The article aims to give an overview of the Swedish health care system and the reforms which have taken place during approximately the last 20 years. The Swedish health care system is characterized by funding on a solidarity basis, which means essentially that funds are raised by incometaxes paid to the county councils, state grants and, to a lesser extent, by patient fees and, when compared internationally, a low level of costs. The latter is the result of immense efforts to cut costs, mainly achieved by reducing the in-patient capacities of hospitals. Along with these costs and funding aspects, the present article looks into both organizational matters and the different levels of responsibility which, during the 1990s, were increasingly decentralized. In addition, many county councils changed during the last 15 years from providing health care themselves to being purchasers in a purchaser—provider model. Problems are mainly the low quality of care for the elderly and the seriously ill and a shortage of physicians which has already persisted for some years. Despite these shortcomings, Sweden is one of the countries with the lowest infant mortality and the highest life expectancy, which leaves the Swedish people relatively satisfied with their health care system. Options for insured persons are comparatively few and consist in the free choice of place of treatment and of one’s general practitioner, as well as the possibility to take out additional private health insurance which is offered almost exclusively for in-patient care. Measures to assure quality of care are increasingly taken at all levels. Particularly in the fields of health monitoring and Health Technology Assessment, Sweden has long-term experience.
