Sweden has a welfare system that is based on the fundamental principle that all
citizens are entitled to good health and medical care, regardless of where they live or what their
economic circumstances are. Health and medical care are considered to be public sector
responsibilities. However, there is growing interest in establishing more private alternatives
to public care. An important characteristic of the Swedish healthcare
system is its decentralization, with a major role for county councils.
County councils are now merging into larger administrative units (region). The whole
Swedish system is in the process of reform, mainly because of perceptions that it was too
rigid and had insufficient patient orientation. An important factor in the reforms is that
power in the system will be even more decentralized and will have greater public input. This change is seen
as calling for increased central follow-up and evaluation of matters such as social, ethical, and
economic aspects. Although the state has decentralized control, it still attempts to control
the general direction of the system through regulation, subsidy, recommendations, and
guidelines. An important actor in the system is the Swedish Council on Technology
Assessment in Health Care (SBU). SBU began in 1987 with assessments of health
technologies, but its success has recently led policy makers to extend its coverage to dental
care. Health technology assessment is increasingly visible to policy makers, who find it useful in decision
making.