Monday, May 27, 2013

Danish Health Care and the Philosophy of Søren Kierkegaard

Today was a packed day, focusing primarily on the Danish health care system and the life and philosophy of Søren Kierkegaard.

In the morning, we discussed the objectives and efficacy of the Danish health care system. Contrary to the 'negative' approach to health care that many in the United States espouse, the Danish health law prescribes a positive perspective of health: we must both alleviate sickness and pain while also actively promoting a state of physical, mental, and emotional well-being. There are several objectives following from this, including easy and equal access of health services, treatment of high quality, free choice, and easy access of information for patients.

Unlike some characterizations of Nordic health care models, Denmark's health care system is a decentralized model with the state delegating block grants and activity-based funding to regional and municipal authorities. This allows for those on the local level to delegate funding to those areas that they feel needs the most attention, which is appropriate given their knowledge of local affairs. There is also a separation of purchaser (the state who purchases health services) and provider (the health professionals and hospitals who actually provide health care) in order to create an 'internal market' and contract bidding. The idea here is that this will lead to more efficient and effective health outcomes and allocation of health services, while also keeping the goals of equality and universality in mind.

In terms of happiness, we were surprised to find out that the research shows Danes are just as likely as Americans to be depressed. This was surprising as we have heard many times that Denmark is one of the happiness nations in the world. What may explain this apparent discrepancy may be the fact that the Danes who are not depressed tend to be happier than the average American. Regardless, this discovery  reminded us that human flourishing is a difficult goal to accomplish regardless of the society - it requires work and due diligence in order to obtain and maintain.

The afternoon brought us an enlightening journey to the life and work of Søren Kierkegaard. Born in the early 19th century, Kierkegaard is considered to be the first Existentialist philosopher. His main task is Socratic - he aims to tear down our preconceived notions and assumptions and realize how ignorant we really are. While it is very difficult to nail down a summary of his extensive work (he published 40 books and 40 articles in one decade), his focus was on how the individual lives and acts in a world plagued by despair and discord between the finite aspects of the body (our mortality and physical limitations) and the infinite aspects of the mind (our imagination and capacity for conscious thought). Ultimately, Kierkegaard suggests for us to appreciate our lives and turn inward in order to fulfill ourselves as individuals.

We finished the afternoon by visiting his gravesite, which was a powerful experience. He is buried with his father and other siblings in the Assistens Cemetery in Nørrebro, Copenhagen. In the same cemetery lies his former fiancé Regine Olsen, whom he broke off an engagement with in order to pursue his lifelong calling of philosophy.  

The Gravesite of Søren Kierkegaard
We also visited various places affiliated with Kierkegaard, including the church his funeral was held, the place he wrote his most famous works, and the church of his baptism. He lived in the inner city for most of his life, and at the end of his life he ended up heavily criticizing the very church he gave sermons in years before. His emphasis on the individual having a relationship with God and Christ was at odds with the Church of Denmark, which for Kierkegaard symbolized corruption and human failure. Ironically, he ended up having his funeral at this same church.
Plaque dedicated to Kierkegaard's Former Place of Residence

Our discussion of both the Danish health care system and the philosophy of Søren Kierkegaard presented to us a possible tension between the collective aspirations of the Danish people as contrasted with Kierkegaard's focus on the individual. Perhaps we can solve this dilemma by looking at Danish culture: Danes may have found the balance between finding an individualism that is sympathetic to notions of collective welfare. Rather than being in opposition to one another, connecting with our true selves requires us to take care of our fellow human beings.

The Group at the Grave of Søren Kierkegaard

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