Strictly speaking, we do not have a healthcare system in Norway. We have a healthcare system. Approximately 97 out of 100 Norwegian health kroner goes to repair injuries and illnesses that have already occurred. Prevention, which is both more effective and less expensive than treatment, is eaten up with crumbs. When we also know that 90 percent of the burden of disease in Norway is non-communicable diseases (such as cancer, cardiovascular disease and type 2 diabetes) which are largely preventable, it is difficult to understand why our politicians do not prioritize different. The proportion of elderly and chronically ill people in society is rapidly increasing. Our total health expenditure has exceeded NOK 400 billion a year. A drastic change of course with more prevention, to treat less, is absolutely necessary. This is the only way we can prevent that, within a few decades, we will end up in a situation where the total health and social security expenses will be so large that we risk our health system, and indeed the entire welfare society, coming to its knees. Even our oil fund will not be sufficient to absorb these increased costs. A course change is needed. Here are our three New Year wishes: Invest in prevention and public health now! For every kroner we invest in prevention, we can expect to get back 14 kroner. You don’t have to be a stockbroker to see that this is a very good investment. Yet some of our best public health measures, such as introducing an hour of physical activity in schools and a free, healthy school meal every day, are scrapped by our politicians time and time again. This year too, these proposals, which were part of the Hurdal platform, were put in the drawer by the government to save money. From a socio-economic point of view, this is at best unwise, at worst it shows gross economic misunderstanding. By not making these relatively small investments in public health, we can expect to incur formidable costs in the future. Allowing children to move a little more at school is not particularly expensive. Inactivity, on the other hand, comes at a cost. The total costs of inactivity in Norway are estimated at approximately NOK 239 billion per year. Introducing a decision that all Norwegian schoolchildren are guaranteed at least one hour of physical activity every day will probably be the most important public health measure since the Smoking Act. Dear politicians – what are you waiting for? You and I must contribute! We Norwegians are not as active and healthy as we like to think. More than 70 percent of us are inactive and move less than the recommended 150 minutes a week. Seven out of ten are overweight, and more than two out of ten are morbidly obese. The figures are discouraging, and show a Norway in physical decline. In fact, measured by the proportion of the population who are sick or disabled, Norway is the world’s sickest country. We can help prevent most of the diseases that affect us, including through physical activity and diet. And much less is needed than many people think. A little more movement in everyday life, for example a walk a couple of times a week, or replacing an unhealthy food item with a slightly healthier one, can contribute a lot to both your health and public health. Don’t spend time hatching the perfect training program or diet, because no one can follow that. The best change is the one you make, and absolutely every man leaves. A little is always better than nothing! Exercise as medicine in the healthcare system Exercise is medicine. For many patient groups, personalized training is important. Adapted training means that patients tolerate the treatment better, get better treatment results, fewer side effects, better mental health and they return to work faster. Exercise as medicine is good health economics and good social economics. Almost 37,000 of us will receive a cancer diagnosis during 2023, and more than 320,000 of us are living with a cancer diagnosis, or have recovered from cancer. Active against cancer has for the past 15 years arranged for cancer patients to have the opportunity to receive personalized training as part of their treatment by establishing Respite Rooms (training centers) in Norwegian hospitals. This is an existing offer that all cancer patients should be referred to at the time of diagnosis. Nevertheless, there are many cancer patients who today do not receive this offer because it is not part of the package process. Introducing referrals to adapted training for cancer patients (and other patient groups) is a good example of well-spent healthcare dollars and an investment in the future. The UN’s third sustainability goal is good health and quality of life. As part of this, Norway has committed itself to the UN’s and WHO’s goal of reducing premature death from non-communicable diseases by 33 per cent by 2030. Lack of investment over time in prevention and public health means that we have a long way to go to achieve this goal. Let 2023 be the year for the “healthy shift”, where together we change course and rebuild Norwegian public health!
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The world’s sickest country – Ytring
