Local variations in old age care in the welfare state: the case of Sweden

Swedish local municipalities are responsible for the provision of social welfare, including old age care. Local autonomy is far-reaching, and local inequities are indeed great for all kinds of domestic and institutional care for the elderly. Not only coverage rates differ widely but also costs per citizen and spending per elderly person vary vastly. Numerous parameters of the political, economic and geo-social structure of the municipalities explain only very little of these local variations. It seems that local differences are often of long standing: this may explain why 'rational' indicators of needs and local capacity fail to explain much of the inequities. Yet, one factor of socio-political importance emerges as significant: the system of tax redistribution enforced on largely autonomous municipalities.