Running Head: Healthcare System in Sweden

Healthcare System in Sweden

Name

Institution
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Abstract

This essay provides brief information on Sweden as a country with one of the best healthcare
systems. The study takes into consideration population and size of the country. To be able to
understand healthcare, the study has dwelt into some of health care indicators such as mortality
and life expectancy as possible reflections on the how effective the health system may be. The
analysis of the healthcare system reveals nature of funding for the sector and the challenges with this
model as compared to other countries of the world as United States of America. While studying the
health care system in Sweden, the social, cultural and economic factors have been examined to
understand their impact on health care services. The challenges in the sector have been
investigated in consideration of the United States to try to find out the comparison on the
different system used in US, health care performance and funding. The study has established
some contingency measures that have been put in place to help correct some of the teething
problems in Sweden. Such plans include the introduction of policies to encourage private
participation through investment in the health sector. Finally, the study has provided some
suggestions for the improvement in the management of the health sector. These
recommendations are not exhaustive, but will provide a better ground for serious discussion on
the required changes to help improve health care provision in Sweden.
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Sweden

Sweden is found in the central Europe on the eastern part of Scandinavian Peninsula. The
land area is 410,335 km2 making it the fourth largest in terms of size in Europe with a population
of just over 9.6 million people by December of 2013. The capital city of Sweden is Stockholm
with a population of about 1.372 million people. The other large cities of Sweden includes;
Goteborg and Malmo with a population of about 536,790 and 303,873 respectively (Ring, et al
2013). The country of Sweden has many mountains and lakes to the north with central lowlands
at the south and eastern parts. On the south of the lowlands are fertile areas made up of the
forest, valley and plains. The coastal area of the land is rocky and divided by bays and inlets
forming many islands one of which is Gotland and Oland (Ring, et al 2013).

Sweden ranks top as one of the countries with the most sustainable renewable energy use
with low carbon dioxide emissions. The rating provides insights into the opportunities available
in terms of investments related to social, governance and environmental practices relative to
other countries. The country has an agency called Swedish Environmental Protection Agency
(SEPA) which is a governmental body. The agency has the responsibility of proposing
environmental policies and their implementation. The body reports directly to the Swedish
Ministry of Environment (Korosec, 2013). The environmental policies are premised on several
objectives that are meant for the sustainability of the ecosystem, conservation of the biodiversity,
good health, and reduction of pollution, preservation of the natural resources and monitoring of
the consumption patterns. On the basis of the progress report which is an evaluation of the
environmental objectives, the government uses it as a background material for budget bill
formulation (Korosec, 2013).

Life in Sweden is relatively expensive compared to the rest of Europe. It is considered to

be a very stable politically and delivers an extraordinary living standard. This makes the country
an ideal place for settlement, and it is because of this that many expatriates are attracted into the
country. People from outside the country forms about twelve percent of the population with large
numbers being expatriates living and working in Stockholm. The large numbers are attracted by
benefits which are the same as those of the native population. The benefits comprises of
education, healthcare and welfare.
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Healthcare Indicators for Sweden

Sweden birth rate is at about 12 per 1000 people and life expectancy in the country is at
80.3 years for men and 81.4years for women (Swedish Institute, 2016). Infant mortality rate is
estimated at about 3 per 1000 children. To maintain these low levels for the health indicators has
been realized as a result of the Sweden’s policy of equitable quality health services for all. This
contributes to low mortality rate and higher life expectancy for its population. However, these
positive trends are not without its challenges such as funding, efficiency and quality of healthcare
services.

Healthcare System in Sweden

The health care system in Sweden is highly decentralized and is funded from by the
Government through taxation. In Sweden, Health care system in this country is funded by local
and regional taxes, State subsidy and private insurance. The Healthcare coverage in Sweden is
universal based on three principles of necessity, cost effectiveness and equal access (Glenngård,
n.d). The comparison made with other systems in the world reveals the distinctive nature of the
service that is provided by the Swedish system. The competence of the Swedish healthcare in
providing high quality and sustainable care reveal a level of success this is Organization for
Economic Cooperation and Development report of 2013 (OECD).

Funding from public sources is done through proportional income tax, that is, county
council taxes, which account for about seventy per cent of the total cost of services. The rest of
the funding is made through National subsidies and private insurance which fund twenty and ten
per cent respectively. The funding of the health services is made through local government
taxation. About 90 per cent of the health care services are provided by county councils and
municipalities and a mere 10 per cent provided by the private practitioners (Swedish Healthcare,
2017).

