Health Care and the Elderly

Abstract

A characteristic feature of Swedish health care is the dominant role played by the county councils. A county council (landsting) is an independent regional political organ which, like the municipalities (kommuner) at lower level, has the right to levy proportional income taxes on inhabitants within its geographical boundaries. There are 23 county councils in Sweden at the present time; three local authorities have opted to stay outside the county councils — in matters of health care these local authorities have the same responsibilities as county councils. In other words, Swedish health care is not a national system. To the extent that it is possible to speak of a system, it is a system which permits of many different variants. The fact that there are differences between county councils (including the three independent local authorities), for example with regard to organisation, resources, costs and taxes, is thus no cause for surprise. Although health care has been conducted according to a plannedeconomy model, it is not in the capital city of Stockholm that the plans have been drawn up but regionally, in each and every one of the county councils. There has been a deliberate political effort, even at the national political level, gradually to devolve former central-government responsibility for health care to the county councils. This circumstance makes it impossible to describe the Swedish model of health care. Different rules may apply to different county councils.