which follow her move to Sweden, almost hitting a child with an Automobile. ( see March posting), now not being able to load her own child into an Auto for transport to a clinic, Did she get her swedish driving license? You would need one to drive the kiddies to the clinic. hope I dont meet her on the road.

she might write about me next, " Inconsiderate driver uses both lanes of the roadway" why does swedish traffic law allow this??? sorry for the rant
17:18 May 4, 2012 by martiancat
Swedish health care works best when you have a car and can get the injured son to the hospital yourself.

And then maybe you will have to wait for hours to get the care.

Either way, everyone in Sweden assumes that you have a licence and a means of transportation in house or not too far shot (grandparents, friends etc).

Just keep that in mind. It is also very good to have the Jour number of your local hospital in order to call them when you are on your way in, so they can find a doc who is available to wait for you when you arrive.
18:29 May 4, 2012 by swedejane
Here's a thought...instead of spending more money to handle "asylum" seekers from Somalia, why not invest in improving the ambulance service?
18:45 May 4, 2012 by tadchem
The US is not mired in 'health care woes.' Anyone who truly needs medical care can obtain it in any emergency room, as well as in many neighborhood clinics. The US is mired in health-care weeping and hand-wringing from people who want services they do not really need, or who want someone else to pay for their elective procedures. That is all changing, now, as Obamacare is forcing for doctors to quit practicing.
19:13 May 4, 2012 by SecondGen
This isn't always true. In Chicago (USA), you don't always get an ambulance and depending on where you live it can take a while. Back in the heydays of Robert Taylor homes someone discovered that paramedics carry cash and no guns, so they started phoning in false calls for help and then would rob them at gunpoint when they arrived.

After a while the ambulance would meet up with the police at a agreed location and they'd go in together as a convoy. Unfortunately that wasn't always timely and at least one person died while waiting.

Per the trib we had 10 shot yesterday and 3 stabbed so it might be a really fun weekend in the city because there are a limited number of ambulances to go around.

Worse part of visiting a hospital is that some use it as their doctor so the waiting rooms are packed. My last trip to the emergency room resulted in a 7 hour wait and I was "on the fast track" because I had good insurance. Course, it was new years eve.
19:36 May 4, 2012 by Douglas Garner
@secondgen... at least in Sweden the hospital fills less of that non critical care function, and the system is truly designed to delay treatment until the basic colds, aches, and pains resolve themselves. That is a good thing. I do miss, however, being able to call my MD and waiting in the office for a quick visit (of course that is all you ever get)!

MDs here in Sweden take a lot more time with patients and that is a very pleasant change. Regarding emergency services... I have been involved in four occassions where they were called and in each case the response was more than acceptable. It was strange to go through the 20 questions routine... yes, I just arrived at a friends apartment... there is no one here but a girl nearly naked and apparently unconcious on the floor... do you know her name and person number... no... could you look for it? Is she making any sounds? Can you move her? Can you wake her? Yell at her and see what happens, I'll wait... No response... okay, do you know if she has been drinking? Does she take any medicines? Is there anyone you can ask?

Finally, she did sent the ambulance and the girl who had overdosed was revived due to emergency intervention and injections and a trip to the hospital!
21:29 May 4, 2012 by caitnor
find out what they will come for and if you feel you need an ambulance, lie. is he breathing? no. is he turning blue? yes. where was he shot? in the chest. does he have a pulse? yes. is it strong? no. i imagine burns are good too because of the risk of infection, but i guess it would have to be a bad burn...etc... crazy not to send an ambulance. there should be enough for emergencies, ambulances should be sent from another district when one district is running low so that they are always ready to go if more or needed. so correct about if you show up in an ambulance at least an actual medical personal has seen your case.
22:54 May 4, 2012 by Swedishmyth
"The Swedish model of care gets so many things right."

That model, socialism, is what is responsible for the lack of accountability and efficiency in public operations. Price controls lead to rationing, the effects of which you got to feel personally. This applies to gasoline, food, healthcare, or any other product or service.

