Re: "Modified patient-pay model from Sweden may work here," by R. Anderson, Letters, Feb. 26.
R. Anderson's letter prompted a reality check, and I encourage both Anderson and Danielle Smith to do the same, starting with a visit to Sweden's website at www. sweden.se. Another good place to compare health systems is the European Observatory on Health Systems and Policies, which publishes both detailed and summary health system profiles.
Most health-care providers in Sweden are publicly owned, and most health professionals, including doctors and dentists, are salaried. Medical education is entirely publicly financed. Ten per cent of health services are delivered by private providers under contract to local government. All services and costs are tightly regulated and monitored.
The cost of care, whether it is provided in public or private facilities or agencies within this system, is covered by public funding. The user fees are small, and there is an annual ceiling; no one pays more than $300 in a year, including on prescription drugs.
Overall, out-of-pocket expenditures are about three per cent of total health-care costs. Ours are about 15 per cent, with another 15 per cent being paid by private insurance.
Out-of-pocket costs in Sweden are offset because the health-care system is closely linked to other universal public social insurance programs, which include income security, even during sick leave, transportation to access health care, housing, subsidized dental care and other benefits.
Because they value independence, the Swedes also provide a range of public supports for the elderly, including home-meal delivery, help with cleaning and shopping, transportation service, as well as social and health care when needed.
Public funding is not provided to the few private providers who have chosen not to contract with the public system -and their fees are higher. About three per cent of the population is covered by private health insurance, usually through employer benefits. This compares with more than 50 per cent of the population in Canada, where these benefits are heavily tax-subsidized.
I agree with the suggestion that we would do well to emulate Sweden -in health care, eldercare, no-fees education (including preschool and after-school care) and publicly funded post-secondary education, and the whole gamut of social security programs -and the proportional tax system which funds these services.
But one can't cherry-pick one minor feature of their complex system and expect it to magically transform our fragmented system.