Sweden invests about 9.2 per cent of its GDP annually on health care. Children and
adolescents of up to 19 years of age are treated free of charge, with some expensive treatments
being covered. Treatments for the elderly and the disabled people who get treatments at places
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where they live are done through local (municipal) taxes. In fact, in Sweden the elderly have the
right to be taken care of in their residences. Whenever a patient decides for a referral outside of
their county council they are allowed the free choice.

County councils set their own fees but a national limit is set on the maximum amount
paid by patients and this covers even pharmaceuticals. The limits regulations also apply to out-
of-pocket payments in cost-sharing arrangements. The subsidies are also available for many
publicly financed health care services. To encourage private participation in the provision of
health care services, they are exempted from taxation.

Healthcare System in Sweden compared to the one in United States of America

In terms of the healthcare indicators, the Swedish health system has a better overall
system. There are about 3 deaths per every 1000 live births and 6 deaths per 1000 live births in
Sweden and US respectively. In Sweden the life span of the general population is longer than
that of the population of United States. Health care is generally in provided by the private
insurance in America as opposed to Sweden where local county councils provide the bulk of the
service.

Sweden is known for promotion of health care by being very generous and effective with
provision of the services to all citizens. Sweden is ranked second and US 41st in terms of the
quality of health care cost. The quality of the care is also high and economically viable than the
United States America. The economic model is that of a capitalist society, all other sectors of the
economy as social welfare and healthcare follow capitalism. Because of this, it is less praised
compared to other systems in the world, thereby considered unaffordable and less effective
contrasted with other systems. Here the patients cater for the cost of healthcare by paying
directly the doctor who provides the care (Swedish Health Care, 2017).

Health Problems Facing Sweden

The major problems confronting health care in Sweden can also be witnessed in other
countries. The challenges include but not limited to issues of funding, access, quality and
efficiency. Governance is also a problem in the healthcare sector with co-ordination being an
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issue between hospitals, primary services and local councils. The major question for the sector
has been how to manage a public-funded monopoly to make it service oriented.

As population is growing, waiting times are increasing for pre-planned care such as those
that require surgery and chronic conditions. This is reducing the access and satisfaction levels for
patients who require these services. The change in policy to allow patients to decide between a
private and a public service provider faces the challenge of selective implementation by the
autonomous county councils. This discourages the level of access that is required to help reduce
waiting times and provide the freedom to make an independent decision by patients on where
they want to get healthcare service.

In many countries just as in America, the challenge is that there is no guarantee to

citizens that they will acquire specific services because of the cost implications. The increasing
cost of medication is an issue as it increases the burden on the countries that fund their healthcare
through taxation in the budgets. Because of lack integration and coordination, America’s
healthcare system lacks the ability to operate as a unit. This lack of integration makes the system
to have communication challenges within the links thereby affecting the quality of services.

In many countries such as United States and Sweden where the responsibility of the
quality lays with the government agencies, the issue of compensation comes up. Penalties due to
failure to meet certain standards make the healthcare organizations incur costs which could
otherwise be avoided. In addition, the challenge of meeting the increased population (volume-
based) that require healthcare against value of the service contributes to the increasing costs.

A number of primary care professionals are dwindling in the sector, this may be because
of lack of funds to train and have competent replacements for the retiring doctors and nurses. The
problem leads to inaccessibility of services. The resulting shortage is gradually contributing to
the reduction of the quality and effective provision of health care services (Agency for
Healthcare Research and Quality, 2015). These services are not unique to America and Sweden,
but also in many other countries of the world. The problems are because of the increasing
populations that are stretching the budgeting allocations and the limited resources available
against other basic requirements.
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Effects of Social, Cultural and Economic Factors on Healthcare in Sweden

Sweden has a decentralized and government –funded health care system which is
delivered under universal model on the principles equal access and quality service. This provides
that the government allocate huge amounts into the provision of health services. To be able to
manage the health sector, government may be forced to cut spending on other equally necessary
amenities. The cuts are therefore likely to affect essential areas such as wages, health insurance
benefits and require employees to bear the burden of the increased spending.

The results of lower wages will eventually affect the social indicators of health. The
effects of the structural indicators and conditions where citizens are born, live, grow; work and
age will have an impact on their health. For instance, children born to illiterate parents are most
likely to be subjected to conditions that pose health hazards because of poor or unsafe
neighborhoods.

