Abstract:

Under pressure from the aging population, intensive new medical technology, & tightly constrained public sector budgets, Nordic health systems have begun to experiment with new methods of health service delivery that incorporate market-driven approaches. Based on published data, two of the more influential organizational models in place or under development in Swedish countries are reviewed: the public competition model, in which only publicly capitalized providers play, & the "internal" or mixed market model, in which public & privately capitalized providers compete for public funds among patients needing specialists. Either model means that responsibilities assigned to county- & national-level health planning will change, & the health planning process will have to be restructured. The main issues yet to be resolved are funding, flexibility in the county budgeting system, & information system needs.