Healthcare in Sweden

The Swedish health care system is a socialized, public health care system. It is informally divided into 7 sections: "Close-to-home care" (primary care clinics, maternity care clinics, out-patient psychiatric clinics, etc.), emergency care, elective care, in-patient care, out-patient care, specialist care, and dental care.

A person seeking care first contacts a clinic for a doctor's appointment, and may then be referred to a specialist by the clinic physician, who may in turn recommend either in-patient or out-patient treatment, or an elective care option. All emergent cases are treated by an emergency department at a hospital.

The health care is governed by the 21 Landsting (County councils) of Sweden, which act on general recommendations of the parliament, and delegate local government to the municipalities. Regulations, waiting times and patient fees vary in the different Landsting.

Financing

The state finances the bulk of health care costs, with the patient paying a nominal fee for examinations and some tests. The state pays for approximately 85 % of medical costs.

When a physician declares a patient to be ill for whatever reason (by signing a certificate of illness/unfitness), the patient is paid a percentage of their normal daily wage from the second day. For the first 14 days, the employer is required to pay this wage, and after that the state pays the wage until the patient is declared fit.

The state also reimburses patients for travel costs to and from the clinic or hospital.

Examples of patient fees in Stockholm:

Appointment at a clinic - 140 SEK (ca €15)

Appointment at a clinic (child) - 0 SEK

Appointment with specialist - 260 SEK (ca €27)

In-patient care - 80 SEK (ca €8.50)/day

tatistics

Swedish health care show relatively good figures compared to other health care systems, with a high number of physicians and nurses compared to the population, with a large amount of the health care costs paid by the state yet with a low health care spending compared to GDP

Waiting times

The national guarantee of care states that a patient should be able to get an appointment with a primary care physician within 5 days of contacting the clinic. If referred to a specialist by the GP, they should get an appointment within 30 days, and if treatment is deemed necessary by the specialist, it should be given within 90 days. However, urgent cases are always prioritized and emergent cases are treated immediately.

Criticism

The main criticism leveled at Swedish health care is that the waiting times are too long.

Another criticism is that waiting times, quality of care and patient fees may vary in different counties, effectively meaning that patients may be treated better depending on where they live. Extreme cases of patients moving to another county just to get better health care has been shown as example of alleged injustice in the health care system.

The health care system has sometimes been criticized as being too conservative with expensive testing and treatment. A recent case tells of a young man in Stockholm who was denied treatment for Hunter's syndrome with a new experimental drug after the clinical trial for the drug ended and the hospital (Karolinska University) refused to pay for the expensive treatment (which cost approximately €840 000/year). When the case got media attention, the patient was however given the treatment, which was paid for by the Stockholm County Council. This has sparked a debate over if expensive treatments should be financed on a national basis instead.

There is no mention that Sweden has taken steps to privatize some elements of their system to battle costs. [http://www.ncpa.org/pub/ba/ba369/]

References

* [http://www.vardguiden.se/ Vårdguiden (The Care Guide)] - EU-regulated health care website by the Stockholm health care system.
* [http://www.expressen.se/nyheter/1.838770/dodssjuke-kalle-far-sin-medicin Dödssjuke Kalle får sin medicin] sv icon