Debate on the new vision of Swedish Health Care

Uppsala Fri 28th aug 09 by Lasse T. Laine

Introduce the new public health care insurance system-

the Swedish republicians debate about the continued reformation of the Swedish Health Care

It´s always interesting to follow the new changes – evenif you are not interested (or allowed so far)

to be with and collaborate to the change. In this case the Swedish newspaper Svenska Dagbladet

(with libertarian valuebase or politically right wing interests) and it´s new design with new themas,

colors, publicing profiles, begun today. Hopefully they are interested about the freedom of press too?

To publish comments from alternative thinkers like me, who would like to go deeper and make a real change

in both society, it´s values and view of man and reality. With help and motivated by science that kind of

structural change would even mean a real change to the global community (civilization).

As I have before written about the Swedish Health Care (when tried to be elected to the new European wide party Libertas voting list in Sweden in election to the European Parliament, june 09), and followed discussions about this issue motivated by own academic SINUS-paper 1990 where I made a proposal to reform the current Swedish Health Care system with flex-price system,new kind of computerized planning and feedback-system and various kinds of organizational changes, the debate article in todays Svenska Dagbladet made me hopefull. Possibly my analysis or criticism of the Moderaterna (Republicans in the Swedish party landscape) Gunnar Axén, Finn Bengtsson and Andreas Norlén (all from Östergötland) debate article (”Inför en statlig sjukvårdsförsäkring”, SvD 082809) about the issue will be published ? As the majority of Swedes are fluent in reading English- and due to my former own experiences with the liberty in the Swedish media when trying to spread interest about my own proposals or solutions, based in the broader paradigm of science- I write this comment in English and send the webblink to Svenska Dagbladet…

The health care reform issue according to moderaterna from Östergötland

The three moderaterna above (all elected to the Swedish parliament and members of the greatest

governmental party Moderaterna) have put forward an interesting debate article, with intention to publish a new

vision to the Swedish h.c. : how to reform it by changing the current county structured system, with elected local

politicians and taxing right to the state level structured system, with state certified insurance premium providers and

freedom and rights for the people to make choices of there own. In seven point arguments they discuss the need for

changes for the Swedish h.c. system which is grounded on the public financing through taxes and both public structure

of hospitals, research doing university hospitals and private alternatives: both insurance companies and private

hospitals or even private doctors (followed up by local counties who are in charge of this system).

I don´t take up the arguments on these detail levels but try to show how their kind of visionis traditional (state based), normative (state certifies the various insurance companies) and libertarian- utilitarian ( based on the best wishes for most people- mainly those who are relatively healthy and have resources- both in knowledge and financially to make right h.c. choices).

How are their arguments then missing- yes partly naive or giving only a partial, financial solution to the needed reform in Sweden? As I have on my Facebook and WordPress bloggs given alternative analyses and shown interest to come with and collaborate to the ongoing h.c. reform in USA,

I´ll show how my broader vision is better, not grounded only on financial question, or organizational changes but even on a real market view, guided by people themselves, according to there interests and unique values, which would best be provided in a new kind of change. By change of the whole public sector: Partially Market Directed Public Sector (”PM for Democracy and People´s Selections”) which- being grounded on public financing but directed another way than traditional politician or bureaucratic ways- would give a wholehearted change- even in the basic culture of society, with deepened values for worth of man and freedom- not only for money, economic gains or narrowly defined quality indexes etc.

Example from real life

Take an example which would put the moderaterna vision to the testbed:

the patient could be an old manual worker, working on nights, every day, to get his economy going.

He would be in danger to develope a following health profile: weared knees, diabetis and hearth failures

( higher blood pressure) due to change of day routines (working on nights but prevented to sleep well due to the

majority people living by: slamming doors, crying babys, huligans on streets on night when laid early , cleaning

worker cars waking him early on the morning when just going to bed etc.). Which kind of individual premium would

the state certified insurance companies give to him? Probably higher premium- to the low paid worker, defeated by the

wellsituated, with right to good jobs, with better salaries, sleep on nights? The moderate vision is a naive vision of the

wellsituated, for the utilitarian middle class.

It´s even naive in it´s view of democracy: thinking that governmentally guided state based h.c. system would be impartial or more democratic than nowadays system of counties, where the people have more choices of h.c. (going to the public or private hospital or doctor; adding his h.c. security by own private premiums when the public system has possibly long waiting time or lower quality; voting for those local politicians who know best the local situations etc).

It´s a danger that moderaterna new vision would only lift the politician guided system to the nation level where the prestige fights and lacked knowledges would be more fatal, guiding the whole system, as for now where the people can go to another county if the wainting time would be too long for them (in extreme case going to EU- level and hoping to get back the paid costs afterwards from the powerful bureau of Försäkringskassan- about the NIF in USA ).

