Health Care Lessons from Sweden

This paper is part of a series that examines the way health services are funded and delivered in other nations. The nations profiled all aim to achieve the noble goal of Canada’s health care system: access to high quality care regardless of ability to pay. How they organize to achieve that goal differs markedly from the Canadian approach. So do their performances and results.The Swedish health care system provides some of the best outcomes when compared with other developed nations that maintain universal approaches to health care insurance. Long considered a mecca of socialist thought, it is valuable to examine how the Swedes have structured their universal access health care system to help inform the Canadian debate over the future of Medicare.Health system performance — Canada compared to Sweden: Looking at factors such as the ability of the health care system to provide healthy longevity, low levels of mortality from disease, and effective treatment for both chronic and terminal illnesses, it seems the Swedish health care system broadly performs at a level similar to if not superior to that in Canada. Specifically, the Canadian health care system outperforms the Swedish health care system in six of 17 measures examined: one of three cancer survival rates, two of three measures of primary care performance, and three of six measures of patient safety. Conversely, the Swedish health care system outperforms the Canadian health care system in nine measures: infant mortality, mortality amenable to health care, all three measures of in-hospital mortality, one of three measures of primary care performance, and three of six measures of patient safety.Lessons for Canada: The combination of similar if not superior access to health care and similar if not superior outcomes from the health care process with 26% fewer resources committed to health care suggests there is much Canadians can learn from the Swedish health care system. A Swedish-style approach to health care in Canada would primarily require important changes to financial flows within provincial tax-funded systems and a greater reliance on competition and private ownership. It would not require a marked departure from the current tax-funded, provincially managed, federally supported health care system in Canada.The Swedish health care system departs from the Canadian model in the following important ways: Cost sharing for all forms of medical services; Salary payment for physicians; Some private provision of acute care hospital services; Activity-based funding for hospital care; Broad private parallel health care sector with dual practice.

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