More Healthcare or More Control?

This post is a translated version of the post Vård eller kontroll?  I’m not a professional translator and it’s not flawless, so please feel free to post a question if something is unclear.


During the last couple of months I’ve read several statements from healthcare professionals about how the field of assessments relating to social insurances needs to change. For instance, a doctor claims that there’s a need for more assessments of working capability and another doctor claims that we need a totally different process with working capability assessments done at the claimants workplace (both of the linked articles are in Swedish). The common denominator of the statements concerned in this post is healthcare professionals advocating for more governmental control of ill and disabled people.

Because even though these assessments are done by healthcare professionals, they are still actions in the interest of governmental control. These are actions whose purposes aren’t to give healthcare but instead to decide if people really have as limited working capability as they and their treating healthcare professionals claim. In Sweden today, the government is trying to deny ill and disabled people the insurance benefits we are entitled through by law, through directions to the Social Insurance Agency and politically decided goals about how many people are aloud to not have working capability. In this reality, healthcare professionals have to keep the distinction between different kinds of assessments in mind. Is the purpose of an assesment to give healthcare or is it done because social insurance agencies are demanding it?

The difference between these assessments matters because the reality for people with severe illnesses is that there’s not always room for both. There are people who due to diseases and disabilities can’t do both without a severe worsening of our conditions, because assessments are simply way too demanding. People have to say no to actual healthcare that could slow down the progression of their diseases and relieve symptoms, because going through insurance-related assessments requires all the capacity they have. Others choose to take a step back from the mess that the Social Insurance Agency is creating and give up their right to financial support. Instead, they are supported by a partner in order to protect themselves from the worsening of their condition that the assessments and so called “rehabilitation” that their social insurance agency demand would lead to. Because, the insurance industry may call it rehabilitation but in reality, it’s about finding a way to deny claimants benefits.

The most important question isn’t which profession, process or institution that’s the most suitable one to assess working capability. The question is if it’s reasonable to increase the control of ill and disabled people, when we’re in a situation where for instance chronically ill people don’t even get the healthcare that we need. Healthcare professionals need to take a stance: Is your primary task to give healthcare or to help the government to demolish social insurances?

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