Culture may have an effect on diagnosis through poor description and communication of
symptoms. This is because; the description is dependent on the perceived causes of diseases,
understanding the disease stages, treatment and making a choice. In addition, the cultural factors
may also affect the interaction with the health care system and health care professionals. This can
be revealed in the reluctance to provide information about contacts and description of such
contacts.

Challenges to Health Services in United States of America

Because of the fears of government involvement in the running of Healthcare system,

there has been reluctance to formulate policies that provide control to central planning and
management. There over-reliance on the free market economy where citizens have to contend
with fee-for-service reimbursement. Another problem that also affects USA’s healthcare is the
inability to control the ever-increasing costs for health care services and the problem of
identifying individuals with health insurance or not.

Despite the model used in US, and the country’s capacity to be the highest spender on
health services, it still falls below all the countries of the world. In fact, it has the lowest ratings
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on life expectancy and the highest infant mortality in the world. Because of the fear to control the
sector by the government some reforms for change are not likely to address fundamental
challenges.

Funding of the health care services is also a challenge in America. The problem is that the
provision of the health services is in the hands of private practitioners and insurance providers.
Because of the drive to make profit, they will tend to invest in areas with the highest possibility
of getting back their investments.

Contingency Plans for Healthcare Problems in Sweden

Sweden is moving to making the health care industry through competitive through
privatizing some of the health services. Private hospitals are coming up in the neighborhood
which is encouraging for the promotion of the country’s health sector. Again this will help to
absorb the part of the population which initially had no choice but seek services in the
government funded centers.

The government through formulation of policies is creating more cancer care centers of
higher standard to increase access to those patients with cancer conditions. This is meant to
improve access by reducing waiting times and minimize regional differences. There is also an
effort to develop greater satisfaction through provision of information and encourage
participation.

There is need for government to relinquish control to county councils, municipalities and
the private sector to be in charge of the management of healthcare. The central government
should remain to the creation of necessary framework for provision of equitable health care for
the nation. This will leave the government with the responsibility of legislation and standards
setting while public authorities are left to control and monitor health care services.
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Recommendations for Improvement of Healthcare System in Sweden

The government should encourage private full participation and control on the sector of
healthcare system. Instead, the government should only remain in the formulation of laws and
regulations for the sector. For instance, putting of price ceiling also referred to as maximum
payment protection for services of health care discourages private entrepreneurs who might want
to invest in the sector. Reducing this control will help direct the savings on the resources to
training of more professionals. In additional the sector should be left to spring up with private
practitioners to help create competition. This will allow the economy to independently find its
own equilibrium and the prices will eventually stabilize.

Conclusion

Whenever the responsibility of the quality lies with the government agencies, the issue of
compensation comes up especially when providers do not meet set standards. To be able to get
value-based healthcare, organizations must strive to enlist the services of the best talents, this is
because, better quality of services can only be provided by the best talents. The problem of
shortage of talents or professionals in the health care can be managed through allocation of more
resources to cater for training for replacements. Another means is to plan for succession for the
professionals who are about to retire. This should be made well in advance so as to help control
acute shortages occasioned by either death or resignation. Otherwise the problem will continue to
pose a challenge to the health care system. Funding for universal provision is critical, so a way
should be found for mitigation, for instance, formulation of policies that free up control and
allow more private participation through public-private partnerships.
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References

Kirsten Korosec, (August 19, 2013). Sweden ‘Most Sustainable Country in the World.’ Retrieved
from https://www.environmentalleader.com/wp-content/uploads/2013/08/top-sustainable-
countries.jpg

Trudy Ring, Noelle Watson, Paul Schellinger, (2013). Northern Europe: International Dictionary
of Historic Places. Routledge
Agency for Healthcare Research and Quality (2015). Future directions for the national healthcare
quality and disparities report

Peter Gourevitch, Andrew Martin, George Ross, Stephen Bornstein, Andrei Markovits, &
Christopher Allen (2016).Unions and Economic Crisis: Britain, West Germany and
Sweden. Routledge
Swedish Institute (2016). Retrieved from https://sweden.se/society/health-care-in-sweden/

Swedish Health Care (2017). Retrieved from http://www.swedishhealthcare.com/about-sweden-

and-swedish-healthcare/swedens-healthcare-system/

.Anna H. Glenngård (n.d). The Swedish Health Care System: Lund University School of
Economics&Management.http://international.commonwealthfund.org/features/governme
nt_role/ Retrieved from 25th November 2017)
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Figure 1: Organization Chart