Being an Outpatient in Norway Can Mean Leaving the Country

COLOGNE, Germany — Norwegians suffering from achy joints, gallstones, back trouble and a host of other ailments are no longer being told to take two aspirin and call their doctors in the morning but to take two aspirin and call an airline in the morning.

Waiting lists for nonemergency surgeries in Norway are so long that the Oslo government budgeted $111 million this year to send patients abroad, mostly to Germany, for operations that would take years to get in their homeland.

The project, launched in February, has already sent 400 Norwegians abroad and aims to finance 10,000 procedures by the end of the year, said project manager Jan-Ove Nisse of the Norwegian National Insurance Administration in Oslo.

While oil-rich Norway has been unable to train or attract enough doctors and nurses to treat its 4.5 million citizens, Germany has more hospital beds and surgical talent than it needs at the moment. Part of that abundance stems from its having inherited an oversupply of medical facilities from the former East Germany and having invested heavily in the last decade to bring that legacy up to western Germany’s high standards.

The happy coincidence of well-heeled demand among the Norwegians and a brimming oversupply among German hospitals is easing physical discomfort on one side and budgetary constraints on the other.

“There are people living in Norway in serious pain with no clear idea of when they will get relief if they wait for their operations at home, and that’s just an unbearable situation for many of them,” said Axel Hollander, chief executive of GerMedic. The company, founded here last year, acts as liaison between foreign patients and 115 German hospitals that belong to another newly created entity, the Committee for the Promotion of German Medicine Overseas.

The marketing organization has contracted with the Norwegian government to provide operations, with GerMedic smoothing the way by arranging transportation for the patients, hotel accommodations for any accompanying family members, postoperative physical therapy and even translation.

Norway’s state-regulated insurers cover each patient’s travel and hospital costs, and most people in the country, which regularly ranks as among the world’s richest, have the wherewithal to bring friends or family with them for what often extends to a three-week stay.

Heidi Anderson, a 34-year-old office manager from the city of Trondheim, got word just this week that she will be treated for her herniated esophagus at a hospital in Hamburg on May 13.

“I’ve already waited three years, and I have so much pain I can’t sleep nights,” she said of the condition that has kept her out of work for 18 months. “There’s a good hospital here, but there just aren’t enough doctors to do anything but emergencies.”

The project is funded for this year only, but all involved acknowledge that the need for foreign relief is likely to continue.

“This problem won’t be going away for at least 10 years. It takes a lot of time to build up medical capacities,” said Claudia Juerss, one of the hospital marketing organization’s managers.

With major operations such as hip and knee replacements costing more than $10,000 and related expenses eagerly covered by Norwegians desperate for greater mobility or pain relief, some hospitals have added Norwegian speakers to their staffs, Juerss said.

Most of the Norwegians forced to travel abroad to avoid long waits have come to Germany, but a few have also found what they need in Denmark or Britain, Nisse said.

Rigmor Kaarvand, a 42-year-old rest-home cook who had been suffering from gallstones for more than a year, underwent an operation in Copenhagen last month and was back home in Trondheim within two days.

“It was all so fast after having to put up with pain for a year,” she said, offering rapturous praise for the foreign caregivers. “Who knows how long I would have had to wait in Norway?”