Viking Economics (15 page)

The persistence in creating systems for the marginalized to return to society works for chronic addicts as well. The Nordics have a lower percentage of drug addiction than many countries; drug addiction, as well as obesity, follows the usual pattern of pathology in which higher addiction rates correlate with greater economic inequality.

New York Times
business writer Landon Thomas, Jr., reported from Norway on May 14, 2009, when most Western countries
were reeling with recession. In his article, he mentioned that Norwegian banks represent only 2 percent of the economy and that they were so tightly regulated by that time that Norway didn’t join the crash of the neoliberals. Instead, Thomas said, the country was riding out the storm.

Thomas reported, however, that around the corner from the Norwegian central bank in Oslo he found a man injecting himself with a drug. For many years an addict, the man told Thomas that he’d never had a job and was in no shape to have one. The man said that the social assistance he gets monthly, $1,500 in high-priced Oslo, keeps him fed and alive.
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The opportunity Thomas didn’t report is that if the addicted man becomes inspired to make a fresh start, the system is there to help him. Not only can he get free in-patient drug rehabilitation treatment but when he gets out he can be paid a living wage to take active job retraining and reenter the work force. Norwegians call it “occupational rehabilitation.”

Most of us in the United States, used to defining poverty as the inability to meet basic needs on a reliable basis, would want to consider how to adopt or adapt the best practices of the Nordics in our own country. Denmark, Sweden, Norway, and Iceland, however, might want to go further and tackle “relative poverty”—the economic marginalization that is measured internationally. That challenge is difficult because relative poverty is more nuanced than food and fuel insecurity and homelessness.

In looking for relative poverty, people need to observe closely where the marginalizing happens: the expected well-packed lunch from home that has
not
accompanied a youngster on the school trip, the expected new dress for the school dance that is
not
worn on the big occasion. These are “discretionary items,” but in the real-life world of peers, such items aren’t discretionary at all. Even though signs of relative poverty may be more nuanced, a teacher’s sharp eye might implement a universal provision of things like packed lunches for school trips that, to more privileged and perhaps clueless well-off people, appear to represent no barrier at all.

Fortunately, the political discourse in the Nordic countries suggests that ending relative poverty has become a widely shared goal. In Norway’s 2001 national election, the Conservatives ran on a platform that attacked the incumbent Labor government for not doing enough to fully abolish relative poverty.

In the introduction to this book, I told the story about a party at Berit’s brother’s house in Skien, where I had my eyes opened to how different the Nordic model is from that of most countries. Our host Leif Erik was retired by then, but most of the adults presently worked at a variety of occupations: teacher, corporate middle manager, industrial worker and more. They all seemed to have found good niches for themselves, and at the same time perked up their ears when they learned that Norwegians—already at 1,400 hours working the fewest hours per year of any nation in Europe—were researching how to increase productivity while working still fewer hours.

The party came to a shocked stop when I told the relatives how long, on average, people in my country work. Their shock motivated me to look into the difference between their perspective and mine. It turns out that the Nordic model assumes a rested worker is a productive worker.

By the 1960s, a five-day week became the Norwegian norm. But when you factor in the paid vacations and holidays, the comparison is startling: according to the OECD’s 2012 data, the average number of hours a person works in a year in Norway is 1,418.
In Denmark, the number is 1,430; in Sweden, 1,621; in Iceland, 1,706; and in the United States, 1,790.
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Another OECD study showed Norwegian workers producing, compared with the United States, 27.8 percent more per hour for the hours worked.
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Sweden is not satisfied with its work/life balance and set up an experiment with the six-hour day in the city of Gothenburg. City workers will be divided randomly, with half continuing the eight-hour day and the other half engaging in the experiment. The goal is to gain higher productivity per hour and have fewer sick days. The researchers are encouraged by positive results from Toyota’s similar experiment in its Gothenburg factory.
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Washington Post
reporter Brigid Schulte told Terry Gross on National Public Radio’s
Fresh Air
that Danish women felt social pressure to leave the office punctually at the end of the day rather than spend extra time “finishing up” at their desks. They did not want to give their colleagues and supervisors the impression that they could not do their job fully within the framework of regular hours.
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By law, Norwegians are entitled to twenty-five vacation days every year, as are the Danes. Working hours may not exceed nine hours per day or forty hours per week.
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Flextime is increasing; employees can choose their own work hours as long as they are at the worksite in the middle of the day for meetings and common tasks.

Economist Sam Bowles at the University of Massachusetts studied working hours in all the OECD countries and found that more unequal countries tend to have longer working hours. He checked the trends over time and discovered that, in those countries where inequality changes over time, the working hours
change in tandem. People in more unequal countries do the equivalent of two or three months’ extra work per year.
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Does all this emphasis on work/life balance mean that the Nordic peoples shirk work? On the contrary, more people there work than in comparable countries. The numbers reported by the Better Life Index show that the following percentages of people aged fifteen to sixty-four have paid jobs: Denmark, seventy-three; Sweden, seventy-four; Norway, seventy-five; and Iceland, seventy-nine. The OECD average is 66 percent. In the UK, it is 70 percent, and in the United States, 67.
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Just as there is no necessary contradiction between equality and freedom, there may be no contradiction between work and life. The design-crazy Scandinavians, when encountering apparent tensions, prefer rolling up their sleeves to shrugging their shoulders. Their advanced democracies make design solutions possible.

Seen in that light, an obvious design flaw in the patriarchal system inherited by most economies is the gendered division of labor within the family.