I've spoken to several Russian immigrants who report having had to deal with much less bureaucracy and inefficiency in their homeland.
23:09 May 4, 2012 by mkvgtired
I have never had a problem with an ambulance arriving in Chicago. I have called one several times for other people and used one myself. Always where there in a few minutes.
00:03 May 5, 2012 by dizzymoe33
Well I never thought I would agree with the Swedish emergency operator but they were correct you didn't need an ambulance. In a case of a broken limb you should have taken your son to the hospital yourself. Now if you are having a heart attack or some type of breathing crisis or you have an open wound that is gushing with blood and guts then yes call the ambulance. Otherwise it sounds like you are better off taking your loved one to the hospital yourself.

I do agree the SOS system needs to be updated and better training provided.
00:20 May 5, 2012 by 4thGenWarrior
it is not just the emergency services- it is the same way with police services, as well- 4 hours for police response after discovery of a break-in.
01:41 May 5, 2012 by Pojken
What is with this sense of entitlement? Lying in order to beat the triage system? Laying down on the floor because of an hour wait? Congrats on your ethics and morals.

Forgive my "triage excuse" - please, call an ambulance because you need a ride. In the US, that would cost you 500-1000 dollars. Lucky in Sweden you only have to pay 20 bucks. Hell, next time I need a ride when the trains close, I'll lay on the sidewalk and pretend I'm having a heart attack. Cheaper than a cab.

Honestly, it's almost embarrassing this overt sense of entitlement coming from... Americans. Gasp!

Here's something you can do that may actually alter your sense of self. Go to a hospital emergency room when you're not sick and sit there. Just sit there and watch the doctors and nurses work. You might actually find some humility and realize that, hey, the center of the universe isn't you.
02:30 May 5, 2012 by rfmann
Ah, Pojken, nothing like a tirade of righteous indignation, mixed with a healthy dose of anti-Americanism.

Didi you read any of the other stories where folks died over trying to convince someone to send them a friggin' ambulance, and failing? Why don't you take your 'center of the universe' speech and your little triage lecture to their families? I'd love to hear what they think about that.
04:13 May 5, 2012 by Eric1
Don't worry President Obama is working to make sure Americans have third world health care. Forward on comrades (over the cliff)!
08:34 May 5, 2012 by RobinHood
There seems to be some confusion here over the definition of emergency. Those entering Sweden should make themselves aware the Swedish ambulance service is not meant as a cheap alternative to a taxi. Walking wounded with reasonable resources are expected to make their own way to hospital, freeing up limited ambulance resources for those who really need it. In other countries, an emergency might be defined in another way, but if you choose to live in Sweden, you really do have to accept the system that exists here, or leave.

Usually, Sweden's excellent taxi services will get you to a hospital faster than an ambulance anyway. Next time Rebecca, for a broken arm, pop him in a taxi. That way, that valuable ambulance will remain available for some poor old guy having a heart attack, and your son will get speedier treatment. Win, win!
09:05 May 5, 2012 by Pojken
Thank you, RobinHood. More eloquently put than I could have written.

rfmann, it's sad that I had to resort to "anti-Americanism" when I, too, am an American. However, this sense of entitlement is often and in this case, truly one that belongs to an American way of thinking about things.

From what I gather from this article, no one's life was in danger. People break bones quite often. Indulging a system that would offer rides simply on the want of one is a waste of money and inefficient.

And sure, those people that died, it's sad. How often, though, does this happen? What caused it? Was it because of poor operator training? An illness that would normally not require an ambulance? Lack of available ambulances? Figure that out first before you paint the entire system as broken due to proper triage.

Confidential to Swedejane: A better solution for you. The next time you stub your toe and need a ride to the hospital, find the nearest Somali and have them piggyback you to the emergency room. That way, they can work off some of their debt to you. It's a win-win!

