Swedish Welfare
If Americans never understand what a social welfare system is, how it salves wounds of our gross economic inequality, why it is one of the most humane, advanced, amazing efforts we as humans can band together and work on, then this country will continue to go down the toilet.† Here is an exceptionally well-written, non-exceptional story, copied out of a tweetstorm by Alison Gerber — you’ll find that link to be dead, likely because Ms. Gerber’s thoughts attracted tons of attention, and in this toilet bowl internet era we live in, likely lots of death threats. Or worse: requests to do television interviews. Anyway:
So I’m an American living in Sweden, the socialist nanny-state hellscape of the GOP’s fantasies. Here’s what it’s like to live in a country with a high effective tax rate and a commitment to spending for the common good: I don’t worry that a minor accident, illness, or other bump in the road will derail my family’s future or mean that we lose everything. We have excellent health care and social insurance, and the state steps up when we are in a crisis. It’s not perfect, of course. There are emergency room wait times and such, just like everywhere else. But, for example: I broke the crap out of my foot a while back, in a pretty awful accident involving a zipline. The local hospital in Malmö took a couple of hours to get me through intake, doctors, x-rays, and diagnosis. They sent me home with a soft cast and instructions to come back for a hard cast in two weeks or so. The next day two handsome gentlemen showed up at my apartment. They were from the city’s “hjälpmedel” office, which I hadn’t known existed. They take responsibility for providing resources to people with permanent or temporary disabilities. Their goal is to provide the aids necessary “to independently, or with help, meet basic personal needs and perform daily activities.”. In my case, this meant that they installed a seat in my shower and fitted me out with a wheelchair. The wheelchair was brand new and they unwrapped a soft seat and made sure the foot rests were adjusted to the correct heights. Then they carried it back down a few flights of stairs and parked it just inside the front door, ready to go. They gave me a crazy grabber stick thing so I could get things from the comfort of my sofa, and pimped the crutches we’d gotten from the doctor with reflectors and soft grips. All of this was free. They gave me their numbers so I could call if I needed anything else. I fooled myself into thinking that I was fine to work from home for a couple of days before I realized that the painkillers I was taking were not exactly helping me to do my best work. I called the HR person at my job, and she walked me through how to call out sick (after scolding me for not calling earlier and for trying to work, which she found ridiculous). I was unpaid for one mysterious “karensdag”, then received the standard 80% of my salary as long as I was out sick - plus a bump up to 90%, since i was employed by the state. Probably if I’d been out for a long time it would’ve involved some hassle, but for a few weeks it was just that call and a form. I had get some folks to cover my classes for me, which everyone treated like a reasonable part of working life. You’re sick. Obviously we’ll solve it. Later I got the hard cast, got the cast removed, got more x rays, then started physical therapy with an amazing PT that I chose from the many options in town. Money was never a part of my decision making. You do pay a small amount to see a doctor here, up to about $50, but you only have to pay $130 per year for such visits, and then you get a “free card” for the rest of the year. There’s a similar system for medication. There is, obviously, no discrimination against those with free cards. I still see that physical therapist from time to time. About a year after the accident the zipline place’s insurance company sent me some money - about $1000 - intended to cover any costs I might have had : new shoes with better support, a couple of taxi rides, etc - this because they had filled out a form when the accident happened.
That’s enough of that. Let’s see. Oh! Yes, I had a kid here. Obviously very intense prenatal, delivery, and postnatal care was included in this medical system - though a good deal of it is actually exempted from those small $20-50 fees, so those visits are totally free. We chose to have our kid at an extremely hippy dippy hospital about an hour away from where we lived; it was the home of Swedish Midwifery. The main differences were, as far as we could tell, that a) it was not a big deal to get vegan meals and b) the essential oils that they would drop into the large whirlpool tub that was provided were biodynamically produced. We stayed for a couple of days after the birth, in a “family room” that was basically a hotel room with constant excellent room service and adjustable beds. An ultrasound had suggested our kid might have something up with his kidneys, so he saw a doctor earlier than most; on day 3 they took him for a lil’ scan. Everything was fine. We stayed for “only” 3 days with the cable TV and vegan food deliveries, then headed home. I don’t remember anything at all about the costs of all this, because there were none, basically. Mothers’ and childrens’ health care is free. We did have to pay for gas to get to that faraway hippy hospital, so that’s probably like $40 round trip.
Well, what more should I say: what is it like living in a country that uses its significant financial resources to take care of its citizenry? Let’s keep talking about those kids. The kid was born, and we didn’t plan well: neither of us had a full-time job with a permanent contract at the time, so we got the minimum allowable parental leave money (as opposed to the 80% of our salaries if we had planned better / if we organized our lives around money). What that meant for us was, more or less, we split child care 50/50 that first year. One of us was always with the kid while the other one was working. When you were “staying home” with the kid, you were never really stuck at home: there was a crazy world of free and nearly-free stuff to do all the time with small kids, mostly run by the city but also with city and state money through a variety of organizations. Our favorite was the local “open preschool”, a few blocks from our place, where parents could bring their pre-preschool-aged kids to a giant very well stocked playroom and hang out. There were rooms full of toys and full-time professional pedagogically-trained staff to play with the kids, but you didn’t drop them off: you stayed, and depending on your personality maybe you were down on the floor playing with the toddlers or maybe you were just sitting over at the table drinking coffee with some other parents. This was basically open all the time and was free, and was a place to meet friends, make friends, give your kid some time with other kids, give yourself a break. Most of the parents there were pretty chill.
