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Cost containment, solidarity and cautious experimentation: Swedish dilemmas

Author

Listed:
  • Andersen, Ronald
  • Smedby, Björn
  • Vågerö, Denny

Abstract

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.

Suggested Citation

  • Andersen, Ronald & Smedby, Björn & Vågerö, Denny, 2001. "Cost containment, solidarity and cautious experimentation: Swedish dilemmas," Social Science & Medicine, Elsevier, vol. 52(8), pages 1195-1204, April.
    • Handle: RePEc:eee:socmed:v:52:y:2001:i:8:p:1195-1204
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    Cited by:

    1. Endrei, Dóra & Zemplényi, Antal & Molics, Bálint & Ágoston, István & Boncz, Imre, 2014. "The effect of performance-volume limit on the DRG based acute care hospital financing in Hungary," Health Policy, Elsevier, vol. 115(2), pages 152-156.
    2. Kaukonen, Pälvi & Salmelin, Raili K. & Luoma, Ilona & Puura, Kaija & Rutanen, Mervi & Pukuri, Tarja & Tamminen, Tuula, 2010. "Child psychiatry in the Finnish health care reform: National criteria for treatment access," Health Policy, Elsevier, vol. 96(1), pages 20-27, June.
    3. Skinner, Mark W. & Rosenberg, Mark W., 2006. "Managing competition in the countryside: Non-profit and for-profit perceptions of long-term care in rural Ontario," Social Science & Medicine, Elsevier, vol. 63(11), pages 2864-2876, December.
    4. Jenny Torssander, 2013. "From Child to Parent? The Significance of Children’s Education for Their Parents’ Longevity," Demography, Springer;Population Association of America (PAA), vol. 50(2), pages 637-659, April.
    5. Benning, Tim M. & Dellaert, Benedict G.C., 2013. "Paying more for faster care? Individuals' attitude toward price-based priority access in health care," Social Science & Medicine, Elsevier, vol. 84(C), pages 119-128.

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