The new moderaterna ( with slogan : Moderaterna – Föregångslandet Sverige, about: Moderaterna

(Republicans) for the nation going a head (in charge of the reformation in Sweden and in the world)

and their vision is only economical- giving freedom of choices to wellsituated middle class.

Could the new leftist parties- guided by my vision of the new kind of public sector (se above) give

better reformation than the moderate vision?

Reforming heath care by structural change- not only by institutionally new overlaids

My vision- grounded on my old SINUS- paper 1990- would have a deeper kind of change than

only financial or institutional. The needed changes and arguments for these according to me are following

(I´m knowing that reformators in USA could possibly follow my points here- but my

proposals for the change or reformation of the USA system- in possible collaboration with the

Obama team- would take another path due to the different traditions there- fe by contacts with

finance sector, insurance companies, research organisations and universities, doctor´s and labor unions,

media, politicians – the Vidorg H.C. reformation package).

1´.My flex-price system would give a better economic guidance than the nowadays general, parliament defined prices. The parliament prices would give the floor and roof-prices for various kinds of sickness, but leave the scale open-ended due to both offered cares by hospitals, doctors and asked care by people and social-ecologically defined, value based prices for poor, old people or sick people collaborating with research.

2´. The nowadays county system- with more effective organization due to better, computerized planning system ( connected by net in the whole country and with various datebases- both general such as the central quality feedback db (which government has just laids hands on after nearly 20 years time) and the patient following system whether she/he goes to the public or private doctor or selects himself or in emergency, would follow the arguments done by research: instead of change of the whole system – with the needed time, new actors learning new roles etc prestige fights- the bit by bit reformation has shown to be the best organizational change- method. Paired with Vidorg-kind of applied socialantropological change methodology (the Obama team uses this kind of method too)- and given freedom to argue for the new view of man and reality, new model of public sector- the work would probably give better results.

3´. Even financially my new model of public sector (leftist solution as – hopefully- the domocratic parties understand the difference here with the moderate vision) – would give better solution: It´s guestionable if the deal with state, different insurance companies (selected by people, evenif variable premiums paid by the state- how, the moderate proposal is not given answer here) and the new organizational regions (guided by state officials in Länstyrelser, state authorities instead of selected local county politicians) would have both the swiftness and needed competence of current and new research to the best for people.

In my PMDPS- solution the market would be real- guided by people- not by autoritarian officials, not countable to the public in voting elections or guided by proper laws on erroneus duty results.

If and as the people´s own selections would be followed by markets (fe. lower prices at winter time compared to summer, rush-time prices; lower prices for reserarch collaboration or by social- economic status of the patient; higher prices in the flex-price scale by drinking too much or smoking etc) and thus give real incitament to take care of himself and his/ her family, the whole system would work better, more fluently than old time, politically guided economy.

4´. The fourth argument which could be taken up here is the new paradigm and it´s new view of man: death is nothing to be scared of (it´s a passage to another dimension of living of the soul- consciousness when the physical body dies)- it could be worthless to care a dying patient to any costs. The new energic solutions – by mental energy in healing as an aiding method in cancer care fe.- could be both more economic and give better care than nowadays solutions based on machine- technology only.

5´. The more globalised world where the Swedish patients can- if they want- seek care abroad

in the European Free Market area (European Community) – is the best case issue if the national

care would have shown to fail or been in error or too slow to react. The common experience of

people is that state officials are too slow.. The same is with 2the chosen people” (with social prestige and

economic-political-ethnic status): it naive to wait for corrections of made errors here

(possibly if taken up by media or international research community). The paradigm fights goes over two or

more generations as those in decision- positions have no counterbalancing powers.

In summary:

The three moderate politicians above have right in showing interest to the guiding vision of

reforming the Swedish health care. But their view on this needed change is too narrow, one sided,

too traditional and erroneus of the concept of market. On the other side- the nowadays leftist alternatives

on their part are also too narrow, trying to keep the status quo as the time and overall

global change talk for need of reform.

The right step forward in this time of crises is to take up the real change: with open-ended view of society

and market; with positive view of people and their possibilities to make rational choices when given new knowledges,

guiding their life in a new ways (if they like). The system which works on a narrow way to take care of it´s economy and

public life is doomed in the long run- if not by judges then by inefficiency, values crises, ethical cynicism (a kinf of

sickness of soul), or by ethnic,economic and religious cleavaces both locally and internationally.

Let´s hope for better and do our best.

Copyright: Lasse T. Laine, Uppsala, aug 28th 2009


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: