Health Care Services

An Expert's View about Medical and Dental Services in Denmark

Last updated: 26 May 2011

Summary
Although healthcare provision in Denmark is free, there continues to be fair prospects for foreign health care providers, particularly within cosmetic surgery, research specific or highly specialized diseases where services cannot be provided in Denmark, or in fields where the U.S. is a market leader such as in cancer treatment.

Market Overview
Healthcare provision in Denmark is to a great extent a public task, as 85 percent of health care costs are financed through taxes. This means that there is free access to most health care services for all persons, regardless of income. The Danish government spent 12.5 billion USD in the sector in 2008. Private health care amounted to 3.5 billion USD. Denmark sees an increase in private health care insurances. Some insurance companies now provide insurance for treatment abroad also.

The health care sector has three political and administrative levels: The government, the regions, and the municipalities (national, regional and local authorities). Denmark is divided into five regions and 98 municipalities that each covers at least 20,000 inhabitants. The municipalities are the decision makers for the allocation of resources to the healthcare sector. There are 60 hospitals and 3,500 doctors or general practitioners in Denmark.

The Danish market for U.S. health care services is relatively small. Currently an estimate is that only two to ten Danish patients travel to the United States to get treatment every year. However, due to long waiting lists and the opportunity to bring public money abroad if waiting times exceed three months, the market is growing for foreign health care providers.

Danish patients have four possibilities if they wish to receive medical treatment in the United States. First option is for patients for to pay for the treatment, which is not a widely used option due to the free health care system in Denmark. The actual number of patients travelling abroad at their own expense is unknown, but a rough estimate from the Danish Association of Patients is that approximately 1000 patients travel abroad every year. Of these, the majority goes to Germany or Sweden, but the United States, along with the United Kingdom and China are also among the countries that are highly sought. The majority are seeking treatment within cancer related diseases.

Second option arises in cases of either research specific treatments that cannot be provided in Denmark, or when the waiting lists in Denmark exceed three months. In these cases, Danish patients are entitled to receive treatment abroad. As for the waiting lists, most Danish hospitals have established agreements with German or Swedish hospitals because of close proximity and low transportation time. For the research specific treatment to be effectuated, certain conditions must be met:
• The patient have been examined or treated at the hospital in Denmark with highest expertise on the subject matter beforehand.
• If the hospital with expertise on the subject matter accepts the treatment abroad as necessary
• The research related treatment must be undertaken in corporation with a Danish hospital
• The research must be in accordance with general standards for scientific tests

The third option relates to highly specialized treatment. The National Board of Health can refer patients to highly specialized treatment abroad in so far as the treatment is not provided in Denmark. Approximately 150 patients are sent abroad by the National Board of Health on this program. The preconditions that must be met are the following:
• The patient have been examined or treated at the hospital in Denmark with highest expertise on the subject matter beforehand.
• If the hospital with expertise on the subject matter accepts the treatment abroad as necessary
• The treatment cannot be provided at a Danish hospital
• The treatment is not experimental, alternative or related to research
• The National Board on Health must approve of the referral prior to the treatment

The last option relates to experimental treatment. Patients can apply to the National Board of Health to receive experimental treatment if they suffer from a life-threatening disease such as cancer where no other treatments can be provided in Denmark. This possibility is called the second opinion arrangement. The National Board of Health examines the market for experimental treatment that may be beneficial to the patient and every year 50 - 70 patients qualify for treatment.
American hospitals are generally believed to have a high level of expertise, and the language barrier is limited due to the high level of English skills among Danes. However, long distance and consequently high travel expenses are some of the challenges that must be met.

Market Demand and Best Prospects
Although there is free access to health care services, some Danes demand a premium service which is not available in public hospitals, which have received criticism for long waiting lists and slack resources, and therefore turn to private hospitals in Denmark or abroad.
U.S. health care providers have a unique selling proposition in the cosmetic surgery area which is not subsidized through the public health care sector. Danes generally connote the American surgeons with professionalism and expertise. However, price of cosmetic surgery is generally estimated to be a bit higher in the U.S. than in Denmark and much higher compared to e.g. Eastern Europe.

Furthermore, Denmark is behind the U.S. in the field cancer treatment, and not as receptive to new methods and as fast as implementing them, why increasing numbers of patients seek treatment abroad. U.S. health care providers with expertise in very specialized disease areas may have an advantage over Danish and other foreign health care providers.

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Posted: 25 May 2011, last updated 26 May 2011

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