Hospital Financing in Seven Countries (Part 9 of 11)

weden is situated in northern Europe. Despite a rather small population (8.7 million in 1992), the country is the fifth largest in area in Europe. Most of the population lives in the southern parts and the coastal areas, leaving many parts sparsely populated. The demographic transition to an aged population is more accentuated in Sweden than other countries. In 1992, 18 percent of all citizens were 65 years or older. All Swedish citizens are entitled to health care regardless of where they live or their economic circumstances. Health care is considered a public sector responsibility. Close to 90 percent of Swedish health care expenditures are publicly financed, most of the health care facilities are publicly owned, and most physicians publicly employed. Responsibility for health care is, to a large extent, decentralized to the county council level. Sweden has three political and administrative government levels: the national government, county councils, and local municipalities. All levels of government are represented by directly elected politicians with the authority to levy taxes. The three levels have extensive functions in the social welfare system and are also involved in different aspects of health care.1 The national government is responsible for ensuring that the health care system develops efficiently and in keeping with overall objectives, based on the goals and the constraints of social welfare policy and macroeconomic factors. The Ministry of Health and Social Affairs is part of the government office. It prepares Cabinet business and draws up general guidelines in fields such as