Oh, and if you could be so kind to please pick those up... my eyes... they seemed to have rolled away.
09:40 May 5, 2012 by Shaikailash
What the Swedish "welfare" consists of? (Cze)

Maybe you should live in other countries for a while to have the answer :) just think that an huge amount of literature and statistics show the nordic model as the best, there must be a reason, or all they wrong?

I just give you some points which make the difference:

- active labour policies (not existing in many other countries)

- universal health care

- strong family policies (not existing in other countries), possibility to reconcile work and family

- free and guarantee education, possibility to life-long learning.

- tax return....you pay taxes, you get services (this is absolutely not guarantee in other countries).

Of course, the fact that Sweden has one of the best welfare system doesn't mean that this is perfect! But instead of complaining as many do, why don't these people fight to improve it, instead of dismantling it?
10:23 May 5, 2012 by cogito
"an huge amount of literature and statistics show the nordic model as the best, there must be a reason, or all they wrong?" (#41)

Probably. Especially if the source of the "literature" and stats. is the S.C.B. or the U.N.

And there is a huge amount of literature and statistics showing that the French system is the best.

And a huge amount of lit and stats. showing the American (or Canadian or fill-in-the blank) system is best...
11:52 May 5, 2012 by Iraniboy
It is not a secret that Swedish ambulance service is in real crisis and everybody knows it. It will just takes long time in Sweden to make an action but they will finally do! By the way when I read the conversation between her and 112, her first comments don't indicate her son has any serious problem. She should have started explaining her observation of displaced arm from the beginning! She said it after she got a No. I guess the person in call center might have though she is exaggerating in the end to change the decision!
12:21 May 5, 2012 by HelmiVainikka
@cogito:

No worries there, some people actually believe in their own BS.

I go by one quote that works for all countries:

No country is as horrible as it is made from the outside, and as great as it is being presented from the inside.

Hej hej! :P
12:23 May 5, 2012 by Max Reaver
I pity those fools who repeatedly bring up the argument of "triage situations". First of all, others' "emergency situation" is not for us to judge. In this article, the author had a story about kids falling off the bed, breaking an arm. Lucky for them the injury stayed at the arm and not further up/down. There is a special branch of medical practice called pediatrics, which means medical care for kids and infants. Kids cannot communicate the same way as adults, also because of the fragile nature of their physic, what seems to be a minor injury could very well have more than meets the eye. If an adult broke an arm and remains conscious, you might consider a taxi. But kids are a special kind of patients altogether.

The advocates of the "triage" seem hellbent on arguing that seemingly non-lethal injuries dont required the ambulance. Then again we have to draw the line of where the injuries are considered non-lethal. Most people, who are not educated in basic medical knowledge, don't know the answer. Take for example someone who has broken a rib. The broken bone in the chest, if handled inappropriately, may puncture a lung, an artery, the heart, or stomach. In the latter cases the patients has high risks of dying. That's why we need trained medical personnel to handle these ambiguous symptoms.

I don't understand why some people are defending the somewhat defunct system. If there's been one death because of late ambulances, then something IS wrong. We don't need more deaths to know for sure. You can never rationalize a life-saving service with deaths, that is completely against its purpose. To Pojken and some others above, do you not agree that dying while denied ambulance is tragic? Do you even dare to bring your arguments to the families of those poor souls face to face, not having your identity protected by an online alias? Furthermore I sincerely hope you don't get denied ambulance when you most need it.
14:49 May 5, 2012 by saar
When my son(7 y.o.) broke his arm it never occurred to me that I have to call the ambulance. I just drove my son to the hospital myself because it is faster. And how the ambulance would have helped in my case? They would not do anything to the arm anyway.
15:04 May 5, 2012 by JulieLou40
I am amazed at this woman's continued displays of stupidity and selfishness. It sounds like on this occasion, the chain worked quite correctly. No doubt it was painful and distressing for her son, but it wasn't life and death. Ambulances are not an automatic rightful entitlement.

