Current Trends in Sweden: Implications for Public Health Policy

Abstract

WED EN is among the most prosperous welfare states s in the world. Between I960 and I983 there has been a ki c Sfivefold increase in Gross Domestic Product (GDP) U ) t when corrected for inflation (i). The goals for economic policy during the postwar period have been full employment, high economic growth, stable prices, a fair distribution of living standards, and regional as well as external balance. The main components in the social reform-oriented Swedish system have been the health and social welfare systems. Thus the percent of the total expenditure for health in Sweden expressed in GDP is the second highest of the OECD countries. There was a growth trend up to I980 when Sweden's health expenditure followed that of the leading country, the United States (9.5 %). After that year, the US increased further to about i I% while Sweden's health expenditure decreased and is now g.o% of GDP (i). Swedish health services are heavily hospital-oriented with an admission rate in hospitals of i9.z% of the total population per year (I983). The average number of physician contacts per person per year is, on the other hand, only 2.7 (I983). By increasing the public primary-care services during the I970S, there was a decrease in the social class differences in health care consumption in favor of blue-collar workers. However, this trend has been interrupted and Sweden has so far faltered in achieving the WHO primary health care goal (z). This interruption coincided with the decline in the growth of GDP for health services around I980. It is also noteworthy that in spite of a present growth in GDP by 3 % per year there is no corresponding upward trend in health expenditure.