Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Tuesday, October 6, 2009

We're number one! ...or are we?

All my Norway Facebook friends are posting, reposting and cross-posting. Big news in these parts, the UN has announced Norway is the best country in which to live.

Husband originally called to tell me this. What I thought he said was "Hey! Norway is now the best place to live. The UN posted a poll on Facebook!" He let me rant on about shoddy data collection methods for a wee while before he corrected me. What he actually said was "I posted it on Facebook!" I really should listen to Husband a little better.

In any event, just because the results weren't collected by a Facebook poll, as a student of statistics and research methods, I still do think it's worth considering the methodology of the poll. I'm not here to comment so much on the results of the survey, but rather to really understand how Norway got to number one.

The Human Development Index (HDI) provides "a broadened prism for viewing human progress and the complex relationship between income and well-being." However, there are some important limitations of the index, namely that it does not include any factors related to gender or income equality, political freedom, or human rights (of course some clever souls have created separate indices for those).

It's worth noting that this is not actually news. Norway has held the number one spot every year since the HDI was initiated in 1980 (see page 167 of the full report*). It's also worth noting that Norway did not win the top spot by a landslide. Norway's 2009 HDI was 0.971, whereas the number 2 and 3 spots were taken by Australia and Iceland with scores of 0.970 and 0.969 respectively.

The methodology of the HDI has also changed. The report authors mention this on page 170, noting that "The human development index values in this table were calculated using a consistent methodology and data series. They are not strictly comparable with those published in earlier Human Development Reports." If it's consistent, then it should also be comparable. A fundamental measure of 'good' research is that it is reliable, which means that the same tests can be repeated using the same instruments. To change these instruments mid-stream calls into question the statistical constructs and comparability of the annual reports.

One of the reasons the underlying tests that comprise the HDI have changed is because the focus of the report has shifted. As of 2009, the report focuses on migration and opportunities available to immigrants in more developed countries. So the report is not necessarily measuring the best place to live, but rather the best place in which to live if you are in one of the less-developed countries looking for a new home that will afford you a longer life expectancy, easier access to education, and more economic opportunity. The HDI is not a measure of where you can find the best healthcare, school systems, and jobs (assuming these are measures of a good place in which to reside). It's more a measure of how to find better versions of those things based on where you originally come from.

So is Norway really the best place to live? Perhaps. But UN statisticians can't decide that - it's up to each of us to find our own best place. And you probably don't even need statistics to do it.
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* I refer to the full 2009 Human Development Report when mentioning page numbers. You can check out the full report here.

Wednesday, August 26, 2009

Death and taxes

Only two things are certain in life... there’s little we can do about the first but wait, but for the second… well, there’s little we can do there either.

A common complaint of expatriates living in Norway is the notion that income taxes are sky high. This is true, compared to say, Qatar, where there are no personal income taxes (PIT), or Paraguay, where PIT maxes out at 10%. But is Norway really much higher than other countries? Some nifty little wizards at KPMG have compiled a report addressing just that.

According to the 2009 Individual Income Tax and Social Security Rate Survey, Norway has a PIT rate* of 40%, the UK 40%, and the US 35%**. However, these are not the highest PIT rates. Denmark has a PIT rate of 62.3%, Sweden 56.7%***, Netherlands 52%, and Austria, Belgium, and Japan 50%. But that’s only part of the story.

When you consider a combination of the highest tax rates based both on personal income tax and social security tax, the highest-taxed locations might surprise you (well, it did me, but I am easily surprised). KPMG found that “When taking both the personal income tax rate and social security rates into account for employees earning 100,000USD, the countries with the highest rates were Slovenia (54.9 percent), Croatia (53.5 percent) and Hungary (48.1 percent).”

In fact, if you consider both PIT and social security tax, on 100,000USD of gross income, one would pay 32.9% in Norway and 25.3% in the US. While a difference of more than 7% might seem quite large, it is worth noting that I am getting a lot for that 7.6% differential in Norway. I am pretty sure that difference is worth inexpensive-to-free health care, subsidized-to-free childcare and schooling, and even a gratis university education from a public institution (how I wish I would have had this kind of benefit before Sallie Mae and I met).

There’s really nothing witty or clever to joke about regarding tax rates so I won’t bother trying (although please feel free to comment if you do have some humor to share about this). However, it’s good to know that I am not being gouged by the Norsk tax system quite as badly as I thought I was. Cheers, Norge!
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For some reason a discussion of taxes requires a lot of footnotes. Of course it does.
* Note that this is the highest tax rate in countries with graduated tax systems.
** This is the federal tax rate only and does not take into account state income taxes.
***The PIT rates for Denmark and Sweden include a social security component as this is rolled into the PIT rate. They get a lot of free stuff for their tax dollars so don't feel too sorry for them.

Wednesday, August 12, 2009

For the love of doxylamine succinate*

I have a secret. It’s a drawer in my bedroom filled with every American over-the-counter drug from Anacin to Zantac. Every time I return to the States, I buy bumper packs of pain relievers and cough drops, much to the amusement of the pharmacy checkout clerk. But I never really get sick so I don’t often open the drawer.

This past week, though, I have been ILL. Of course it’s nothing exotic like the swine flu, but just a plain old summer cold. It started in my chest and has now settled, days later, in my head, causing ferocious sneezing, hacking and wheezing.

I finally broke down today and wobbled to the local pharmacy, desperate for a fix of some OTC goodness. The pharmacist patiently explained the different potions, but the net result is she had something to make the cough stop, something to make the cough start, and some feeble saline nasal spray which I suspect does nothing more than wet an already soppy place. I kept asking, over and over, “But don’t you have anything that will help ALL my symptoms?” The blank look said it all.

Sensing her good humor might soon wane, I scooped up the ‘stop coughing’ cough syrup and went on my way. I figured between that and the contents of my secret drawer I could cobble together an approximation of what I wanted.

I am one of those annoying long-term expats who always spouts off lofty things to my fellow foreigners such as “You can find everything you need here in Norway!”, “There’s always a substitute!”, or “There’s nothing from the US I can’t live without!” Turns out I have been beaten and these sentiments are not true when it comes to cold medicine.

That being said, I came home with my second rate cough syrup and pulled out the recently emptied bottle of Nyquil I finished off two days ago. Reading each line of the ingredients of the Nyquil, I managed to scrounge a similar drug out of the secret drawer. After necking about 8 tablets of varying medications, slurping the Norwegian cough syrup, and topping it all off with a swig of Cognac** (hey, Nyquil is 10% alcohol, you know), I settled in and waited for sweet respite.

It didn’t come. Instead I ended up with a sore tummy, a fuzzy head, and the same sneezing, hacking, and wheezing as before.

So to every expat that I have every smugly rebuffed for bemoaning something they missed from home, I take it all back. While I do still think you can whip up biscuits and gravy or a Thanksgiving dinner with close Norwegian approximations, I have learned that there is, in fact, something I can’t recreate here. But I am receiving my just desserts as I lay in a pajama-ed heap on the couch listening to repeats of Murder She Wrote.

Perhaps I didn’t get the cocktail just right… another swig or three of whiskey might just do the trick!***
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* Doxylamine suucinate is the 'so you can rest' part of Nyquil. It's classified as a hypnotic, and since I never got into the hallucinogens during college, this is the cloeset I will likely come to a drug-induced state of bliss.
** Please note I have no medical expertise other than what I have read on Web MD, so I do not recommend this concoction.
*** To be fair, you can get cough syrup with codeine with a prescription from a doc here in Norway, but since I am allergic to codeine this is of little comfort. I am also allergic to visiting my doctor, incidentally.