You can’t put your kid in public child care till one year of age, so it’s assumed that everyone will take at least a year’s parental leave (divided between parents) and most will take more. Anyway. We took hella advantage of the open preschool, theatre and singing groups for babies, everything there was. Then it was time to start preschool when he turned one. It wasn’t perfect. We were assigned to a preschool in the building next door to ours, and we didn’t love it. We thought it was a bit too dark and that they didn’t spend enough time outdoors, and we liked some of the teachers a lot but weren’t in love with some others. It was full-time care, with relatively flexible hours, and cost us about $100 a month if I remember correctly. When our son was a few months old I had to go to Norway to work for a few months, and we decided to take advantage of the break and request that he change preschools. By this time we had a sense of the reputations of all the preschools within walking distance of our place (and yes, this was an incredibly frustrating process, since officially all of the preschools are of exactly the same quality and have exactly the same amenities and procedures etc etc… navigating social democratic bureaucracies is not all chocolate and roses, especially for a foreigner) and had a list of a few we’d have been happy to switch to.
When we came back after the Norway trip, our son started at an amazing place with wonderful teachers and nice bright rooms and they spent all the time playing outside we could have hoped for and we loved it. And he loved it. Again, we didn’t make much money, so it was less than $100 a month for full time care; if we’d been rich, the fees would have topped out at about $150 a month. Of course, if you have multiple kids, you pay less for each child you have in full time preschool - the second kid costs about $110 a month in my city if you’re well off, and the third about $90 per month. You pay for max three kids even if you have octuplets.
Oh! I forgot. When you have a kid you get a “child allowance” in your bank account every month. At the moment this is about $125 per month if you have one kid. Everyone gets this, even the superrich. You get the allowance for each kid, plus a “large family supplement” that increases with each extra kid. Anyway, the child allowance basically pays for child care and other stuff you need - afterschool care, school supplies. Anyway. Let’s skip ahead a decade. Kid is now 12 and firmly ensconced in middle school. He goes to school a block from our house. If we wanted him to go to another school, we could pick another school. We have “free school choice”, which is not all positive consequences for society, but it does mean.. that if our kid’s school wasn’t working out for some reason we could change to one of the other schools in the area - a variety of municipal schools, nonprofit schools, and for-profit schools. He goes to a nonprofit school, and we love them. His first couple of years there we used their “free time care” program, which provided before-, afterschool, and vacation day programming. They were AMAZING. Some of the most dedicated teachers I’ve ever met, doing the hard work to build amazing lil’ citizens. They hung out, danced, had tough conversations, crafted, developed interests and hobbies, and were safe and cared for when we (parents who worked long hours) couldn’t always be right there. One summer two teachers decided to take our son, along with a couple of other kids, to an amusement park in another city about three hours away. We dropped him off at the train station in the morning and picked him up late at night, laughing hysterically and covered in candy floss. It’s one of his best memories from the last few years. These teachers were SAINTS, I tell you.
We make more money now than we did when he was born, so those last couple of years we were paying the maximum fee for all this before-school and after-school and vacation day care (and oh there are many many vacation days here), so we paid $107 per month. If we still made as little as we did when he was born, we’d have been paying $24 per month for the same care. Anyway.
He’s no longer using that program, being a big man and all nowadays, but we use the bejesus out of city programming for kids in other ways. Here’s an example: during the summertime and the longer school breaks, the city distributes money to nonprofits all over the city to create free programming for kids. A big catalog comes out, and you just do what you want. This last summer, among other things, lil’ man went to a weeklong full-day camp on the ocean where he learned to sail boats. TO SAIL BOATS. BY HIMSELF.
Well, this is starting to get long. What else. Transit. In the US we had a car, because we had to have a car. It was expensive, and dangerous (compared to other modes of travel), and not great for the environment, but we needed it to commute to work and get to a decent grocery and just generally to do much of anything. I am from the midwest, and have both had a car and needed to have a car since I was old enough to drive. You can get by without one, of course, but it’s not easy, and in a lot of places not really plausible. Here, we don’t have a car, and I haven’t even gotten a license (my US one hasn’t worked here since my one-year anniversity of living here. It’s ridiculous, but that’s another story). Once every four or six months we borrow a friend’s car to run an errand, or rent a car for a few days while we’re on vacation. Otherwise it’s all walking, biking, and excellent public transit. There are bike lanes everywhere, no one ever screams at me or tries to hit me with their car, and there are bike tools and pumps in public for everyone to use. I commute to the next city over for work, which commute involves: I bike less than five minutes to the nearest train station (I could also walk ~15 minutes), go down an escalator, and within ten minutes or so I get on a train that takes me to the next city in 12-20 minutes. From there it’s another five minute walk to my office. I pay for my travel a month at a time, which costs $105 per month. I think that this is egregious, and that it should be further subsidized. But such is life. The trains run on time and frequently throughout the day. As do buses, both city and regional. We complain when trains and buses are the least bit late and act like it’s a travesty but to be honest I’ve never encountered public transit this good anywhere in the US. We think it’s expensive, but compared to pretty much anywhere in the US that I’ve been it’s a steal - especially considering that it can get you almost anywhere you need to be, relatively quickly and easily. Almost always more quickly than it would be to drive yourself. I’ve taken public transit out to national parks in the countryside and onto tiny island ferries into legit hobbit wonderlands. It works.
