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Nordic Health Care Systems Pb:Nordic Health Care Systems Pb 11/8/09 14:04 Page 1 Nordic Health Care Systems pb:Nordic Health Care Systems pb 11/8/09 14:04 Page 1 Nordic Health Care Systems Recent Reforms and Current Policy Challenges European Observatory on Health Systems and Policies Series “The book is very valuable as actual information about the health systems in the Nordic countries and the changes that have been made during the last two decades. It informs well both about the similarities within the ‘Nordic Health Model’ and the important differences that exist between the countries.” Bo Könberg, County Governor, Former Minister of Health and Social Insurance in Sweden (1991-1994) “The publishing of this book about the Nordic health care systems is a major Nordic Health Care Systems event for those interested not only in Nordic health policy and health systems but also for everybody interested in comparative health policy and health systems. It is the first book in its kind. It covers the four “large” Nordic countries, Denmark, Norway, Sweden and Finland, and does so in a very systematically comparative way. The book is well organized, covers “everything” and is analytically sophisticated.” Ole Berg, Professor of Health Management, University of Oslo This book examines recent patterns of health reform in Nordic health care systems, and the balance between stability and change in how these systems have developed. Nordic Health Care Systems The health systems in Norway, Denmark, Sweden and Finland are investigated through detailed comparisons along a variety of policy-driven parameters. The following themes are explored: Recent Reforms and Current Policy Challenges • Politicians, patients, and professions Financing, production, and distribution • &Saltman Magnussen,Vrangbaek • The role of the primary health sector • The role of public health • Internal management mechanisms • Impact of the European Union The book probes the impact of these topics and then contrasts the development across all four coumntries, allowing the reader to gain a sense of perspective both on the individual systems as well as on the region as a whole. The editors also explore the extent to which a Nordic Health Care Model exists, and the degree to which that model will continue to help explain the future direction of health policy-making in these four countries. An additional chapter on recent developments in Iceland completes the work. Jon Magnussen is Professor in the Department of Public Health and General Practice at the Norwegian University of Science and Technology in Trondheim, Norway. Jon Magnussen Karsten Vrangbæk is Director of Research at the Danish Institute of Governmental Research, Copenhagen, Denmark. Richard B. Saltman is Associate Head of Research Policy at the European Observatory on Health Systems and Policies, Karsten Vrangbaek and Professor of Health Policy and Management in the Rollins School of Public Health of Emory University in Atlanta, USA. Richard B. Saltman Contributors: Tinna L. Ásgeirsdóttir, Paula Blomqvist, Johan Calltorp, Terje P. Hagen, Unto Häkkinen, Peter K. Jespersen, Pia M. Jonsson, Lars Erik Kjekshus, Allan Krasnik, Meri Larivaara, Juhani Lehto, Kalevi Luoma, Jon Magnussen, Dorte S. Martinsen, Pål E. Martinussen, Bård Paulsen, Clas Rehnberg, Ånen Ringard, Richard B. Saltman, Signild Vallgårda, Karsten Vrangbæk, Ulrika Winblad, Sirpa Wrede. www.openup.co.uk Nordic health care systems Recent reforms and current policy challenges The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Office for Europe, the Govern- ments of Belgium, Finland, Norway, Slovenia, Spain and Sweden, the Veneto Region, the European Investment Bank, the World Bank, the London School of Economics and Political Science, and the London School of Hygiene & Tropical Medicine. Nordic health care systems Recent reforms and current policy challenges Edited by Jon Magnussen Karsten Vrangbæk and Richard B. Saltman Open University Press McGraw-Hill Education McGraw-Hill House Shoppenhangers Road Maidenhead Berkshire England SL6 2QL email: [email protected] world wide web: www.openup.co.uk and Two Penn Plaza, New York, NY 10121–2289, USA First published 2009 Copyright © World Health Organization 2009 on behalf of the European Observatory on Health Systems and Policies. The views expressed by authors or editors do not necessarily represent the decisions or the stated policies of the European Observatory on Health Systems and Policies or any of its partners. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the European Observatory on Health Systems and Policies or any of its partners concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitations of its frontiers or boundaries. Where the designation ‘country or area’ appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the European Observatory on Health Systems and Policies in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The European Observatory on Health Systems and Policies does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. Rights to translate into German, Spanish, French and Russian should be sought from WHO at WHO Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen, Denmark or by email at [email protected]. Rights to translate into all other world languages should be sought from Open University Press. All rights reserved. Except for the quotation of short passages for the purpose of criticism and review, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher or a licence from the Copyright Licensing Agency Limited. Details of such licences (for reprographic reproduction) may be obtained from the Copyright Licensing Agency Ltd of Saffron House, 6–10 Kirby Street, London, EC1N 8TS. A catalogue record of this book is available from the British Library ISBN-13: 978-0-33-523813-2 ISBN-10: 0335238130 Library of Congress Cataloging-in-Publication Data CIP data applied for Typeset by RefineCatch Limited, Bungay, Suffolk Printed in the UK by Bell and Bain Ltd, Glasgow Fictitious names of companies, products, people, characters and/or data that may be used herein (in case studies or in examples) are not intended to represent any real individual, company, product or event. European Observatory on Health Systems and Policies Series The European Observatory on Health Systems and Policies is a unique pro- ject that builds on the commitment of all its partners to improving health care systems: • World Health Organization Regional Office for Europe • Government of Belgium • Government of Finland • Government of Norway • Government of Slovenia • Government of Spain • Government of Sweden • Veneto Region • European Investment Bank • World Bank • London School of Economics and Political Science • London School of Hygiene & Tropical Medicine The series The volumes in this series focus on key issues for health policy-making in Europe. Each study explores the conceptual background, outcomes and lessons learned about the development of more equitable, more efficient and more effective health systems in Europe. With this focus, the series seeks to contribute to the evolution of a more evidence- based approach to policy formulation in the health sector. These studies will be important to all those involved in formulating or evaluating national health care policies and, in particular, will be of use to health policy-makers and advisers, who are under increasing pressure to rationalize the structure and funding of their health system. Academics and students in the field of health policy will also find this series valuable in seeking to understand better the complex choices that confront the health systems of Europe. The Observatory supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of the dynamics of health care systems in Europe. Series Editors Josep Figueras is Head of the Secretariat and Director of the European Observatory on Health Systems and Policies, and Head of the European Centre for Health Policy, World Health Organization Regional Office for Europe. Martin McKee is Head of Research Policy of the European Observatory on Health Systems and Policies and Professor of European Public Health at the London School of Hygiene and Tropical Medicine as well as a co-director of the School’s European Centre on Health of Societies in Transition. Elias Mossialos is Co-Director of the European Observatory on Health Systems and Policies, and Brian Abel-Smith Reader in Health Policy, Department of Social Policy, London School of Economics and Political Science and co-director of LSE Health and Social Care. Richard B. Saltman is Associate Head of Research Policy of the European Observatory on Health Systems and Policies, and Professor of Health
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