On the other hand, maybe she wanted someone who would at least drive the vehicle in a safe manner, and (unlike her) not almost kill any children on the way to where they were going (see her March entry).

Why oh why is this moron given space for her nonsensical and stupid "articles". I hope to God she's not getting paid for them!!
15:54 May 5, 2012 by MitchT
I have raised two fine sons and nearly finished one tomboy, so the ER people have come to know us well. Best practice for your common or garden variety broken bone is to bundle the precious snowflake into the family car and take him in for treatment. Ambulances are for patients who cannot be safely moved otherwise, or for those requiring the lifesaving EMT treatment they would receive in the ambulance. There may very well be severe problems with Sweden's ambulance service, but this is not the story I would use to demonstrate it.
18:15 May 5, 2012 by Pojken
Would I discuss this with the parents or friends of someone who died because of an anomaly in medical care? I wouldn't be so callous. I would, however, reprimand someone who abused the system because they felt entitled.

Let me ask you, what would you say to the parents of the child who just died because their ambulance didn't arrive in time die to you wanting a sage ride to the hospital for a minor injury.

One can have a warehouse of ambulances, but without proper triage assessment, they become meaningless in times of true need.
20:43 May 5, 2012 by girlllllllly
I would have called an ambulance just like this woman did. If her kid's hand was broken that badly, the kid could lose movement in his hand forever on the car ride over if it wasn't splinted correctly. Also, I wouldn't know which hospital to go to that had an oncall pediatric orthopedic surgeon or pediatric anesthesiologist. Not all hospitals have these doctors available.
11:01 May 6, 2012 by cogito
@49. Given Swedish taxes, obviously there should be enough ambulances to go around.

How insensitive of this mother to care so much for her child. So un-swedish of her. She should first consider the welfare of samhället (the state) and the collective needs of society in general.
14:08 May 7, 2012 by libertarianism
In answer in part to Reason and Realism, plus my two-plus cents:

Beyond the scope of this article, it seems the general rule in Swedish healthcare is IGNORE the PROBLEM. If you ignore a problem long enough, it (ie he or she or more specifically YOU) eventually "goes away".

Our bodies are miraculous machines and have a great capacity for selfhealing. Yet there are generally treatments which accelerate/improve this process and reduce physical/mental discomfort. It's far cheaper though for the State to ignore you and let your body slowly and painfully heal as best it can. Ignore the problem. Save money.

But even w/ time and suffering, some people don't heal. Some illnesses grow worse and what was initially a small easily treatable disturbance mutates into fullblown physiological chaos. Even at this stage many Swedish doctors will still heed the company line, ignore ignore ignore.

If you need emergency care often enough you may eventually be allowed to begin the (up to) quarter-year wait for any individual specialist. (No, you can't wait simultaneously for multiple doctors.) W/ serially underfunded healthcare there's a shortage of pathologists, specialists doctors/nurses, medical equipment, etc. And so some people die waiting. Ignore the problem. Save money.

You may finally even get to a doctor who is competent/caring. But they too are stuck in the system. They're stuck w/ deadweight coworkers, dated/restrictive guidelines and retro pharmaceuticals. What's to be done? Nothing. Ignore the problem. Save money.

And even if you somehow make it through all this or go outside the State for care, FK has its own "doctors" whose opinions trump those of all other doctors. So your tax money actually goes to pay the salary of multiple layers of bureaucracy whose job it is to IGNORE and DENY you life/life-quality dependant services.

Tax payers (ie. living breathing beloved humans) are not well-served by this system. The system (and us by extension) has been rationed to death. Familjeläkare especially often act more like doormen/bouncers than doctors. Where are the healers? To some degree the Swedish church has spoken out against the system's inhumanity. Förenings advocate for patients and are an incredible source of support/information and often collaborate as well w/ the few caring doctors, researchers, lawyers.

Individuals have little-to-no control over their own lives, their own treatment. State employees decide who lives/dies. Jante healthcare means you are nothing. Only the herd is of value. A system that pathologically boasts of its fairness, instead has frightening, unchecked power which it wields most unfairly.

