A reflection on Richard B. Saltman 'Structural patterns in Swedish health policy
Author
Summary, in English
Looking back over 30 years of Swedish health care, professor Saltman examines structural changes in the Swedish health care sector. This is a very welcome contribution to the literature, and it makes good sense – institutional change is often a slow process, and it may take considerable time before the effects can be fully appreciated.
Saltman’s paper provides a useful analytical overview of three decades of Swedish health care. He identifies several noteworthy structural patterns: the resilience of the county councils, the slow growth of diversity among service providers and the slow strengthening of patients’ choice.
It is interesting to consider this health-sector development in a broader perspective. Both diversity of providers and free choice for patients can be seen as deregulations of the Swedish market. The period from the early 1980s till today is in fact characterized by a deep-going trend of deregulation in Sweden. At the macro level, this is captured by the Economic Freedom Index (Gwartney et al., 2013). This index measures economic freedom in five dimensions and the overall score lies between 0 and 10. For example, second-placed Singapore has an overall index score of 8.60.
Back in 1980, Sweden was “a highly regulated economy with several state monopolies and low levels of economic freedom. Less than 20 years later, liberal reforms turned Sweden into one of the world’s most open economies with a remarkable increase in economic freedom” (Bergh and Erlingsson, 2008). The Swedish score increased from 5.68 in 1980 to 7.73 in 2010 (Table 1). This moved Sweden up from 37th to 18th place worldwide (the average score for the 101 countries for which there is data back to 1980 increased by 1.52). Economic freedom increased also in Denmark, Finland and Norway (Norway peaked in 2005–2007), but Sweden increased the most.
Saltman’s paper provides a useful analytical overview of three decades of Swedish health care. He identifies several noteworthy structural patterns: the resilience of the county councils, the slow growth of diversity among service providers and the slow strengthening of patients’ choice.
It is interesting to consider this health-sector development in a broader perspective. Both diversity of providers and free choice for patients can be seen as deregulations of the Swedish market. The period from the early 1980s till today is in fact characterized by a deep-going trend of deregulation in Sweden. At the macro level, this is captured by the Economic Freedom Index (Gwartney et al., 2013). This index measures economic freedom in five dimensions and the overall score lies between 0 and 10. For example, second-placed Singapore has an overall index score of 8.60.
Back in 1980, Sweden was “a highly regulated economy with several state monopolies and low levels of economic freedom. Less than 20 years later, liberal reforms turned Sweden into one of the world’s most open economies with a remarkable increase in economic freedom” (Bergh and Erlingsson, 2008). The Swedish score increased from 5.68 in 1980 to 7.73 in 2010 (Table 1). This moved Sweden up from 37th to 18th place worldwide (the average score for the 101 countries for which there is data back to 1980 increased by 1.52). Economic freedom increased also in Denmark, Finland and Norway (Norway peaked in 2005–2007), but Sweden increased the most.
Department/s
Publishing year
2015
Language
English
Pages
217-219
Publication/Series
Health Economics, Policy and Law
Volume
10
Issue
2
Full text
- Available as PDF - 75 kB
- Download statistics
Document type
Journal article (comment)
Publisher
Cambridge University Press
Topic
- Economics
Keywords
- health care
- economic freedom
- index
- welfare state
- deregulation
Status
Published
ISBN/ISSN/Other
- ISSN: 1744-134X