Sweden: no easy choices

This paper describes some characteristic aspects of the Swedish health care model which can explain why choices and prioritizing have been difficult to discuss officially until very recently. Health care is an important symbol and cornerstone of the welfare society and it is therefore difficult to admit and formulate the concept of limits regarding this part of society. Parallel to a considerable decrease in the health care sector's fraction of GDP during the last 10 years, where real cuts have been more and more visible, a public discussion on choices has emerged. A parliamentary committee of politicians and experts has addressed the issue and published a final report in the spring of 1995. It proposes an 'ethical platform' as a base for addressing the issue and describes guidelines for prioritizing on a political-administrative level and clinical level.