Before, the State actively sterilized "problem" populations. Even NAZIs actively killed their "problem" blue-eyed sick. Today's socialized state handles the problem sick more passively, by actively ignoring them. Ignore the problem, save money. Ignore the problem, it (i.e. you the budget item) goes away.
16:10 May 7, 2012 by Urabutln
I'd like to know WHERE in Sweden this woman lived - since the Swedish ambulance services are administrated on a local level, the response times can be radically different depending on where you live. This means that people in Stockholm and surroundings quite often wait for hours. Gothenburg and the west coast seems, in my experience, to be blisteringly fast.

In the north of the country, it depends on how many ambulances there are, and how many emergencies there are at that particular moment.
09:58 May 8, 2012 by Beaniebear
When my Swedish husband tore the ligaments in his knee and I was going to call an ambulance for him he said not to bother since it would be hours before they would come to get him. Instead I fetched the car and some friends to help load him in the car and then drove him to the hospital myself. Two weeks later our neighbor fell and broke her hip. She waited fourteen hours for an ambulance to come!
15:38 May 8, 2012 by Baned
Stories like this infuriate me! In my experience, the lack of care isn't limited to the healthcare industry or workers, but with actual Swedes!

Swedish societal norms have their pluses: it's a peaceful country but when someone's injured, I've seen firsthand how Swedes will doubt and downplay the situation, pretend to be doctors instead of actually helping the person injured! WHEN IT'S A NECESSITY FOR AN INJURED PERSON TO MAKE A FUSS JUST TO GET HELP, something's seriously wrong.

I don't know if it's a lack of compassion, or a lack of understanding anything outside of yourself, but it's definitely lacking here. It sickens me to think about it and hear more and more stories.

In many ways Sweden is cold.
15:01 May 9, 2012 by skogsbo
No suprise that an anti Swedish article come from her, it's all she can write, yet she still chooses to stay?

Anyway, how does she know that there weren't greater emergencies elsewhere and the ambulance was sent to greater priority? The fact that her son was making alot of noise, actually means it's less serious, if he was silent, unconcious, drowsy then it's more concerning. Having broken my arm/collar bone twice myself and chopped the tip of finger off, all before the age of 11 I speak from experience, in all cases I went to hospital under my own steam / parents car.

If not sending an ambulance won't make you injury worse, why use a resource. Save yourself time and just head straight for hospital. Healthcare is privilege that much of the world lacks, why waste it. A bit of pain, will have been forgot about, by the time her fingers reached the keyboard, plus pain is the reward for doing something daft or dangerous, we learn from it, I did.
19:34 May 9, 2012 by Kaethar
Pointless arguing here when the headline is INCORRECT. Might shock the article writer to know that people HAVE been denied ambulances in the US (Here's one example: http://jacksoncounty.fox4kc.com/news/news/68819-mother-claims-daughter-was-denied-ambulance-service). That she seems to think this happens only in Sweden is due to media bias - The Local reports on nearly every story like this they come across because it gets visitors to their site (English-speakers looking for evidence of the failures of the Swedish medical system).

That being said it IS more likely to happen in Sweden for obvious reasons. When ambulances bring in lots of money they want to pick up as many people as possible. When this is budgeted they'll stick to a guideline. For example in the article's example I can see why she was turned down. If you break your arm with someone else present you are perfectly able to get into the hospital yourself. When I dislocated my knee I needed ambulance assistance and they came straight away. When I broke my wrist I got driven to the hospital instead - it wouldn't have occurred to me to call an ambulance.
10:38 May 10, 2012 by libertarianism
Re 57, TL does not report on nearly every story like this. There are far more such stories buried in the Swedish news, which still barely hits upon the issues and the people they affect. TL largely translates Swedish news, and Swedish state media has a very heavy Left bias.

