Voters reject private hospitals
Last summer Canada’s private health
lobby held Sweden up as a society willing to embrace for-profit hospitals
Problem is, Swedes said no thanks.
Last summer, the Canadian media was awash with stories about
how the socialist Swedes had supposedly turned their back on public ownership.
Most notably, they were said to be selling their major public hospitals to
corporations. Not surprisingly, researchers associated with right-wing think
tanks were quick to jump on the story. After all, with Sweden’s history of
international business success and socialist government, it is associated with
all things both efficient and egalitarian. If for-profit hospitals work there,
why can’t they work in Canada?
Many of the press accounts from last summer regrettably
confused Swedish with socialist. Most stories featured the decision of Stockholm
County Council to turn over operation of St. Göran’s hospital to a private
firm and to contract-out an increasing volume of care to other private
facilities. However, few of the stories noted that Stockholm County was governed
by a coalition of parties led by the Moderates (Sweden’s equivalent of our
Alliance party). Shut out of power nationally and in most local councils, the
Moderates chose to use their position in Stockholm, where they won control of
both the county and city councils, to showcase their agenda of public restraint
Far from turning their back on public provision, socialists
vigorously opposed the "Stockholm agenda." In the health sector, the
Social Democratic government (supported by the Communists and Greens) issued a
moratorium blocking further hospital privatizations until this fall.
So how has the Stockholm County experiment turned out? The
financial world has certainly not been impressed by the Moderate-led council.
Standard and Poor’s lowered Stockholm County’s debt rating last fall. In
terms of patient care, there have also been worrying signs. There have been
allegations that the private hospitals and clinics in Stockholm are pre-disposed
to cream-skimming, making it more difficult for seriously ill patients to get
For example, on September 5th, the pro-business Svenska
Dagbladet published an opinion piece co-authored by one of Sweden’s leading
heart specialists. The piece states that Stockholm County’s decision to favour
private care has placed the health of cardiac patients in jeopardy. Unlike the
public hospitals, which treat patients regardless of their condition, the
private sector will not handle the most seriously ill patients. Having chosen to
divert funding from the public to the private sector, the Moderate-led County
Council turned logic on its head. Spaces have been created by for-profit firms
to treat patients least in need of care, who now receive speedier treatment.
Meanwhile, those most in need of care face longer waits, as the public hospitals
no longer have the funds to work at full capacity.
Politically the decision has turned out even worse for the
Moderates. Far from attracting voters with their Stockholm showcase, the party
suffered its worst performance since 1973 in the September 15th election.
Meanwhile the Social Democrats strengthened their grip on power at the national
level and ousted the Moderates and their allies from control of both Stockholm
County and Stockholm City Councils.
Last summer Canada’s private health lobby held Sweden up as
an efficient and egalitarian society willing to embrace for-profit hospitals. In
fact it was only a narrow right-of-centre political coalition that made that
choice. Swedes have rejected both them and their for-profit hospitals. Take it
from the roughly 6.7 million Swedish experts on efficiency and egalitarianism
who voted on September 15th: private hospitals and the public interest do not
Daniel Cohn is an assistant professor in the department of
political science at Simon Fraser University and a research associate with the
Canadian Centre for Policy Alternatives (www.policyalternatives.ca).