Healthcare In Sweden Amanda Wilson NUR301 Transition to Professional Nursing Professor Lori Dowell 10/24/12 Healthcare in Sweden There are pros and cons for any health care system researched. Obviously no country in the world has perfected the job of balancing supply and demand in a cost effect manner. Everyone has complaints about how the government runs things in their country and everyone has horror stories about how they have been treated at some point by the medical profession.
After all of my research I believe that Sweden has incorporated many good aspects of service while only having a few downfalls. With continued reform Sweden’s healthcare system could become a highly efficient system. Overview The main objective of the Swedish healthcare system is to provide quality healthcare with equal access for all. There are three principles that are followed by the medical profession and those are: “human dignity, which means that all human beings have an equal entitlement to dignity, and should have the same rights, regardless of their status in the community.
Need and solidarity means that those in greatest need take precedence in medical care, and cost effectiveness means that when a choice has to be made from different health care options, there should be a reasonable relationship between the costs and the effects, measured in terms of improved health and improved quality of life. ” (Anell et al, pg. 33) The healthcare system is organized into three divisions: national, regional, and local. The main agency at the national level is the Ministry of Health and Social Affairs.
It oversees the other national agencies such as the Medical Products Agency (which regulates the manufacturing and sales of pharmaceuticals), Pharmaceutical Benefits Board (sets the prices on drugs), and the National Corporation of Swedish Pharmacies (which owns all pharmacies and is responsible for supplying drugs at uniform prices). (Hogberg, 2007) The regional agencies are made up of county councils and they are responsible for all services rendered from primary care to hospital care as well as having agreements with, and supervising private health care providers (Hogberg, 2007).
Municipalities make up the local level. The municipal council’s duty is to watch over people who have been discharged from hospitals and are now using public nursing homes or home care (Hogberg, 2007). Cost Control The majority of funds (80%) for the Swedish healthcare system come from taxes, while 3% comes from grants, 17% comes from user-fees. As of 2009 9. 9% of Sweden’s GDP was spent on healthcare (Anell et al, pg. 15). The user fees are comparable to copays in the United States and are set by the county councils.
These user fees are as follows: $16-31 for a pcp visit, $31-47 to see a specialist, and prescription drug fees, for which consumers pay a sliding scale fee until they reach $270 and then all prescriptions are covered, and hospital visits are $12 a day. There is a cap of $140 per year that can be charged for medical expenses (Anell, pg. 99). In “Lesson from Sweden’s Universal Health System: Tales from the Health-care Crypt”, author Sven Larson (2008) quotes Dr. Olle Stendahl as saying “In our budget-government health care there is no room for curious, young physicians and other professionals to challenge established views.
New knowledge is not attractive but typically considered a problem that brings increased costs and disturbances in today’s slimmed-down health care. ” (pg. 22) Currently, a large segment of the budget is portioned out for hospital care but there are initiatives and reforms in place focusing on primary prevention such as promoting physical activity and healthy diet habits as well as tertiary preventions aimed at preventing alcohol, drug, tobacco abuse and gambling addictions. Another focus is on coordination of care in hopes of cutting back on costs from repeat procedures (Anell et al, pg. 22).
Equality Healthcare in Sweden is universal. All citizens as well as undocumented immigrants under 18 years old are entitled to subsidized care and undocumented adults have the right to non-subsidized immediate care. (Anell, 2011) All health care is covered from inpatient to outpatient to preventive services as well as mental health and rehabilitation. In addition to citizens, Sweden also has bilateral agreements with nine other countries and emergency services are provided to all patients from those countries as well as people from EU/European Economic Area countries (Anell et al, pg. 59).
Priority is placed on those with life threatening diseases and people with chronic diseases and disabilities, while those wanting preventive and rehab services as well as non acute and non chronic diseases have to wait. User Satisfaction There were 8,000 complaints made in 1997 and that number increased to 9,000 by 2000 and has stayed in that range since (Anell et al, pg. 47). In 2004 $44,880,500 in compensation was paid to patients who had suffered preventable injuries. (Anell et al, pg. 47) Overall satisfaction with care seems to be high after services are rendered, however wait times seem to be a major problem.
In 1992 a three month guarantee was issued, meaning if you couldn’t receive treatment within three months you were offered treatment at a hospital in another county or with a private facility. Currently, many clinics have armed security guards to keep tempers from flaring when patients get unruly in waiting rooms. (Larson, pg. 21) Depression and hopelessness appear to be common symptoms as more than half of the patients in need of non-emergent surgeries are waiting more than the three months promised. Another wait time guarantee has been made, called the “0-7-90-90” rule (Anell et al, pg. 4). This means that a person gets instant (0) access to health care, consultation with a general practitioner within a week (7), consultation with a specialist within three months (90), and no more than three months between diagnosis and treatment (Anell et al, pg. 45). A concern is that even with the assurance there are still not enough doctors to meet the need. For example, one city in Sweden with 200,000 people only has one specialist in mammography and it is reported that within a few years most Swedish women will not have access to mammography. (Larson, pg. 22) Health of population
At present, Sweden has one of the oldest populations in the world with a life expectancy on average of 83. 2 years for women and 79. 1 years for men (Anell et al, pg. 27-28). Diseases of the circulatory system account for 40% of all deaths, with the second leading cause of death being cancer (Anell, pg. 17). The largest portion of funding is allocated for hospital care but the focus is shifting toward preventing disease before it becomes a hospital-sized issue. In April 2003 the “Public Health Objectives” Bill was adopted which focuses on initiatives for primary prevention as opposed to secondary or tertiary prevention (Anell et al, pg. 0). The goal was to lighten the load of the medical professionals and allow them to focus more time on those that truly needed the help by teaching those who could help themselves how to prevent diseases. These initiatives focus on teaching the public about things like communicable disease control and immunizations as well as drug, alcohol and tobacco prevention and population based screenings (Anell et al, pg. 10). Since 2003 accident prevention has been successful. Sweden, Norway and the UK currently have the world’s lowest rates of mortality due to traffic accidents (Anell et al, pg. 2). Alcohol related mortality has gone down by one-third (Anell et al, pg. 13). Conclusion Overall, the health status in Sweden is among the best in the world. Some of its strong points include unbiased care for all based on need, freedom of choice, and cost containment. Some of its downfalls include long wait times, discouraging research and new ideas and the fact that as the population ages there is less coming in as far as taxes go and more medical necessity. I think that in general it is a very good concept that could become a great policy if tweaked in a few areas.
There are far too many people in the United States that have no access to health care because they are uninsured and there has to be a way to bring some type of insurance to those people. I think that we could combine the system we have now with the system Sweden has to provide services to everyone. If we could put money into primary prevention of everyone then the only uninsured people that would need coverage would be those in emergent situations or those with acute illnesses. References Anell, A. , Glenngard A. H. , Merkur S. (2012).
Sweden: Health system review. Health Systems in Transition, 14(5):1–187. Larson, S. R. (2008). Lessons from Sweden’s universal health system: tales from the health-care crypt. Journal of American Physicians and Surgeons, 13(1), 21-22. Hogberg, D. (May 2007). Sweden’s single-payer health system provides a warning to other nations. National Policy Analysis, #555. Retrieved from http://www. nationalcenter. org/NPA555_Sweden_Health_Care. html Anell, A. (2011). International Profiles of Health Care Systems, The Commonwealth Fund, 99-105.