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Docs tell 83-year-old Swede she's 'too old' for treatment

The Local · 24 Jul 2009, 10:23

Published: 24 Jul 2009 10:23 GMT+02:00

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"Without the operation, I might have lived another five years in incredible pain. But what kind of life is that?" Marianne Skogh told the Östgöta Correspondenten newspaper.

Skogh has suffered from pain and numbness in her legs since 2004.

After waiting for more than a year to see a specialist in the public health system, Skogh was finally told that the pain was likely to do problems in her back.

Doctors told her she suffered from spinal stenosis, a disease that involves a narrowing of one or more areas in the back.

The narrowing puts pressure on the spinal cord or on the nerves that branch out from the compressed areas, often causing cramping, pain or numbness.

But despite the lengthy wait for the diagnosis, Skogh was then told that, even though the ailment was treatable, she was too old for the surgery.

In addition to Skogh's age, the fact that she had previously undergone heart surgery also made her ineligible for the operation, doctors explained.

In lieu of the surgery, Skogh was prescribed painkillers, which didn't alleviate her symptoms.

Christer Andersson, head of medicine at Linköping University Hospital, denied that age was the deciding factor in the diagnosis.

He told the Östgöta Correspondenten that county health official don’t prioritize patients based on age, but that age can play a factor if it is deemed the patient is unable to handle a course of treatment.

With her condition failing to improve, however, Skogh eventually became worried about her ability to walk and finally decided to finance the operation herself by seeking treatment at Sophiahemmet, a private hospital in Stockholm.

"I would have been confined to a wheel chair if we hadn't called a private hospital. I immediately got an appointment and the doctor didn't say anything about me being too old," Skogh told the Expressen newspaper.

Skogh ended up paying 130,000 kronor ($17,500) for the surgery needed to relieve the pain caused by the spinal stenosis.

Less than a month after the surgery, she is living pain-free and says the price she paid for private treatment was worth regaining her quality of life.

"There are thousands of people in my situation. With a meager pension, they don't have the ability to do what I did. It's important that they receive assistance in preserving their right to a dignified life," she told Expressen.

Skogh is particular upset that county health officials didn’t inform her about options for seeking a second opinion or about options for private care in the area.

But Anders Olai, a spinal specialist at the department of orthopedics at Linköping University Hospital, said that it is not common practice to refer patients to other doctors.

Story continues below…

"We have no policy of directing people to another doctor for a second opinion. If someone is dissatisfied with one doctor's assessment, they can turn to the county in order to try and get another diagnosis," he told Östgöta Correspondenten.

The who episode has left Skogh questioning the value she received from all the money she’s paid in taxes over the years.

"I can understand that the county feels it is expensive to 'fix' us elderly, there more and more of us, but in general, I am healthy," she told Östgöta Correspondenten.

"We end up paying for healthcare for younger people, but we don’t get anything ourselves."

The Local (news@thelocal.se)

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Your comments about this article

12:32 July 24, 2009 by Random Guy
and people in the usa want this type of health care?

sue the state for the cash i say!
12:49 July 24, 2009 by Octover
Given the age of 83 she probably would've been on government health care in the US as well. I suppose if Medicare would pay for it today than why wouldn't a government plan pay for it tomorrow?

Why do people think that private health insurance is more lovingly going to pay for things? They try and weasel out of things for the simplest billing mistakes, wasting untold amounts of money going back and forth to get the invoices just right and then paying them like they should've done in the first place.

Facts are no matter what system there is rationing and mistakes. I think the American people are realizing that government officials just might be able to be held more accountable than their company's HR department and the private insurer that they choose. That's another great myth that Americans have choice, they usually only have the choice as to whether or not to be in the plan their employer has chosen.
12:50 July 24, 2009 by Nemesis
Older people are not throw away people to be discarded. They should be treated with dignity.

I hope she sues for compensation and publicly embarress's the people who made this insane decision.
13:43 July 24, 2009 by Mib
Everyone...get used to this! Even in a highly taxed country like Sweden, there are not enough resources. It will get worse until people who can afford it, have private insurance. People living longer is what every Government strives for. However, the longer people live, the more they have to pay in pensions and the more illnesses they will have to treat due to advances in technology. Who is going to pay for that? Are you prepared to pay an extra 20% in taxes? Will that be enough to cover the extra costs. This is in the confines of much lower salaries in Sweden for medical staff than in the UK!
15:29 July 24, 2009 by Kaethar
Since I read Swedish newspapers I always try to guess what will be reported at thelocal - and this story was predictable. Seriously, with all that's happening why the constant reporting of healthcare and rape cases? Surely this story comes as no surprise? All hospitals in the world use cost effective management since no one has endless resources. I'd need more details about the case and the doctor's motives before making a judgement.
17:43 July 24, 2009 by vladd777
I have found that one has to fight for one's rights and I totally agree with Nemesis.

