Swedish Healthcare Reform Newsletters 2002

Encouraging market competition in the publicly-funded, universal health care system could improve productivity and decrease wait times in Canada


The purpose of this project was to inform Canadian policy makers about changes to the publicly run health care system occurring in Sweden. The Swedish health care system allowed incremental privatization of some services beginning in the early 1990s, and these publications were designed to facilitate information transfer about the successes of different initiatives for health care reform in the Swedish system. The reports documented an improved sense of ownership among employees, greater productivity, successful implementation of user fees, and the effective introduction of private healthcare providers into the public system in the Swedish context.

Grant Outputs

When Employees Take Over – http://www.fcpp.org/pdf/when_employees_take_over.pdf

This article highlights the experiences of two private clinics in the Stockholm region and their successes in the new partially-privatized system. The interviewees suggested that since they had become directly accountable to their patient base, rather than to the federal medical care system, their productivity had increased while their costs decreased. Health care providers reported higher satisfaction with their pay and working conditions in the private sector.

User Fees for Health Care in Sweden – http://www.fcpp.org/publication.php/26

This article examines the political impetus for the movement towards a more market driven Swedish health care system. It explains the long history of user fees, in place in Sweden since the 1970s. The report concludes that higher user fees were a minimally contentious political issue because the system ensured that children and low income people were not denied medical care due to insufficient funds.

Despite Swedish Elections: Health Reforms Continue – http://www.fcpp.org/publication.php/451?print=yes

This report considers the implications on health care reforms of the Social Democrats winning in the federal elections in Sweden. It hypothesizes that certain reforms to the medical system would proceed, such as the guarantee that Swedes living in any district could use public funding from their local council in another region to obtain treatment if it was unavailable in their district. The report concludes that other reforms, such as using federal tax funds to purchase private emergency room services, would be slowed due to the election results, but that they would not reverse the process of marketization in health care provision.

Health Care Treatment Prices in Swedish Hospitals – http://www.moyak.com/papers/ehr-sweden.pdf

This article explains how in the early 1990s the Swedish Social Democratic party introduced the Diagnosis Related Group (DRG) system into their publicly funded medical care system. The DRG assigned a cost to approximately 10,000 different medical treatments, each fitting into one of 500 equivalent price points. This allowed private service delivery to occur alongside public medical care provision, where both public and private providers were paid equally for equivalent services from public funds. This new private sphere competition led to increased productivity not only in private clinics, but in public clinics as well. The report concludes that in the first year of the DRG system, public hospitals increased their productivity from 19-30%. DRGs proved to be an effective way to reform publicly funded health care.

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