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International Healthcare Models: Sweden, Norway and Finland

June 22, 2010 in Health Care Around the World | 1 comment

Here is my earlier review on Norway.  The information below on Sweden and Finland has not yet been presented before in my blog.

SWEDEN

Hospitals

  • There are 4 types of medical facilities: local health centers, county level hospitals, district level hospitals, and regional teaching hospitals.
  • Local health centers are staffed by GPs, nurses, midwives, occupational therapists, social workers and psychologists.
  • Citizens can pick their own local health center and their own physician.

HIT

  • 98% of Swedish GPs have computerized practices
  • 90% use electronic medical records.
  • Patients can provide physicians with necessary information before the visit using the patient’s Smart card.

Malpractice

  • The Scandinavian model is built on the premise of no-fault liability.
  • About 3 patients file a malpractice claim for every 1 in the U.S.
  • Awards payments come from a compensation fund supported by tax revenues.

FINLAND

Hospitals

  • Finland is divided into 20 hospital districts, each with 1 central hospital with more sophisticated technology and several satellite hospitals.
  • Of the central hospitals, 4 are university hospitals with the most specialized care.
  • Municipal health centers serve the majority of each community’s health needs. 

Funding

  • Funding is very decentralized.  The central government only paid for 18% of care in 2000.  The municipalities pay for the majority of care.

Malpractice

  • Similar to the Swedish system

NORWAY

Insurance

  • Has a centralized system, like Canada.
  • The National Insurance scheme covers all citizens.
  • No private insurance exists

Funding

  • The National Insurance Scheme is funded by general tax revenues. 

Physicians

  • Most physicians work are paid via capitation.  The capitation rate is based on the number of patients who have chosen a doctor to be their primary physician. 
  • Some specialists do work on a fee-for-service basis.

Malpractice

  • Similar to the Swedish system

Source: Roth, WF (2010) Comprehensive Healthcare for the U.S.: An Idealized Model. Productivity Press, 174 pages.

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Health Care Around the World: Norway

April 18, 2008 in Health Care Around the World, International Health Care Systems | 27 comments

All Norwegians are insured by the National Insurance Scheme. This is a universal, tax-funded, single-payer health system. Compared to France, Italy, Spain and Japan, Norway has the most centralized system.

Percent Insured. 100%. All Norwegian citizens and residents are covered.

Funding. The National Insurance Scheme is funded by general tax revenues. There is no earmarked tax for health care. The Norwegian tax burden is 45% of GDP. The government sets a global budget limiting overall health expenditures and capital investment.

Private Insurance. Norwegians can opt out of the the government system and pay out-of-pocket. Many pay out-of-pocket and travel to a foreign country for medical care when waiting lists are long.

Physician Compensation. Hospital and nonhospital physicians generally are paid on a salaried basis. Some specialists can receive an annual grant and fee-for-service payments. Reimbursement rates, however, are set by the government and, unlike in France, the physician can not charge higher rates than the centrally-set reimbursement rate.

Physician Choice. Patients choose general practitioners (GPs) from a government list. These GPs then act as gatekeepers for specialist services. Patients can only switch GPs twice per year and only if there is no waiting list for the requested GP.

Copayment/Deductibles. There are no copayments for hospitals stays or drugs. There are small copayments for outpatient treatment.

Waiting Times. There are significant waiting times for many procedures. Many Norwegians go abroad for medical treatments. The average weight for a hip replacement is more than 4 months. “Approximately 23 percent of all patients referred for hospital admission have to wait longer than three months for admission.” Also, care can be denied if it is not deemed to be cost-effective.

Benefits. Very generous. The program also provides sick pay.”  As Michael Moore has noted, the Norwegian system will even pay for ‘spa treatments’ in some cases.”

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