How does the Swedish health care system work?

25. September 2019.

Under the Swedish health law, healthcare is decentralized and is divided into three levels: national, regional and local. All residents, including foreigners, have access to publicly funded health services.

The role of the national government, ie the Ministry of Health and Social Welfare, is to establish principles and guidelines and to determine the health and medical care plan under which regional and local administrations are directed. The ministry also oversees lower-level administrations and performs regular inspections to ensure that health care services are at the set level.

At the regional level, responsibility for funding and providing healthcare is decentralized to 21 county councils. County councils also regulate the prices and level of service offered by private service providers who are required to have a contract with the council. It is imperative for each county council to provide residents with quality health and medical care and promote a healthy life. As of 2019, county councils also cover dental care costs for residents under the age of 23, while the central government is responsible for subsidizing dental care for citizens over the age of 24.

At the local level, municipalities are responsible for maintaining the critical environment of citizens such as water supply and social services, as well as for the care of the elderly in their homes or special accommodation. Their duties also include the care of people with physical disabilities or mental disorders.

Swedish healthcare covers 7 departments: care in the immediate vicinity of the home (primary care clinics, maternity hospitals, outpatient psychiatric clinics, etc.), emergency care, elective care, inpatient care, outpatient care, specialist care, and dental care. Although coverage is widespread, patients pay small fees which are limited to a maximum of 1100 SEK a year (around 102 €). The resident of Sweden does not have to pay more than 300 SEK (28 €) for each visit to a doctor, whether it is a private doctor or a doctor at a local health center, and on average the state covers approximately 97% of the cost of all treatments.

Prescription drugs are not free, but user fees are limited to 2200 SEK (205 €) per year. Once the patient’s prescriptions reach this amount, the state covers all the additional costs for the rest of the year and the patient can obtain the required medication for free. The funding system is automated to recognize when a patient has reached the limit.

Waiting times for planned care, such as hip replacement surgeries, have been a cause of dissatisfaction among Swedes for a long time. To end this displeasure, Sweden introduced a health care guarantee in 2005 that required all patients to be in contact with the local health center on the same day they asked for medical help and could schedule a medical examination within seven days. After the initial examination, no patient should wait more than 90 days for specialist examination, and also no more than 90 days should pass for surgery or treatment after determining what medical attention is needed. If the waiting time is exceeded, patients are provided with care elsewhere, and all excess costs are paid by the competent county council.

The emergency aid is available to everyone by calling 112 or 1177, including tourists and residents who are not covered by health insurance. Emergencies are treated promptly, and once you recover you will need proof of your travel or international insurance. If you have visited Sweden temporarily, you can be treated at any of the public departments. If you are a visitor from an EU or EEA country, you can access your health insurance through your European Health Insurance Card (EHIC). Tourists from non-EU or EEA countries do not have the automatic right to free or reduced health care but need proof of insurance in their own country or comprehensive travel insurance.

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