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The Challenge of the Age


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The Challenge of the Age

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Norway has a respected social-democratic governmental model and the health sector here is   strong, with over 10% of the working population involved in the health-care sector as of 2009.   Now, there are many here in this country joining the debate as to just how long this can be sustained with a population that has among the longest life spans in the world. People retire early – and live a long time.

This represents a huge challenge as Norway seeks to find solutions – and money for the next decades. The cost of health here is high, and this combined with the fact that over half of the working population works directly or indirectly for the government puts more pressure on the private sector to innovate and excel. In addition, in 2009 nearly half (48%) of the population (source: Statistics Norway – SSB) received financial support of some sort from the government, something that press the budget as the income from “ancient sunlight” (fossil fuels) begins to disappear.

Get them in, Get them out
The strategy is clear – keeping costs stable while increasing the level of service to the patients. This is a challenging task in a country where costs are high, and leads to patients being treated quickly in the hospitals – where the government covers the costs – and then returned home where the municipalities foot the bill for services rendered.

These lines of responsibility have been laid out by the government, with the municipalities being responsible for all primary health care services, including home health care as well as nursing homes; and the national government maintaining responsibility for specialist health services, including hospital care.

Talking in Tongues
Quick and effective treatment in the hospital system is reflected in national patient statistics from 2009 where the average hospital visit decreased from 4.8 to 4.6 days. There were a total of 4 million individual hospital visits – the majority being “day visits”.  Upon release from a state-run hospital, patients move from the domain of governmental responsibility to the local municipalities – making clear communication between state and local health organizations an absolute necessity.


One major challenge is a basic lack of communication between the different health sectors – at least according to former Minister of Health Bjarne Håkon Hanssen noted in a speech in Japan in 2009, “There is a lack of coordination in all segments of the health care services…and a serious lack of coordination between hospitals and primary health care”.

Through Rain, Snow & the Dark of Night
One should not paint too dark of portrait of the current health care here in Norway. The quality of the Norwegian hospital system is high, and the elderly here in this country often have a choice – and one of these choices means living at home, a preferred alternative reflected in the fact that the majority of Norwegians remain in their homes as they age. Here lies one foundation of the Norwegian health care strategy –  the “hjemmesykepleier” (home care nursing).

In order to make longer home living possible as people age, each of Norway’s 430 municipalities is tasked to establish and manage health care services, including home health care. Every day of the year, day and night, through rain, sleet and snow, these municipality managed “hjemmesykepleier” brigades are out visiting and caring for the elderly and others in need.

This system is an excellent example of the health sector working well here in Norway, reflected in the fact that that when all home health care patients were given the opportunity to choose between private health care and the municipality health services earlier in 2011, well over 90% chose the municipality-managed “hjemmesykepleier” service.

Rising to the Challenge
There are a number of initiatives taking place that feature a cooperation between government and the private sector that include several of Innovation Norway’s Arena and Norwegian Centres of Expertise programmes as well as iniatives by regional development organizations such as Oslo Teknopol, a non-profit organization dedicated to bringing the public and private sectors together to meet present and future challenges.

In April 2011, Oslo Teknopol was the host of a debate related to eHealth and the Aging Population organized in the framework of two EU projects, BaSIC and JOSEFIN. This event brought together representatives from the capital cities of Scandinavia, the Baltics and Germany as well as politicians, hospital personnel, researchers and global corporate innovators such as Google and Microsoft to discuss solutions to improving life quality – and increasing transparency – as people get older.


The event was based on the knowledge that much of health care will be based on IT solutions – and this debate focused on aspects of IT that included confidence in the Internet, the rights of the patients, a secure environment for patient information – and improved communication between patients and caregivers.

For more information about this event, the initiatives and the EU projects, contact Oslo Teknopol (see also the Norway Communicates article “The Scandinavia Mega-Region” to learn more about another OT initiative).

The Elderly Take Control
With over 80% of the Norwegian health sector financed by the government, innovative solutions are needed to help the country tackle the challenges of an aging population, a population that will see the number of elderly rise rapidly as the Baby Boom generation continues to reach retirement age here in the country.

These “Baby Boomers” are strong, healthy, vocal, and plentiful both in numbers as well as financial resources, and are going to have much to say about how the elderly are going to function as part of Norwegian society.

The challenges and opportunities are many – and innovative action rather than bureaucracy is the answer. Can the social democracy of Norway rise to this challenge? Only time will tell as Norway moves into an uncertain health future.

Source: Norway Communicates

Published: December 4, 2022