In an attempt to understand how education and healthcare is managed in Sweden, I found these two articles.MA
Health care in Sweden
From Wikipedia, the free encyclopedia
(Redirected from Healthcare in Sweden)Total health spending per capita, in U.S. dollars PPP-adjusted, of Sweden compared amongst various other first world nations.
The Swedish health care system is mainly government-funded and decentralized, although private health care also exists. The health care system in Sweden is financed primarily through taxes levied by county councils and municipalities.
Södersjukhuset is one of the largest hospitals in Sweden. The hospital is owned, funded and operated by Stockholm County Council.
Sweden’s health care system is organized and managed on three levels: national, regional and local. At the national level, the Ministry of Health and Social Affairs establishes principles and guidelines for care and sets the political agenda for health and medical care. The ministry along with other government bodies supervises activities at the lower levels, allocates grants and periodically evaluates services to ensure correspondence to national goals.
At the regional level, responsibility for financing and providing health care is decentralized to the 21 county councils. A county council is a political body whose representatives are elected by the public every four years on the same day as the national general election. The executive board or hospital board of a county council exercises authority over hospital structure and management, and ensures efficient health care delivery. County councils also regulate prices and level of service offered by private providers. Private providers are required to enter into a contract with the county councils. Patients are not reimbursed for services from private providers who do not have an agreement with the county councils. According to the Swedish health and medical care policy, every county council must provide residents with good-quality health services and medical care and work toward promoting good health in the entire population.
At the local level, municipalities are responsible for maintaining the immediate environment of citizens such as water supply and social welfare services. Recently, post discharge care for the disabled and elderly, and long term care for psychiatric patients was decentralized to the local municipalities.
County councils have considerable leeway in deciding how care should be planned and delivered. This explains the wide regional variations.
It is informally divided into 7 sections: “Close-to-home care” (primary care clinics, maternity care clinics, out-patient psychiatric clinics, etc.), emergency care, elective care, in-patient care, out-patient care, specialist care, and dental care.[1]
All citizens are to be given on line access to their own electronic health records by 2020. Many different record systems are used which has caused problems for interoperability. A national patient portal, ‘1177.se’ is used by all systems, with both telephone and online access. At June 2017 about 41% of the population had set up their own account to use personal e-services using this system. A national Health Information Exchange platform provides a single point of connectivity to the many different systems. There is not yet a national regulatory framework for patients’ direct access to their health information.[2]
Provision[edit]
Private companies in 2015 provide about 20% of public hospital care and about 30% of public primary care, although in 2014 a survey by the SOM Institute found that 69% of Swedes were opposed to private companies profiting from providing public education, health, and social care, with only about 15% actively in favour.
In April 2015 Västernorrland County ordered its officials to find ways to limit the profits private companies can reap from running publicly funded health services.[3]
Financing[edit]
Costs for health and medical care amounted to approximately 9 percent of Sweden’s gross domestic product in 2005, a figure that remained fairly stable since the early 1980s. By 2015 the cost had risen to 11.9% of GDP -the highest in Europe.[4] Seventy-one percent of health care is funded through local taxation, and county councils have the right to collect income tax. The state finances the bulk of health care costs, with the patient paying a small nominal fee for examination. The state pays for approximately 97% of medical costs.[5]
When a physician declares a patient to be ill for whatever reason (by signing a certificate of illness/unfitness), the patient is paid a percentage of their normal daily wage from the second day. For the first 14 days, the employer is required to pay this wage, and after that the state pays the wage until the patient is declared fit.
Details and patient costs[edit]
Prescription drugs are not free but fees to the user are capped at 2,200 kr per annum. Once a patient’s prescriptions reach this amount, the government covers any further expenses for the rest of the year. The funding system is automated. The country’s pharmacies are connected over the Internet. Each prescription is sent to the pharmacy network, which stores information on a patient’s medical history and on the prescriptions fulfilled previously for that patient. If the patient’s pharmaceutical expenses have exceeded the annual limit, the patient receives the medication free of charge at the point of sale, upon producing identification.
In a sample of 13 developed countries Sweden was eleventh in its population weighted usage of medication in 14 classes in 2009 and twelfth in 2013. The drugs studied were selected on the basis that the conditions treated had high incidence, prevalence and/or mortality, caused significant long-term morbidity and incurred high levels of expenditure and significant developments in prevention or treatment had been made in the last 10 years. The study noted considerable difficulties in cross border comparison of medication use.[6]
A limit on health-care fees per year exists; 150-300 SEK for each visit to a doctor, regardless if they are a private doctor or work at a local health-care center or a hospital. When visiting a hospital, the entrance fee covers all specialist visits the doctor deems necessary, like x-ray, rheumatism specialist, heart surgery operations and so on. The same fee is levied for ambulance services. After 1100 SEK have been paid, health-care for the rest of the year will be provided free of charge.
Dental care is not included in the general health care system, but is partly subsidized by the government. Dental care is free for youths up to 19 years of age, while a general dental care insurance (introduced in 1974) covers all inhabitants from the age of 20 onwards.
Mental health care is an integrated part of the health care system and is subject to the same legislation and user fees as other health care services. If an individual has minor mental health issues, he is attended to by a GP in a primary health setting; if the patient has major mental health issues he is referred to specialized psychiatric care in hospitals.Sweden’s educational system possesses a democratic mission. This mission, along with the Swedish Education Act, states that all children and young people are to have equal access to education, regardless of gender, where they live or social or economic factors.
Education
Schooling is free in Sweden, except for nursery schools and higher education (although these are partly funded by the government). Swedish government also supports the idea of independent schools (also known as school choice) and funding.
To date, schools operate as an open market and the right to for parents to choose any school for their child to attend is recognized by the government. Because of this, each child is allocated funding for the years of school that are mandatory. Below is a breakdown of schooling by age:
Preschool
Nursery school and preschool are open to children from one to five years of age. Sweden has made it mandatory for facilities to be provided for children if the parent works or attends school. The Swedish tradition of nursery/preschool emphasizes the importance of play in a child’s development and learning. In the nursery/preschool curriculum, the interests and needs of children are essential parts of their education.
Preschool class
All children are offered a place in a preschool class starting in fall of the year they turn six until they start attending mandatory schooling. The preschool class is designed to stimulate each child’s development and learning, and provide a platform for their future schooling. Preschool is followed by elementary school for years 1—3, middle school for years 4—6 and junior high school for years 7—9.
Children between six and twelve are offered daycare before and after school hours. Daycare can be at an after-school center, a family daycare home or an open after-school program.
Senior high school
Senior high school is not mandatory and also free of charge. Students who have completed junior high school with at least a pass in Swedish, mathematics and English will qualify for a space at senior high school. Practically all students who finish preschool, middle school and junior high school will start senior high school.
Senior-high-school programs run for three years. Students can choose from 17 different programs leading to qualifications to study at colleges and universities. All programs include eight core subjects: Swedish (alternatively Swedish as a second language), English, mathematics, science, social studies, religious studies, arts and crafts, physical education and health.
Students in the Swedish system are evaluated through regular meeting and constant communication with parents and caregivers. However, a formal grade is not issued until the 8th year of school using the same A-F (pass/fail) system used here in the United States. The continual communication between teachers and parents ensures children are progressing and learning the content needed to advance to the next level.
The test scores in Sweden continue to rise, children are passing grade levels and advancing to senior high schools and parents have the right to choose which school their child will attend. Can the rate of success be linked to the parent’s right to choose the school, coupled with the teacher and parent’s collaborative effort to ensure the child is successful? This system seems to be working, and the government has committed funds to ensure the system continues.
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