Professional medical förenings, patient advocacy förenings, personal blogs, and even some lawyers and the Swedish church do a lot to identify weaknesses in the system and/or advocate for patients' rights and proper care. The continuing themes, thoughout these sources are budget cuts / rationing and apathy of medical workers.

Furthermore, it's very mean to keep berating the author over her concern for her son's emergency, especially after so many have pointed out that bad breaks can be life-threatening. As someone earlier wrote, such situations should be judged by compassionate experienced medical personnel.

If the American right jumps on these stories, good for them. Such stories need exposure. (And as the American right is far from perfect, they're fair game to be criticized as well.) Identifying weaknesses and actively correcting those weaknesses is how humanity grows.

It's revolting that non-Swedes get slammed by non-Swedes, especially, for identifying grave errors in the system. Numerous Swedes in Swedish are advocating for patient rights. They are not happy with the system's status quo. For non-Swedes and/or newcomers to Sweden to uncritically parrot state propoganda is a grave disservice to the many sick and elderly whose voices are burried by an authoritarian medical state.

Far too often people love state-peddled ideas more than they love actual, living, breathing human beings.
12:34 May 10, 2012 by cogito
"It's revolting that non-Swedes get slammed by non-Swedes, especially, for identifying grave errors in the system." (#58)

@libertarianism, Right. It is always the same poster (#56) who foams at the mouth if anyone points out that Sweden is not paradise. Maybe Sweden is paradise, compared to Britain.

Non-Swedes do Sweden a service in advocating for patients' rights.

Those whining love it or leave it are not are not. And, yes, it is revolting.
17:51 May 10, 2012 by skogsbo
it's just such a one sided story. You give a US story where the ambulance came, you give a Swedish one where it didn't. Neither were potentially life threatening in reality, yes it hurts, but a broken arm is much less serious than a hip or femur etc. Plus how does anybody know what other emergencies were happening at the same time? Also US ambulances bring insurance carry customers to hospitals, it's a business, or a fluffy flashing lighted taxi service that brings them money?

I have no idea on the US, but compared to the UK, I would say Sweden is better for medical services, but everyone experience differs, because we all live in different parts of Sweden, we do all live here don't we? ;)
21:05 May 10, 2012 by cogito
That the Swedish system is better than the UK is killing with faint praise.

This is not an isolated incident. Search the Local:

"Report slams denied ambulance call death" (27 Mar 12)

"Heart attack victim dies after ambulance denied" (14 Mar 12).

...and many more stories in the Swedish press, which, at long last, is starting to cover the shoddy healthcare system.
21:37 May 10, 2012 by libertarianism
Out of curiosity, I found...

If you suspect a fracture [or break], you should go to the nearest hospital or emergency room. If it is a dangerous fracture [or break] you should ring 112 for an ambulance. // You can also get 24-hour medical advice from a nurse at 08-320 100 or in Arabic 08-528 528 38. (No other languages were named. The info itself was in Swedish.)

www.vardguiden.se/Sjukdomar-och-rad/Omraden/Sjukdomar-och-besvar/Frakturer-hos-barn/

And out of curiosity, a U.S. site says as well to call an ambulance for a broken bone * if *: The person is seriously injured. You suspect an injury to the person's head, neck, or back. Bone is sticking out of the skin. Bleeding doesn't stop after several minutes of firm pressure. Blood spurts from the wound.

http://firstaid.webmd.com/broken-arm-treatment

Beyond this, since Sweden's child services can have sticky fingers, it's probably good that this mother took the safest measures to secure help for her child's injury.

