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Chapter Three: Privatisation and Marketisation Within a Healthcare System: The Swedish Experience

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Navigating Private and Public Healthcare

Abstract

Sweden has a universal, tax-financed healthcare system which provides a comprehensive package of health services to the entire population at little or no out of pocket cost for the individual. When the system was implemented during the post-war period, it was believed by the ruling social democratic party that a virtually exclusive public provision of services would ensure that the system remained egalitarian and health services would be distributed on the basis of medical need, rather than employment or ability to pay. The market-orienting reforms undertaken in the system during the 1990s and 2000s, which led to an increased share of private, predominantly for-profit care providers, appears to have undermined these principles. The entry of private care providers has also led to a growing market for voluntary private health insurance.

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References

  • Alexandersen, N., Anell, A., Kaarboe, O., Lehto, J., Tynkkynen, L. and Vrangbaek, K. (2016). The development of voluntary private health insurance in the Nordic countries. Nordic Journal of Health Economics, 4(1), pp. 68–88.

    Article  Google Scholar 

  • Anell, A. (2011). Hälso- och sjukvÃ¥rdstjänster i privat regi. In Konkurrensens konsekvenser Studieförbundet Näringsliv och samhälle.

    Google Scholar 

  • Anell, A. and Claesson, R. (1995). Svenska sjukhus förr och nu: ekonomiska aspekter pÃ¥ struktur, politik och framtida förutsättningar. Lund: Institutet för hälso- och sjukvÃ¥rdsekonomi (IHE).

    Google Scholar 

  • Anttonen, A. (2002). Universalism and social policy: a Nordic-feminist revaluation. NORA: Nordic Journal of Women’s Studies, 10(2), pp. 71–80.

    Article  Google Scholar 

  • Anttonen, A., Häikiö, L., Stefánsson, K. and Sipilä. (2012). Universalism and the challenge of diversity. In: A. Anttonen, L. Häikiö and K. Stefánsson (eds.) Welfare State, Universalism and Diversity. Cheltenham: Edward Elgar Publishing.

    Google Scholar 

  • Béland, D., Blomqvist, P., Andersen, J., Palme, J. and Waddan, A. (2014). The universal decline of universality? Social Policy Change in Canada, Denmark, Sweden and the UK. Social Policy and Administration, 48(7), pp. 739–756.

    Google Scholar 

  • Blomqvist, P. (2004). The choice revolution. Privatization of Swedish welfare services in the 1990s. Social Policy and Administration, 38(2), pp. 139–155.

    Article  Google Scholar 

  • Blomqvist, P. and Rothstein, B. (2000). Välfärdsstatens nya ansikte. Stockholm: Agora.

    Google Scholar 

  • Dahlgren, G. (2008) Neoliberal reforms in Swedish primary health care: for whom and for what purpose? International Journal of Health Services, 38(4), pp. 697–715.

    Article  Google Scholar 

  • Dixon, A., Robertson, R., Appelby, J., Burge, P., Devlin, N. and Magee, H. (2010). Patient Choice—How Do Patients Choose and How Do Providers Respond? Report. London: The King’s Fund.

    Google Scholar 

  • Fredriksson, M., Blomqvist, P. and Winblad, U. (2013). The trade-off between choice and equity: Swedish policy-makers’ arguments when introducing patient choice. Journal of European Social Policy, 23(2), pp. 192–209.

    Article  Google Scholar 

  • Freeman, R. (2000). The Politics of Health in Europe. Manchester: Manchester University Press.

    Google Scholar 

  • Goul Andersen, J. (2012). The concept of universalism and its operationalization in a mixed economy of welfare. Paper presented at CCWS seminar, Aalborg University, October 31, 2012. CCWS working paper nr. 2012-81.

    Google Scholar 

  • Green-Pedersen C. (2002). New public management reforms of the Danish and Swedish welfare states: the role of different social democratic responses. Governance, 15(2), pp. 271–294.

    Article  Google Scholar 

  • Gustafsson, R. Ã…. (1987). Traditionernas ok. Den svenska hälso-och sjukvÃ¥rdens organisering i historie-sociologiskt perspektiv. Doctoral Dissertation, Department of Economic History, Stockholm University. Solna: Esselte studium.

    Google Scholar 

  • Heidenheimer, A.J. and Elvander, N. (eds.) (1980). The Shaping of the Swedish Health System. London: Croom Helm.

    Google Scholar 

  • Hood, C. (1995). The ‘new public management’ in the 1980s: variations on a theme. Accounting, Organizations and Society, 20(2), s. 93–109.

    Article  Google Scholar 

  • Immergut, E.M. (1992). Health Politics: Interests and Institutions in Western Europe. Cambridge: Cambridge University Press.