Pensioners are forced to pay higher taxes and in this we are not found to be 'too old' sooo...sock it to them!
18:40 July 24, 2009 by Mb 65
If she was an immigrant she would have got the treatment. She should take her case to the court of human rights.
02:26 July 25, 2009 by xykat
I'm an immigrant and I never received treatment for swine flu and I went to the hospital.
02:37 July 25, 2009 by Puffin
Although being too old does have its benefits in Sweden - the prosecutor has decided not to prosecute the 85 year old pork chop robber who hit a supermarket assistent while making off with her pork chops as she is too old to stand trial

19:24 July 25, 2009 by CTIDinÅrsta
So the doctors at the University hospital in Linköping gave a medical prognosis that the woman wasn't suitable for the surgery and instead prescribed an alternative. The doctors at the private Sophiahemmet decided she was suitable. I'd be interested to hear why the medical diagnosis at the private hospital differed from the original one. I can think of 130000 reasons.
21:18 July 25, 2009 by Calumet
Agreed. Plus, we really don't know enough about this person's health to fully understand if her other health issues made the 1st unwilling to do the surgery.

"Patient selection - Deciding on surgical intervention in a patient with LSS [Lumbar Spinal Stenosis] requires a careful consideration of potential risks and benefits. Patients should know that the benefits of surgery decline over time and that repeat operations are performed in 15 to 25 percent [16,17,22,23,30].

Surgical complication rates include mortality in 0.5 to 2.3 percent [24,31]. Other serious complications (eg, infection and deep venous thrombosis) occur in approximately 12 percent of patients. The patient's age and number of comorbidities impact significantly on surgical risk [24,31,32]. Features of the surgical procedure, including the use of fusion and/or instrumentation and the number of levels operated on, may also impact complication rates [25,33-35].

Several studies have identified varying predictors for outcome of surgical treatment of LSS [21,22,36-38]. Predictors of a good clinical outcome after surgery are quite variable between studies. A systematic review identified the following predictors in one or more high quality studies [37]. Negative predictors were:


Concomitant disorder influencing walking capacity

Cardiovascular comorbidity


Positive predictors were:

Male gender

Younger age

Better walking ability

Better self-rated health

Less comorbidity

More pronounced canal stenosis"

Source: UpToDate
22:52 July 25, 2009 by travels
"We have no policy of directing people to another doctor for a second opinion. If someone is dissatisfied with one doctor's assessment, they can turn to the county in order to try and get another diagnosis,"

You need to go through the county in order to be able to get a 2nd opinion?? WOW! In the USA you just go and get a 2nd opinion and your insurance pays for it.
23:34 July 25, 2009 by Roger O. Thornhill
No truth to this statement. There are @1300 health insurers in the US Market. If someone doesn't like the insurance their company provides they are free to purchase any insurance as they like.
23:39 July 25, 2009 by Calumet
Easier said than done if that person has a "pre-existing condition".
04:15 July 31, 2009 by Hedley
I am agree with KI docs!

Although, this old lady went fine, she would have had a very hard time with a cardiac or a thrombotic event.

Anyway, all the team involved in her medical procedure deserve to be congratulated, because it is not easy at those ages!

I am a Panamanian medical doctor.
05:33 July 31, 2009 by Bender B Rodriquez
Lol, so true!
05:43 August 20, 2009 by MichaelZWilliamson

I think the American people are realizing that government officials just might be able to be held more accountable than their company's HR department and the private insurer that they choose.

Wow, and you said that with a straight face, too. The quality service of the Post Office or Bureau of Motor Vehicles or Internal Revenue Service, brought to your medical care! Bravo.

PS: You can't sue a government employee for actions performed in pursuit of their duties.
20:14 August 20, 2009 by conboy
No but you can go to the Discrimination Ombudsman and if you can afford a good lawyer go through the courts including the European Court on the other hand who can afford that? Having said that Sweden has never defended a single case which came before the European Court and has conceded and been heavily fined. Sweden's record in the European court is not a good one!
09:45 August 21, 2009 by jacks
A big question mark on values of morality and equality. Shame if after paying taxes for whole life one ends up in a condition of lost rights to avail life quality maximizing care option. Doctors working in government health care would try to baffle with one or other excuses, but this case has proved they were grossly wrong.
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