In The health care revolution in Stockholm Johan Hjertqvist describes developments during the past ten years of change. This small publication is the first English-language introduction to the Stockholm County Council's full-scale experiment in systematic change.
The Swedish welfare state has attracted international interest ever since the 1930's. For 50 years the name of the game was an expanding political and administrative power. Now the opposite goes - to increase the freedom of consumers, employees, and entrepreneurs, thereby re-shaping the strategy of welfare service distribution.
Here the Stockholm region is ahead of other parts of Sweden. The Stockholm County Council is attempting to transform public health care from an old-style, politically administered monopoly to the consumer-related, incentive-driven network of tomorrow.
It is a change by many small steps, a strategy for implanting modern incentives into a public structure. It sends signal of change to other countries, inspiring for example the Blair government to re-shape the NHS. The health care system of Stockholm remains publicly funded, with open and equal access for every inhabitant, but the Council also contracts many privately owned operators to deliver the services.
But a choice will have to be made: between maintaining an exclusively public funding or accepting a mix. Will Sweden be able to carry the taxes needed to safeguard public funding? Whatever the outcome, the future health care network of solutions will have to be very flexible and made to meet the increasing individual consumer demand.