Perhaps we all should take a first-aid course(s) to better ensure our own safety and to better argue for our rights to access to care... Just a thought.
00:42 May 11, 2012 by TheWatchman
@Karex

That's just sad. :(

Canadian services take things seriously. We thought someone tried to break in or something, we heard a loud knock at the door no one uses in the middle of the night. We called the police just to look around the neighbourhood, they never found everyone, but they responded quickly, 5-10 minutes for something which might not be a big deal. We were impressed. If this were Sweden, I'd bet it would take maybe an hour or so.
07:11 May 11, 2012 by skogsbo
Cog, but to suggest that USA healthcare is free and that ambulances always arrive promptly for everyone in the USA and that the USA has equal healthcare for everyone is also untrue and misleading. In Sweden everyone gets equal treatment for their 150 or 300kr, what about the US?
08:50 May 11, 2012 by cogito
Although you often see idiots calling healthcare in Sweden "free,"

where have I, or anyone, suggested that healthcare in the U.S. is free?

What is true is that that those without means or insurance receive high-quality treatment in local clinics and hospital ERs without having to pay a cent.

To believe that everyone gets "equal treatment" in Se. is as naive as believing that healthcare is free in Sweden.

The quality of care in Se. depends on where you live, your level of education, your age, your sex, your class, your accent and whether or not you are a pure Swede or what they call "new Swede."

There is in Sweden a parallel, but tacit, triage: At the bottom are immigrant women and the elderly. At the top are Swedish men from 25-35.
09:17 May 11, 2012 by RosemarysBaby80
In a phrase ironicly coined by Americans "If you don't like it, then get out!"
10:47 May 11, 2012 by skogsbo
Cog, clearly I buck the trend, I'm an immigrant, speak poor Swedish and don't fall into your peak age bracket, but have recieved excellent treatment. Do USA patients get equal ongoing care once they are no longer an emergency. I know that you specifically didn't suggest it was free. But comparing usa to se is like chalk and cheese.
12:58 May 11, 2012 by libertarianism
Re 67, Clearly if YOU'VE received excellent care, then ALL other patients in Sweden must also have received excellent care. Someone please alert the lawyers, researchers, professional förenings, patient advocacy groups, support groups, grief counselors, insurance companies, etc. that skogbo received excellent care. Mission accomplished. Someone please draw up a wikipedia article that the pinnacle of all human acheivement has now been reached. Wait! I think I see Jesus, returned, just outside my window... --Yes, Jesus. It's true. Skogsbo recieved excellent treatment. Everything is truly good and fair and equal now. There's no more suffering, in Sweden...
12:58 May 11, 2012 by Twiceshy
soultraveler3 you got to be kidding when you say that fire trucks always show up in the US.

Google this: "No pay, no spray: Firefighters let home burn."
16:44 May 11, 2012 by libertarianism
Written in 2010 by a Swedish psychologist:

The number of hospital beds are only a third of what they were in the 1970s (and mental healthcare now barely exists). Hospital patients are left in corridors and coat vestibules, with no ability to contact staff. The author herself has experienced this several times, has been hoarse from screaming for help. Patients were everywhere, total chaos. The staff did the best they could, but it was too much.

No other country has such long waiting lists where people die waiting for surgery. No other country in the OECD has so few hospital beds, 2.6 per 1000 residents, compared to 4.6 per 1000 for other OECD lands. Last week two elderly people died, lying in a hallway. When complications happened, no one was close. No one checked on them regularly. The staff was found to be poorly trained.

www.newsmill.se/node/29105
20:12 May 11, 2012 by oledeluca
Don't stay on the phone. Hang up! Either set the arm your self and see a doctor when you can or just get to the nearest hospital right away. Carry him if you have too! Then, if a U S citizen, file a complaint through normal diplomatic channels and raise all kinds of ruckus until you receive a formal apology and assurances that it is corrected. If you are a Swedish subject, then formally complain or better yet run for office and change things. As a last option, vote with your feet and move elsewhere. Norway is good, Iceland better and Germany is quite good. :)
14:50 May 13, 2012 by libertarianism
Re 72, tax payers have clothed princess Estelle in head-to-toe Baby Dior, with her tiny coat alone priced at 2 000 SEK (287 USD).

(Compare to some senior homes where favorite, simple, basic comfort foods such as coffee and butter have been rationed.)

http://starlounge.se.msn.com/photopage.aspx?cp-documentid=161338291#image=1
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