ALMOST PARADISE? A look at life in contemporary Sweden from a citizens perspective Memphis in May International Teachers Conference Focus on Sweden Memphis,

ALMOST PARADISE?A look at life in contemporary Sweden from a

citizen’s perspective

Memphis in May International Teacher’s ConferenceFocus on Sweden

Memphis, TNFebruary 23, 2013

Susan L. Holmberg, Ph.D.Visiting Scholar, Department of Scandinavian Studies

University of WashingtonSeattle, WA

[email protected]

CONTENTS

1. “Utopian” aspects of life in Sweden (from US perspective)

a) Health careb) Family policyc) Democracy

2. Shadows on the horizon

HEALTH CARE

”Health care: Equal access — key to keeping Sweden healthy”

Everyone in Sweden has equal access to health care services under a largely decentralized, taxpayer-funded system. Like many other countries, Sweden faces numerous challenges, such as funding, quality and efficiency of its health care services.”

(from Fact Sheet on Health Care, Swedish Institute, www.sweden.se)

SWEDISH HEALTH CARE DISTRICTS(Landsting)

Price Ceilings (in US Dollars)

Item Maximum costs

Medication Max $328.00 /year

Doctor visits (GP) Max $30.00 (free after total $164.00 spent)

Specialist visits, ER visit $44.80

Hospital visit $12/day (first 10 days), then $9/day

Diagnostic tests (pap smear, pregnancy test, other regular tests) without doctors appointment

$15.00

Conversion rate:SEK 100 = $15.13

Average net annual income in Sweden = $ 34, 920

NEXUM ACIPHEX PLAVIX SIMVASTATIN FLUTICASONE ASMANEX0

200

400

600

800

1000

1200

PRICE COMPARISON of SELECTED DRUGSUS Dollars per 30 Day Supply

USSweden

What the pharmacist told me…

After explaining my initial idea of asking pharmacy customers to guess how much Americans pay for the medications they are picking up, a pharmacist told me:

”They won’t be able to make a guess because they don’t need to think about it like that. There is a price ceiling above which they do not spend any money, regardless of the type of medicine.”

Exact ceiling level is set at the county or municipal level: no higher than SEK 2,200 ($328.00) per year

”The best feature of the Swedish system is…”

Male, 20’s..that it doesn’t cost money,

you just pay one fee and it’s protected

Male, 50’s…that it is available to everyone – everyone has a right to health care

Male, 70’s...when you are sick you are well taken care of – one need never worry that one cannot afford care

Female, 70’s…all citizens are covered, if you are born here you have a right to it

Female, 20’s..that you don’t have to pay much, like in some other countries…

Male, 60’s..that it is open for everyone, regardless of your social position, it makes no difference if you are rich or poor

”The worst feature of the Swedish system is…”

Male, 20’s..that it can be uneven quality

at different clinics…

Male, 50’s…the long waiting periods, several hands working together so it takes time (?)

Male, 70’s…that everything is being cut back to save money because of the increasing costs, new machines, equipment so expensive

Female, 70’s…that it’s gotten worse over time, long waiting periods, lines, even cancer care can take up to 2 or weeks..

Female, 20’s..it depends, I’ve heard bad things about some clinics where they don’t greet you well

Male, 60’s..that doctors are not on a fixed schedule like other health care employees – most Landsting don’t have enough doctors, causes long waits

FAMILY POLICY

Child AllowanceAll children are entitled to tax-free allowance

($164/mo) until the age of 16*

* Note that additional money is given per additional child

Study Allowance

At 16, children in school receive study allowance (SEK 1050/mo except July and August) until they are 20 years old, provided they are studying full time

Paid Parental Leave

• A total of 480 paid days provided to parents

Free Daycare

• Children between the ages of 1 and 5

• National standards

Free Education

Tuition-free schooling from primary through PhD levels

Free lunch for K-12

DEMOCRACY

Voter Turnout

Sweden maintains relatively high levels of voter turnout, generally above 80% over the past 60+ years

Political PartiesProportional Representation system with 4%

minimum to gain representation in Parliament (or local, regional legislatures)

Party Distribution in Parliament following 2010 election

Level playing field

• All parties receive funding for election campaign• Interest representation generally inclusive, collective

– lobbying in the US sense does not exist• Restrictions on political advertising on commercial

(and public service) television and radio – campaigns not dominated by TV ads as in US

• In Sweden, money is not as necessary a precondition for political mobilization as it is in the US

Independent, accountable media

Public service broadcasting in Sweden is oldest and most trustworthy source of political information

• Funded 100% by license fees (BBC model), not taxes or advertising

• This keeps broadcast budgets independent of political alignments in Parliament

• It also maintains independence from corporations (i.e no advertising)

Financial and editorial independence

Accountability and transparency

Because it is funded by the public, program content must maintain certain standards of quality and responsibility – in news reporting, standards of impartiality and substance are required

Shadows…?

Health care

• Aging population with low population growth• Increasing costs for medical equipment and

medication• Provision of quality across the board, in urban and

rural areas, wealthier and poorer neighborhoods• Recruitment of quality medical personnel –

doctors, nurses, technicians and home help/elder care

Family Policy

• ”benefits addiction”? Extensive and generous universal benefits are costly, but expectation and sense of entitlement are deeply entrenched

• ”curling generation” might not be motivated to work, sacrifice for others

• Parental leave creates uneven pockets in the workforce, increases need for temporary workers

Democracy

• Recent decades have seen rise in right wing extremism, reactions against influx of immigrants and refugees – Sweden Democrat Party now established in Parliament and regional governments

• ”American style” politics in the form of lobbying and political advertising are edging into the Swedish system

• The media landscape is rapidly changing, becoming increasingly commercial - public service is struggling to maintain its prominence and the license fee is a recurring issue

SUMMARY• To an American, life in Sweden can seem like a dream or fantasy where many of the

economic burdens of everyday life simply don’t exist

• Health care is practically free across the board, with price ceilings and protections, along with guarantees of quality treatment for all

• All children receive money each month and free school lunch, along with free schooling, and parents are given a year and a half of paid leave when a child is born

• Political participation is widespread and inclusive, and political discourse takes place in a (relatively) responsible and ethical media environment

• One of the main challenges for the future is maintaining this high level of universal benefits and guarantees, all of which are tax-based – without universal benefits, the consensus to contribute (and receive benefits) may erode

• Another major challenge to the Swedish ”paradise” is creeping intolerance against ”outsiders”, particularly non-European ethnic groups, as competition for scarce resources increases

For more information, try the following links

• www.sweden.se - The Swedish Institute Home Page (Gateway to Sweden)• www.riksdagen.se – The Swedish Parliament – the Riksdag• www.fhi.se — The Swedish National Institute of Public Health• www.scb.se — Statistics Sweden• www.forsakringskassan.se - The Swedish Social Insurance Agency• english.skl.se — The Swedish Association of Local Authorities and Regions• www.socialstyrelsen.se — The National Board of Health and Welfare• www.sweden.gov.se — The Government Offices of Sweden