Health Care Analysis

, Volume 7, Issue 4, pp 321–330

Access to Health Care in the Scandinavian Countries: Ethical Aspects

  • Sören Holm
  • Per-Erik Liss
  • Ole Frithjof Norheim

DOI: 10.1023/A:1009460010196

Cite this article as:
Holm, S., Liss, PE. & Norheim, O.F. Health Care Analysis (1999) 7: 321. doi:10.1023/A:1009460010196


The health care systems are fairly similar in theScandinavian countries. The exact details vary, but inall three countries the system is almost exclusivelypublicly funded through taxation, and most (or all)hospitals are also publicly owned and managed. Thecountries also have a fairly strong primary caresector (even though it varies between the countries),with family physicians to various degrees acting asgatekeepers to specialist services. In Denmark most ofthe GP services are free. For the patient in Norwayand Sweden there are out-of-pocket co-payments for GPconsultations, with upper limits, but consultations forchildren are free. Hospital treatment is free inDenmark while the other countries use a system without-of-pocket co-payment. There is a very strongpublic commitment to access to high quality healthcare for all. Solidarity and equality form theideological basis for the Scandinavian welfare state.Means testing, for instance, has been widely rejectedin the Scandinavian countries on the grounds thatpublic services should not stigmatise any particulargroup. Solidarity also means devoting specialconsideration to the needs of those who have lesschance than others of making their voices heard orexercising their rights. Issues of limited access arenow, however, challenging the thinking about a healthcare system based on solidarity.

accessethicshealth care systemprimary health caresolidarity

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Sören Holm
    • 1
  • Per-Erik Liss
    • 2
  • Ole Frithjof Norheim
    • 3
  1. 1.Centre for Social Ethics and PolicyUniversity of ManchesterManchester
  2. 2.Department of Health and SocietyUniversity of LinköpingLinköpingSweden (Corresponding author E-mail
  3. 3.Department of Public Health and Primary Health Care, Division for general practiceUniversity of BergenUlriksdal, BergenNorway