The Swedish health care system is a socialized, public health care system. 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.

Sweden’s entire population has equal access to health care services. The Swedish health care system is government-funded and heavily decentralized to the county councils and the municipality of the island of Gotland’. The role of central government is to establish principles and guidelines for care and to set the political agenda for health and medical care. Every county council must provide residents with good-quality health services and medical care, including preventive care. Waiting times and patient fees vary in the different county.

Sweden’s 290 municipalities are also responsible for care for elderly people in the home or in specially adapted housing. This includes people with physical or psychological disabilities.

Physician’s services are not a municipality responsibility but are provided through laws and ordinances or with the Swedish Association of Local Authorities and Regions which represents the county councils and municipalities.

The state finances the bulk of health care costs, with the patient paying a nominal fee for examinations and some tests. The state pays for approximately 85 % of medical costs. The state also reimburses patients for travel costs to and from the clinic or hospital

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.

Primary care has traditionally played a less important role in Sweden than in many other European countries. Most health care is provided in health centers where a variety of health professionals – doctors, nurses, midwives, physiotherapists and others – work. The intent is simplify things for patients and foster teamwork. Patients should be able to choose their own doctor. Around 25 percent of health centers are privately run by enterprises commissioned by county councils. There are special clinics for children and expectant mothers as well as family planning clinics for teenagers.

A person seeking care first contacts a clinic for a doctor's appointment, and may then be referred to a specialist by the clinic physician, who may in turn recommend either in-patient or out-patient treatment, or an elective care option. All emergent cases are treated by an emergency department at a hospital.

Waiting times for pre-planned care, such as cataract or a hip replacement surgery, have long been a weakness that has caused dissatisfaction. Despite a major increase in productivity – the number of operations in relation to population size is higher in Sweden than in other countries – there are still long waiting lists. Therefore the county councils and the government agreed to establish a care guarantee at the end of 2005, stating that no patient should have to wait for more than three months once it has been determined what care is needed. If the time limit expires, the patient is offered care elsewhere, which is paid for by his or her own county council, including any travel costs.

Generally, patients are free to choose where to go for care. Referrals may be necessary, for example for treatment outside the region where the patient lives. No referral is usually necessary for specialist care. This is different from many other countries where such “gatekeeper functions” are more common.

Sixty hospitals provide specialist care with emergency room services 24 hours a day. Eight are regional hospitals where highly specialized care is offered and where most teaching and research is located. Since Sweden only has nine million inhabitants, the entire country serves as a single service area for the most advanced specialist care. This is coordinated by a newly formed committee, Rikssjukvårdsnämnden, within the National Board of Health and Welfare.

The county councils own all emergency hospitals, but health care services can be outsourced to contractors. For pre-planned care there are several private clinics from which county councils can purchase certain services to complement care offered within their own units. This is an important element of the effort to increase accessibility.

Most county councils use some form of purchaser–provider system, in which a council negotiates compensation agreements with health care units. This allows hospitals to become more independent of political bodies. In some cases hospitals have become corporations owned by the council. It is now more common for county councils to buy health care services – 10 percent of health care is financed by county councils but carried out by private health care providers.

“The fee for staying in a hospital is about $13.50 per day. Fees for outpatient care are decided by each county council. Fees to consult a primary care physician range from about $1.50. to $2.55. An appointment with a specialist will cost more. To limit costs for the individual there is a high-cost ceiling, which means that after a patient has paid a total of estimate $150.00, medical consultations in the twelve months following the date of the first consultation are free of charge. A similar ceiling exists for prescribed medication, so no one pays more than about $300 per twelve-month period.”

Costs for health and medical care amount to approximately 9 percent of Sweden’s gross domestic product (GDP), a figure that has remained fairly stable since the early 1980s. In 2005 care and services provided by the county councils, including the subsidization of pharmaceuticals, cost SEK 175 billion (USD 25.4 billion). Seventy-one percent of health care is funded through local taxation, and county councils have the right to collect income tax, the average level being 11 percent. Contributions from the state are another source of funding, representing 16 percent, while patient fees only account for 3 percent. The remaining 10 percent come from other contributions, sales and other sources. Cost restrictions are a must, and it is necessary to maximize existing resources. Several years ago the system ran into severe financial problems.

At national level there are a number of authorities within the area of health care. The National Board of Health and Welfare, The Medical Responsibility Board, The Swedish Council on Technology Assessment in Health Care, The Pharmaceutical Benefits Board ,The Medical Products Agency , and state-owned Apoteket AB, a national chain of pharmacies.
Organization

David Hogberg, Ph.D. of The National Center for Public Policy Research in 2007 wrote

“In practice, the political notion of "equal access" actually means "restricted access." Swedes who do not have private insurance must wait, often for months, for treatment. For all Swedes who needed an operation in 2003, slightly more than half waited more than three months. The situation continues. Moreover, patients often wait in great pain and distress.

Sweden is one of several nations whose practices offer proof that single-payer health care systems lead to the proliferation of waiting lists. It also shows that waiting lists have adverse and sometimes tragic consequences for patients.”

“Sweden's health care system offers two lessons for the policymakers of the United States. The first is that a single-payer system is not the answer to the problems faced as Americans. Sweden's system does not hold down costs and results in rationing of care. The second lesson is that market-oriented reforms must permit the market to work. Specifically, government should not protect health care providers that fail to provide patients with a quality service from going out of business.”

Comment: although the first two paragraphs reflect conditions in Sweden the last paragraph is quite disputable. Market oriented reformation as applied to the state regulated utilities resulted in an increase in consumer costs rather than the promised savings. The National Center for Public Policy Research claims to be a “Conservative Think Tank” but is a protagonist for the right wing.