Norway was the first country in the world to establish a scheme that incentivizes dads to take more responsibility for their children. A paid leave of absence from the job is set aside for the father; if he doesn’t take it, the couple can’t transfer that time to the mom. The policy is working: by 2008, 90 percent of fathers were using their quota, and 16.5 percent were extending their leave beyond the reserved amount.
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In Denmark, the current system is this: families receive a total
52 weeks of parental leave, with full pay. Mothers take eighteen weeks and fathers get a dedicated two weeks. If they don’t use it, the couple loses it. The rest of the paid time off is up to the family to use as they wish, again building in the freedom for couples to decide what works best for them.
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Dads can’t breast-feed, and most Norwegians do recognize the health and other benefits of breast-feeding their children. In Norway, a new mother at her job has the right to two hours of break time each day to permit breast-feeding.
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If the dad takes care of the baby at home when the mom resumes her job, he can bring the baby to the workplace for feedings. For moms who combine job with baby, many workplaces have day care for their employees’ children on-site. If a child is primarily being taking care of by a job-holding dad, he has an equal right to access the day care on-site.

Affordable, publicly financed day-care institutions are available if a parent’s worksite doesn’t have one. Either parent has the right to stay at home with sick children at least twenty days per year.

Many heterosexual couples aren’t choosing marriage these days, but that’s not stopping them from having children; Norwegian fertility is high. In 2005, unmarried moms living with their partners accounted for 42 percent of all births. Single mothers accounted for 10 percent.
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When I heard Schulte’s interview on NPR describing the office pressure to leave work after eight hours, I remembered the Wall Street firms who are reportedly pressuring young analysts to work fifteen hours a day. A Penn professor published a study finding that people at two investment banks spent up to 120 hours per week on the job. Goldman Sachs, New York economics writer
James Surowiecki wrote, recently broke ranks by announcing that analysts shouldn’t work more than 70 to 75 hours per week!
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In the United States, neither women nor men are able to advance in competitive workplaces like large law firms and academia and still strike a sane work/life balance. I understand the passion that can drive some individuals to clock incredible hours to finish that painting or bring in the harvest or heal the refugee children. What I respect is the choosing, rather than a workplace pressure that takes away employees’ freedom to create meaningful lives on their own, individual terms. This is one of the starkest contrasts I have found in exploring the Nordic model: the extraordinary lack of freedom available to individuals in the United States to place work in the perspective that makes sense to them.

When we moved to Oslo, Berit found a primary-care physician for us both—the doctor-patient relationship is important to Norwegians. I usually catch the flu once each winter, and the Norwegian snow didn’t give me an exception. I felt too feverish and miserable to go to the doctor, so the doctor came to our little apartment and treated me. He gave me an invoice and I paid him with cash. He told me that when I was better I should take the invoice to the health office and get my cash back minus a very small service charge.

That was it. Procedures change over time, but the basic model remains the same: a doctor-patient relationship, and whatever care is needed paid by the publicly funded insurance system. If I were
living at the other end of the country, north of the Arctic Circle, and got a brain tumor that required the kind of surgery that’s only done in a hospital in Oslo, the system would fly me to Oslo and handle the surgery. I learned that everyone is covered equally—even an American who fell in love with a Norwegian.

As in my first encounter with the university, I asked as a stranger in a strange land, “How does it make sense for the whole society to pay for medical care? Isn’t that a burden on the economy?” I learned two things.

The total cost per capita is a little more than half what the United States pays for health care. That’s partly because of an emphasis on prevention of illness instead of waiting until it’s a matter for the emergency room. Another reason is that the Norwegian system is so much easier to administer—another shock, since I believed that a “welfare state” would be so full of bureaucracy and paperwork that everything would cost more to get done, not less. The Danes also pay less than the United States, even though Danes on average visit their primary-care physician seven times a year.
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It turns out that there’s far more bureaucracy and paperwork in the U.S. market-based health-care system, with multiple insurance companies and their multiple plans covering different things, with multiple employees acting as gatekeepers. In the United States, the plans keep changing their policies on which prescriptions they will and won’t cover. Medical practices are so burdened with paperwork that some doctors simply leave their vocation. In health care, so-called “market efficiency” is actually “market wastefulness.” So wasteful, in fact, that despite the Affordable Care Act (so-called “ObamaCare”) tens of millions of Americans don’t get covered at all, and countless others who are insured still don’t get the treatment they need.

The second thing I learned was that Norwegians believe there is a relationship between health and productivity. I heard a talk by Dr. Karl Evang, the legendary Norwegian health minister who went on to lead the World Health Organization. He said that long ago the Norwegian Medical Society was among those pushing for a socialized system because doctors admitted there was no other way that Norwegian health could be protected at a high standard. As I listened to him, I realized the other economic payoff: a healthy population is a productive population. Health may be a human right, as Norwegians believe, but it is also a necessity for optimum work performance and work/life balance.

All this was still hard to wrap my mind around, but by putting “free health care” together with “free higher education,” the paradox was getting clearer: Norwegians believe they get what they pay for, and that they need to pay for what they get. They notice when it’s more practical for that payment to be made by the community rather than by individuals. They also acknowledge that collective care for the health of the nation is an expression of solidarity and equality.

Nordic health-care systems are also less expensive because health problems are more common in unequal countries. Epidemiologists Wilkinson and Pickett did the math on this question. At one end of their graph describing rich countries are the Nordics and Japan, which are both more equal and have better health, and at the other end are the UK, Portugal, and the United States. The authors double-checked by creating a different graph that related health problems to national average income, and found a weak relationship. Per-capita average income is a poor predictor of rate of health problems, whereas the degree of inequality predicts very accurately, far beyond what chance alone could produce. This pattern
also holds true among our states in the United States: high inequality correlates with worse health.
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