Anne Korkeakivi

Opinion contributor

In 1991, after nearly 10 years of recurring wracking pain in my lower abdomen, I walked into a hospital in Helsinki, Finland. I wasn't a Finnish citizen and wasn't, at that time, married to one. I was an American writer visiting my Finnish boyfriend, working temporarily in Helsinki.

An admitting nurse listened to my symptoms and guessed my problem — a diagnosis that received preliminary confirmation by ultrasound within the hour.

A month later, I underwent laparoscopic diagnosis plus surgery and, in one morning for the equivalent of about $45, was freed from a debilitating condition that visits to four medical establishments in the U.S. had done nothing to manage.

What had caused my left ovary to feel as though it had been grabbed by a metal vise and twisted? Endometriosis, a condition in which the uterine lining shows up in another part of the body (in my case wrapped around an ovary). With no known cause, endometriosis affects about 176 million females around the world and an estimated one out of 10 women in the U.S. annually.

Setting aside other debilitating side effects, the main complication of endometriosis is what the Mayo Clinic calls "impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant."

Why did it take so common and potentially destructive a condition so long to be diagnosed? As a freelance writer, I did not have and could not afford to purchase comprehensive health insurance. Diagnosis of my problem required an initial ultrasound, and ultrasounds were expensive. None of the American medical professionals suggested it.

I have since had the opportunity to live in three countries — Finland, France and Switzerland — with some form of universal health care. In each, my family and I have received prompt medical care when required. (Yes, thanks probably to care by the free Finnish health care system, I subsequently and without intervention had children).

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In France and Finland, the government largely funds health care; in Switzerland, individuals are required to purchase health insurance pro-rated to match their income. (The Swiss government subsidizes coverage for the indigent.) Of course their health care systems face challenges. But in each country, the system goes beyond a piece of legislation. People may, for example, need to pay higher taxes, but they don’t need extra savings in the bank to get care for sick kids. Doctors may draw lower salaries, but they typically incur radically less debt as students and, in some countries, may also spend less on malpractice insurance.

There is choice as well. In Switzerland, the government mandates minimum coverage and maximum deductibles; it’s up to the individual to decide the rest. Employers in Finland and France typically offer a supplementary private insurance which, if employees choose to accept, may or may not require a pay-in; individuals without supplementary insurance still have comprehensive coverage but potentially less choice where to use it or a fractional charge. Anyone can see whatever doctor they wish if they are willing to pay a supplement.

When your kid comes home from school with a 102° fever in one of these countries, when an aching tooth keeps you up at night, you do not check the balance in your bank account. Poor or rich, you visit a doctor.

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Over the years, I've visited many an emergency room in these countries and have never had to wait as long as in an American ER. The general practitioner I see in the U.S. is top-notch, but medical care in these other countries has also proved excellent — from the Swiss surgeon who performed reconstructive surgery on my shoulder to the French obstetrician who saved my second child’s life in delivery, back to that Finnish nurse who, in 10 minutes with an American writer lacking adequate healthcare insurance, paved the end to a decade of suffering.

To me, freedom is being able to choose a career path based on vocation rather than the fear of ending up without medical insurance. Having a choice means deciding to become a novelist — or any independent profession — without gambling on never having endometriosis. Yes, it takes a societal shift. But it is worth it.

For me, whether universal health care systems don't and can't work is not a theoretical question. I can give you an answer from real-life experience.

They can. And they do.

Anyone who claims otherwise is either hoodwinked or has an agenda. My beautiful children prove it.

Anne Korkeakivi, an American writer currently living in Switzerland, is the author of the novelsShining Sea and An Unexpected Guest. Follow her on Twitter@annekorkeakivi.

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