Cost containment, solidarity and cautious experimentation: Swedish dilemmas

This paper uses secondary data analysis and a literature review to explore a “Swedish Dilemma”: Can Sweden continue to provide a high level of comprehensive health services for all regardless of ability to pay — a policy emphasizing “solidarity” — or must it decide to impose increasing constraints o...

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Bibliographic Details
Published in:Social science & medicine (1982) 2001-04, Vol.52 (8), p.1195-1204
Main Authors: Andersen, Ronald, Smedby, Björn, Vågerö, Denny
Format: Article
Language:English
Subjects:
Access
Access to health care
Biological and medical sciences
Competition policy
Comprehensive Health Care
Cost analysis
Cost Containment
Cost containment Solidarity Access Market reforms System change Health policy Sweden
Cost Control - methods
Delivery Systems
General aspects
Health care
Health Care Costs
Health care expenditures
Health care policy
Health Care Reform
Health Care Sector
Health Care Services Policy
Health economics
Health policy
Health Policy - trends
Health services
Health Services Accessibility
Health systems. Social services
Humans
Managed Competition
Market reforms
Medical sciences
MEDICIN
MEDICINE
Policy Reform
Political Systems
Private Sector
Public health. Hygiene
Public health. Hygiene-occupational medicine
Reforms
Social Cohesion
Social conditions & trends
Social medicine
Social Welfare
Socialmedicin
Solidarity
State Medicine - economics
State Medicine - organization & administration
Sweden
System change
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Summary:This paper uses secondary data analysis and a literature review to explore a “Swedish Dilemma”: Can Sweden continue to provide a high level of comprehensive health services for all regardless of ability to pay — a policy emphasizing “solidarity” — or must it decide to impose increasing constraints on health services spending and service delivery — a policy emphasizing “cost containment?” It examines recent policies and longer term trends including: changes in health personnel and facilities; integration of health and social services for older persons; introduction of competition among providers; cost sharing for patients; dismantling of dental insurance; decentralization of government responsibility; priority settings for treatment; and encouragement of the private sector. It is apparent that the Swedes have had considerable success in attaining cost containment — not primarily through “market mechanisms” but through government budget controls and service reduction. Further, it appears that equal access to care, or solidarity, may be adversely affected by some of the system changes.
ISSN:0277-9536
1873-5347
1873-5347
DOI:10.1016/S0277-9536(00)00239-2