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Structural patterns in Swedish health policy: a 30-year perspective

  • Richard B. Saltman (a1)
Abstract

This perspective reviews key institutional and organizational patterns in Swedish health care over the last 30 years, probing the roots of several complicated policy questions that concern present-day Swedish decision-makers. It explores in particular the ongoing structural tension between stability, on the one hand, and the necessary levels of innovation and dynamism demanded by the current period of major clinical, technological, economic, social and supranational (EU) change. Where useful, the article compares Swedish developments with those in the other three European Nordic countries as well as other northern European health systems. Sweden’s health sector evolution can provide valuable insight for other countries into the complexity involved in re-thinking tradeoffs between policies that emphasize stability as against those that encourage innovation in health sector governance and provision.

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Corresponding author
*Correspondence to: Richard B. Saltman, Professor of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30338, USA. Email: RSALTMA@emory.edu
References
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Alesina, A. and Giavazzi, F. (2008), The Future of Europe: Reform or Decline, Cambridge, MA: MIT Press.
Andersson, G. (2014), Personal communication, 19 March.
Anell, A. (2011a), ‘Choice and privatization in Swedish primary care’, Health Economics, Policy and Law, 6(4): 549569.
Anell, A. (2011b), ‘Hälso och sjukvårdstjänster i privat regi’, in L. Hartman (ed.), Konkurrensen konsekvenser. Vad händer med svensk välfärd [The consequences of competition. What is happening with Swedish welfare?], Stockholm: SNS, 181214.
Anell, A., Glenngard, A. H. and Merkur, S. (2012), Sweden: Health System Review. Health Systems in Transition Series, Volume 14 No. 5, Brussels: European Observatory on Health Systems and Policies.
Atun, R. and McKee, M. (2005), ‘Is the private finance initiative dead?’, British Medical Journal, 331(4): 792793.
Bruce, A. and Jonsson, E. (1996), Competition in the Provision of Health Care: The Experience of the US, Sweden and Britain, London: Ashgate Publishing Company.
Calltorp, J. (2012), Personal communication, 18 September.
Department of Finance (2003), Health Service Reform Program, 18 June, Dublin.
Edwards, N. (2011), ‘England’, in R. B. Saltman, A. Duran and H. W. F. Dubois (eds), Governing Public Hospitals: Recent Strategies and the Movement Toward Institutional Autonomy, Brussels: Observatory Studies Series No. 25. European Observatory on Health Systems and Policies, 113140.
Fagerstrom, C. and Willman, A. (2012), ‘Sweden’, in N. Genet, W. Boerma, M. Koimann, A. Hutchenson and R. B. Saltman (eds), Home Care across Europe: Current Structure and Future Challenges, Volume I. Observatory Studies Series No. 27, Brussels: European Observatory on Health Systems and Policies, 272279.
Ferriman, A. (1999), ‘Dobson defends use of PFI for hospital building’, British Medical Journal, 319(275): 1.
Genet, N., Boerma, W. and Rissanen, S. (2012), ‘Finland’, in N. Genet, W. Boerma, M. Koimann, A. Hutchenson and R. B. Saltman (eds), Home Care across Europe: Current Structure and Future Challenges, Volume I. Observatory Studies Series No. 27, Brussels: European Observatory on Health Systems and Policies, 8697.
Genet, N., Boerma, W., Koimann, M., Hutchenson, A. and Saltman, R. B. (eds) (2012), Home Care across Europe: Current Structure and Future Challenges, Volume I. Observatory Studies Series No. 27, Brussels: European Observatory on Health Systems and Policies.
Harrison, M. and Calltorp, J. (2000), ‘The reorientation of market-oriented reforms in Swedish health-care’, Health Policy, 50(3): 219240.
Hutchinson, A. (2012), ‘England’, in N. Genet, W. Boerma, M. Koimann, A. Hutchenson and R. B. Saltman (eds), Home Care across Europe: Current Structure and Future Challenges, Volume I. Observatory Studies Series No. 27, Brussels: European Observatory on Health Systems and Policies, 6778.
Johansson, L. (1997), ‘Decentralization from acute to home care settings in Sweden’, Health Policy, 41(Supplement): S131S144.
Jonsson, P.-M. (2014), Personal communication, 16 April.
King, S. D. (2010), Losing Control: The Emerging Threats to Western Prosperity, London: Yale University Press.
King, S. D. (2013), When the Money Runs Out: The End of Western Affluence, London: Yale University Press.
Landstingsforbundet (1991), Vagval: Halso och Sjukvardens overgripande structure och framtiden [The Pathway: Health care’s overall structure and future], Stockholm: Landstingsforbundet.
Martinussen, P. and Magnussen, J. (2009), ‘Health Care Reforms: The Nordic Experience’, in J. Magnussen, K. Vrangbaek and R. B. Saltman (eds), Nordic Health Care Systems: Recent Reforms and Current Policy Challenges, Maidenhead, UK: McGraw-Hill Education, 2152.
