From Plan to Market: A Comparison of Health and Old Age Care Policies in the UK and Sweden

Abstract

This article reviews changes in the organization, delivery and financing of health care and old age services in the UK and Sweden over the past 25 years. User autonomy has become a more important policy objective than equity of access or equality of opportunity, with a greater reliance on market mechanisms for delivering services. The public and politicians seem to be prepared to accept that competition, choice and decentralization may result in a widening of regional and geographical inequalities, and the erosion of the universal character of the welfare state. These developments reflect broader normative shifts in both societies, and are likely to continue and become more widespread in the future, as they will be strongly influenced by demographic and social factors, fiscal constraints and the policies of supranational bodies such as the European Union.