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Demokratiskolan
The Healthcare card from MethodKit for Society and Politics
Card 33 of 128 · MethodKit for Society & Politics
  • AreaWelfare & health
  • Centre of gravityThe region
  • Points of influence3 on the journey
  • Decisive electionThe regional election
Welfare & health

Healthcare

Consultations, treatment & medicines

The health centre, the emergency room and prescription medicine: healthcare is the regions' biggest task and takes about nine kronor in every ten of the region's budget. Yet the election debate is usually about the Riksdag. Anyone who wants to influence healthcare should look at the regional election, that is where the budget and leadership of healthcare are decided.

Where does the power lie?1

  • Municipality · home care & care nursing · approx 10 %
  • Region · health centres, hospitals & budget · approx 55 %
  • State · laws, oversight & medicines · approx 30 %
  • EU · medicines & care abroad · approx 5 %

The centre of gravity lies clearly with the region. The regional election decides the healthcare budget, the terms for health centres and the length of the queues.

How it works: the breakdown

The municipalityCare at home
The regionThe responsible authority · centre of gravity
Central governmentThe framework & oversight
Who decides?
The municipal council (kommunfullmäktige) and the social welfare committee, in some municipalities a separate elderly-care committee.
The regional council (regionfullmäktige), the healthcare committee and the hospital managements.
The Riksdag, the Government, the National Board of Health and Welfare (Socialstyrelsen) and IVO.
What do they decide?
Home healthcare and nurses in elderly care, in most counties by agreement with the region.
Runs health centres and hospitals, allocates the budget, employs the staff and decides where care is provided.
The Health and Medical Services Act, the care guarantee, national guidelines, medicine subsidies and oversight of healthcare.
Where are decisions made?
In the social welfare committee and the municipal council. The minutes are public.
In the regional council and the healthcare committee. The meetings are open.
In the Riksdag and at the agencies. IVO reviews healthcare after complaints and on its own initiative.
Who pays?
The municipal tax pays for home healthcare and nursing in elderly care.
The regional tax plus central government grants. Patient fees are a small part.
Central government grants to the regions and a large share of medicine costs.
Fastest way in?
Municipal election Views to the social welfare committee, a citizen's proposal (medborgarförslag), relatives' councils.
Regional election Email to the committee's politicians, the patients' committee, the region's citizen dialogues.
General election A complaint to IVO, a referral response on draft legislation.
EUThe EU approves medicines through the European Medicines Agency and gives you the right to certain care in other EU countries. Shaped in the European Parliament election.

Read the table by column to understand one level, or by row to compare the levels. The green level is the area's centre of gravity.

How it works: follow the decision

The case The health centre is full, what happens now?
  1. State

    The care guarantee sets the clock

    The Health and Medical Services Act and the care guarantee say that you should reach primary care the same day and get a medical assessment within three days. That is the floor every region must meet.

    Point of influence

    The general election shapes the law and the central government grants. Changes to the law go out for referral (remiss) before a decision.

  2. Region

    The region draws the care map

    The regional council decides how many health centres there are, where they are located and how they are reimbursed. Through the care-choice system, private practices may also open, with the region's money and rules.

    Point of influence

    The regional election decides the budget and the rules for care choice. The committee's politicians are reachable between elections.

  3. Region

    You seek care, and the list is full

    You call the health centre or contact it through 1177. If your practice is full you have the right to register with another, and the care guarantee applies wherever you are registered.

    Point of influence

    You can change health centre freely. Complaints go first to the practice, then to the patients' committee.

  4. RegionState

    When care falls short

    If the complaint does not help, the region's patients' committee can support you further, and serious incidents can be reported to IVO, the state oversight authority, which reviews the care provider.

  5. Your everyday life

    An appointment on Thursday at ten

    Fifteen minutes with a doctor who has your record in front of them. Behind the visit lie a law, a regional budget and a care-choice system, and all three can be influenced.

The journey looks the same in reverse: what has been built came the same way, through the same decisions. Whoever knows where the decisions are made also knows where they can be changed.

Questions to discuss

  1. What matters most to you: a health centre close to home or a larger hospital with everything in one place?

  2. Care queues look different in different regions. Is that reasonable, or should healthcare be more equal across the country?

  3. Who should run health centres: the region, private companies or both, and why?

  4. What do you know about how your region prioritises in the healthcare budget, and how would you find out more?

  5. Have you ever changed health centre or complained about care, and what happened if so?

Glossary

Vårdgaranti
A legal right to receive care within a set time, for example a medical assessment in primary care within three days.
Vårdval
The system where you choose your own health centre and the money follows your choice.
Patientnämnd
An independent body in every region that helps you if you have complaints about care.
IVO
The Health and Social Care Inspectorate, the state authority that oversees health and social care.
Högkostnadsskydd
A cap on what you pay in total in patient fees over one year.

Go further

Footnotes

1) This is an estimate of how decision-making power over the issue is split between the municipality, the region, central government and the EU, based on how responsibility is divided in legislation. A teaching guide, not an exact measurement.