Um, let’s see. What else. Ah yes, inequality. Obviously Sweden’s better on this count, unless you enjoy watching the poor suffer. Which I guess some people do. Income inequality, poverty rate, you name it: Sweden’s a better place to be for most of us. But what about the American Dream, you ask? Don’t we want to give everyone the opportunity to succeed? Well, chances for upward intergenerational mobility are far better in Sweden than in the US - so if you’re going to be poor, you probably would want to be born poor here, both because your quality of life will be better, your health outcomes will be better, etc etc etc., but also because you are more likely to be able to “get ahead in life” here than in the USA. If that’s your jam.
Crime? Well, I’m careful when I’m out alone at night in the US, and I don’t think about it here, though I live in what those with no knowledge of the situation on the ground think of as Sweden’s “murder city”, Malmö. Murder rate per 100,000 in Sweden: 1.1. In the US: 4.9. Generally speaking, yeah, I will probably get my bike stolen someday, but I’m very unlikely to be killed by a stray bullet (much less one that’s aimed at me). I could go on and on. What I meant to say is this: that ridiculous tax bill is headed back to the Senate this morning and most likely to the president’s desk. I haven’t seen much in the way of in-depth, well-reported explainers on what we stand to lose as a nation: what the near-inevitable cuts to public services and infrastructure are going to mean, while my feeds are dripping with straightforward “ways to make the new tax bill work for you,” & a cynical guide to “hacking the tax plan” that promises to help you learn “ways to profit off the Republican tax bill.” There’s no texture to that conversation, no sense of what it means on the ground.
We made more money on paper in the US than we do in Sweden, and we paid far less in taxes. We were also more stressed for money than we’ve ever been in Sweden, including back in the days when we lived well below what the Swedes call the “existence minimum”, and one little problem - a nonserious but lengthy illness, a lost job, a car breakdown, a day care closure - was always out there, dangling above our heads, threatening to send everything into a chaos we might have never recovered from. We chose to move back to Sweden. We now are lucky to have two reasonably OK paying middle-classish jobs; we also pay high taxes. We make less on paper, and we net less each month - far less. We basically don’t have a ton of disposable income each month after the bills are paid. But that’s the thing: we had some “disposable” income back in the US… that we used to pay for life’s necessities… for ourselves. We weren’t lifting everyone else’s boat, we were furiously paddling our own little raft, and while we weren’t exactly stomping the fingers of desperate swimmers that clutched at our planks we also weren’t pulling them on board… not really, anyway. Sure, we used some of that disposable income to “do the right thing”. We gave to charities and nonprofits & shopped at the coops & bought organic. But really, it was all we could do to keep our own heads above water.
Now, with two middle class salaries, we have to consider costs when we go to eat, go out for a beer. For an American it can be hard. We have to save up for major purchases, sometimes for quite some time. We don’t have much disposable income. And we basically don’t think about it…. ever. Because we’re not desperately fighting to stay afloat, and the people around us aren’t, either. It’s hard to explain what it feels like when that stress is lifted from a community, from a city. But you can feel it. And it’s true that stress hasn’t been lifted from everyone. There are people living in poverty here, migrants living without access to the system. And not everything about these systems works perfectly, or as it should, or as we’d want it to. But I wanted to put this out there so that some of you could get a sense of what it’s like, on the ground, to stop worrying about your tax bill and to start thinking in terms of the country that we can build together. I peek at the AM papers in the US: the tax bill is still being carried forward. The rich will get far richer, and you might get to keep a little more of your income, for a while. But don’t forget what you’re giving up, and take a moment to consider whether it’s worth it.
So the bill passed, of course. I thought about coming back to my earlier rant-thread when I got home from work (I have so much more to say! I didn’t even get into, say, the fact that my son’s preschool teachers made reasonable salaries! Or that we welcome more refugees per capita than anywhere else in Europe! I didn’t get all that much into the weeds about Sweden’s integration issues vs America’s structural racism!) but I’m just feeling… defeated. Most Americans opposed the tax bill, and it didn’t matter. Let’s hope the backlash is a strong one.
Sweden, Norway, Denmark. What amazing places to live. Thousands of years from now, they’ll be remembered as the pinacle of our democratic age.
† This is my “going down the toilet” justification footnote. Consider these: universal healthcare. Universal childcare. Basic services for all. Obligate maternity and paternity leave. All areas where the United States is so far behind it can’t hope to ever catch up unless citizens agree on the necessity of these things. And they don’t. Hence my toilet bowl comment.