Mollstedt, B. (1983), Personal communication, 15 April.
Mor, V., Leone, T. and Maresso, A. (2014), Regulating Long Term Care: An International Comparison, Cambridge, England: Cambridge University Press.
Ohrming, J. (1990), Kvarters Akuten, Stockholm: Arbetslivscentrum.
Olejaz, M., Nielsen, A. J., Rudkobing, A., Birk, H. O., Krasnik, A. and Hernandez-Quevado, C. (2012), Denmark: Health System Review. Health Systems in Transition Series, Brussels: European Observatory on Health Systems and Policies.
Oliver, A. (2007), ‘The Veterans Health Administration: An American Success Story’, Milbank Quarterly, 85(1): 535.
Oliver, A. and Mossialos, E. A. (2005), ‘European Health Systems Reforms: Looking Backward to See Forward?’, Journal of Health Politics, Policy and Law, 30(1–2): 728.
Palm, W. and Glinos, I. (2010), ‘Enabling Patient Mobility in the European Union: Between Free Movement and Coordination’, in E. Mossialos, G. Permanand, R. Baeten and T. K. Hervey (eds), Health Systems Governance in Europe, Cambridge, UK: Cambridge University Press, 509560.
Rechel, B., Wright, S., Edwards, N., Dowdeswell, B. and McKee, M. (eds) (2009), Investing in Hospitals of the Future. Observatory Studies Series No. 16., Brussels: European Observatory on Health Systems and Policies.
Ringard, A., Sagan, A., Saunes, I. S. and Lindahl, A. K. (2013), Norway: Health System Review. Health Systems in Transition Series, Volume 15 No. 8, Brussels: European Observatory on Health Systems and Policies.
Robinson, R. and LeGrand, J., (eds) (1994), Evaluating the NHS reforms, King’s Fund, London.
Roos, K., Hultin, H., Bengtsson, J., Johansson, H., Stenstrom, O. and Brogren, P.-O. (2014), Tankesmedjan Natverket for Halso-och Sjukvard, Lakaretidningen, Stockholm. (forthcoming).
Saltman, R. B. (1992), Patientmakt over varden [Patient Power over Healthcare], Stockholm: SNS Forlag.
Saltman, R. B. and von Otter, C. (1987), ‘Re-Vitalizing Public Health Care Systems: A Proposal for Public Competition in Sweden’, Health Policy, 7: 2140.
Saltman, R. B. and Bergman, S. E. (2005), ‘Renovating the Commons: Swedish Health Care Reforms in Perspective’, Journal of Health Politics, Policy and Law, 30(1): 253276.
Saltman, R. B. and Bankauskaite, V. (2006), ‘Conceptualizing Decentralization in European Health Systems: A Functional Perspective’, Health Economics, Policy and Law, 1(2): 127147.
Saltman, R. B. and Cahn, Z. (2013), ‘Re-structuring health systems for an era of prolonged austerity’, British Medical Journal 2013; 346: f3972.
Saltman, R. and Vrangbaek, K. (2009), ‘Looking Forward: Future Policy Issues’, in J. Magnussen, K. Vrangbaek and R. B. Saltman (eds), Nordic Health Care Systems: Recent Reforms and Current Policy Challenges, Maidenhead, UK: McGraw-Hill Education, 78104.
Saltman, R. B., Duran, A. and Dubois, H. W. F. (eds) (2011a), Governing Public Hospitals: Recent Strategies and the Movement Toward Institutional Autonomy, Brussels: European Observatory on Health Systems and Policies.
Saltman, R. B., Calltorp, J. and de Roo, A. (2011b), Health Sector Innovation and Partnership: Policy Reponses to the New Economic Context, Paris: DELSA/HEA Organization for Economic Cooperation and Development (OECD), 17.
Saltman, R. B., Vrangbaek, K., Lehto, J. and Winblad, U. (2012), ‘Consolidating National Authority in Nordic Health Systems’, Eurohealth, 18(3): 2125.
Serner, U. (1980), ‘Swedish Health Legislation: Milestones in Re-Organization Since 1945’, in A. J. Heidenheimer and N. Elvander (eds), The Shaping of the Swedish Health System, New York: St. Martin’s Press, 99118.
SOU (2007), 10 Ansvarskommitténs slutbetänkande – Hållbar samhällsorganisation med utvecklingskraft. Stockholm.
SOU (2012), 33. Gor Det Enklare! Slutbetankande av Statens Vard och Omsorgsutredning. (Make it Simpler! Final Report of the Government Investigation on Health and Social Care), Stockholm.
Stockholm County (2013), New Karolinska Solna, Stockholm, http://www.nyakarolinskasolna.se/en/The-New-Hospital [30 May 2014].
Sundhedsstyrelsen (2009), Evaluerings rapport forloebsydelsen for diabetesomsorg in almen praksis, Copenhagen.
Voipio-Pulkki, L.-M. (2013), Personal communication, 13 December.
Vrangbaek, K. (2012), Personal communication, 21 April.
Vuorenkoski, L., Mladovsky, P. and Mossialos, E. A. (2008), Finland: Health System Review. Health Systems in Transition Series, Volume 10 No. 4, Brussels: European Observatory on Health Systems and Policies.
Winblad, U. and Ringard, A. (2009), ‘Meeting Rising Public Expectations: The Changing Roles of Patients and Citizens’, in J. Magnussen, K. Vrangbaek and R. B. Saltman (eds), Nordic Health Care Systems: Recent Reforms and Current Policy Challenges, Maidenhead, UK: McGraw-Hill Education, 126150.
Winblad, U. (2014), Personnal communication, 21 May.
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Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
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