Health care reform in Sweden in the 1990s: local pluralism versus national coordination

Because of the poor state of the Swedish economy, publicly provided health care services, like other welfare services, are increasingly vulnerable to possible cutbacks. A growing discontent among the public in the late 1980s paved the way for experiments with new economic incentives among health care providers. Although many parts of the welfare state are being questioned today, the principle of universalism in health care has not been seriously challenged, but support for the present health care system among Swedes depends on how well the system functions. The prospects for implementing major organizational changes in health care through a top-down procedure, however, are limited. The appointment of the Committee on Funding and Organization of Health Care in 1992 by the previous government can be regarded as merely a way to show activity rather than as an instrument to achieve meaningful change.