    Google Scholar 

  • Isaksson, D., Blomqvist, P. and Winblad, U. (2016). Free establishment of primary health care providers: effects on geographical equity. BMC Health Services Research, 16(28), pp. 1–10.

    Google Scholar 

  • Ito, H. (1980). Health insurance and the medical services in Sweden and Denmark 1850–1950. In: A.J. Heiderheimer and N. Elvander (eds.) The Shaping of the Swedish Welfare System. London: Croon Helm.

    Google Scholar 

  • Kautto, M., Fritzell, J., Hvinden, B., Uusitalo, H. and Kvist, J. (2001). Nordic welfare states in the European context. London and New York: Routledge.

    Google Scholar 

  • Kildal, N. and Kuhnle, S. (2004). The principle of universalism: tracing a key idea in the Scandinavian welfare model. In: G. Standing (ed.) Promoting Income Security as a Right: Europe and North America. London: Anthem Press.

    Google Scholar 

  • Kullberg, L., Blomqvist, P. and Winblad, U. (2018). Market-orienting reforms in rural health care in Sweden: how can equity in access be preserved? International Journal for Equity in Health, 17(1).

    Google Scholar 

  • Kullberg, L., Blomqvist, P. and Winblad, U. (2019). Health insurance for the healthy? Voluntary health insurance in Sweden. Health Policy, 123(8), pp. 737–746.

    Article  Google Scholar 

  • Lapidus, J. (2017). Private health insurance in Sweden: fast-track lanes and the alleged attempts to stop them. Health Policy, 121(4), pp. 442–449.

    Article  Google Scholar 

  • Le Grand, J. (2006). Equality and choice in public services. Social Research: An International Quarterly, 73(2), pp. 695–710.

    Google Scholar 

  • Mellbourn, A. (1986). Bortom det starka samhället: socialdemokratisk förvaltningspolitik 1982–1985. Stockholm: Carlsson.

    Google Scholar 

  • Pollitt, C. and Bouckaert, G. (2011). Public Management Reform: A Comparative Analysis-New Public Management, Governance, and the Neo-Weberian State. Oxford: Oxford University Press.

    Google Scholar 

  • Rehnberg, C., Janlöv, N. and Andersson, F. (2014). Konkurrens, kontrakt och kvalitet – hälso- och sjukvÃ¥rd i privat regi. Stockholm: Ministry of Finance.

    Google Scholar 

  • Rothstein, B. (1998). Just Institutions Matter: The Moral and Political Logic of the Universal Welfare State. Cambridge: Cambridge University Press.

    Google Scholar 

  • Sagan, A. and Thomson, S. (2016). Voluntary health insurance in Europe: role and regulation. Observatory Studies Series, 43.

    Google Scholar 

  • Saltman, R., Busse, R. and Figueras, J. (2004). Social Health Insurance Systems in Europe. London: Open University Press.

    Google Scholar 

  • Serner, U. (1980). Swedish health legislation: milestones in reorganization since 1845. In: A.J. Heiderheimer and N. Elvander (eds.) The Shaping of the Swedish Welfare System. London: Croon Helm.

    Google Scholar 

  • Swedish National Audit Office (Riksrevisionen). (2014). PrimärvÃ¥rdens styrning – efter behov eller efterfrÃ¥gan? Rapport RIR 2014: 22.

    Google Scholar 

  • Thompson, S. and Hogett, P. (1996). Universalism, selectivism and particularism. Towards a postmodern social policy. Critical Social Policy, 16(46), pp. 21–42.

    Article  Google Scholar 

  • Vrangbæk, K., Østergren, K., Okkels Birk, H. and Winblad, U. (2007). Patient reactions to hospital choice in Norway, Denmark and Sweden. Health Economics, Policy and Law, 2(2), pp. 125–52.

    Article  Google Scholar 

  • Wagstaff, A. and van Doorslaer, E. (2000). Equity in health care finance and delivery. Handbook of Health Economics, 1(part B), pp. 1803–1862.

    Google Scholar 

  • Wendt, C. (2009). Mapping European health care systems: a comparative analysis of financing, service provision and access to healthcare. Journal of European Social Policy, 19(5), pp. 432–445.

    Article  Google Scholar 

  • WHO (1999). Making a Difference. The World Health Report 1999. Report, The World Health Organization.

    Google Scholar 

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Correspondence to Paula Blomqvist .

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Blomqvist, P. (2020). Chapter Three: Privatisation and Marketisation Within a Healthcare System: The Swedish Experience. In: Collyer, F., Willis, K. (eds) Navigating Private and Public Healthcare. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-32-9208-6_3

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  • DOI: https://doi.org/10.1007/978-981-32-9208-6_3

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  • Publisher Name: Palgrave Macmillan, Singapore

  • Print ISBN: 978-981-32-9207-9

  • Online ISBN: 978-981-32-9208-6

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