This contributed a lot to the current socialized healthcare system. In United States, the survival for the fittest ideology dominates the minds of the citizens unlike the Swedes whose minds are occupied by the sense of unity that considers help to another man as help to oneself.
Generally Sweden exhibits a model of social welfare democracy where by the people are considered as the source of the power of the state and since the government established the home of the people what is commonly known as a folkhelment with a purpose of curbing unemployment that followed centuries of war and subsequent food shortage in the state in 1932, the Swedes achieved an universal welfare that was free of stigma.
The universal coverage in Sweden was prepared by National Insurance Act which determined the county council’s reimbursement schedule before the Health and Medical Care Act was passed by the parliament in I982 with an aim of providing an ensuring good healthcare to the entire population on equal terms, a move that indicated the actual start of the universal healthcare in Sweden. Since then the eligibility rules became universal as every residence was entitled to the benefits.
In the United States, this is contrary as the eligibility emphasizes on strict requirements for applicants of the various healthcare programs. Furthermore, the citizens in the United States are entitled to the benefits based on their individual needs for them, or in absolute equal amount without considering their needs. (Chambers 2000, 99). Unlike in Sweden where the Health and Medical Care Act ensures absolute equity in healthcare provision for the entire population on equal terms, in the United States the healthcare equity is proportional as select groups are favored, and those who are not insured are left out.
Furthermore, since the benefits can be allocated either horizontally to involve all individuals in need or vertically to involve individuals with severe needs, the vertical equity is considered in the United States thus provides benefits to disabled and low-income individuals except the Medicare that considers age against need. This is contrary to Sweden where the horizontal equity is considered.
The universal healthcare system in Sweden is financed by several bodies such as private insurances, out-of-pocket user fees, employer-paid national social insurance and the government taxes. In the year 2001, 8. 7 % of the Sweden’s gross domestic product was spent on healthcare, 85. 2% of the public expenditures were associated with the healthcare services while 14. 8% of the expenditures were considered private. (WHO 2004d).
Moreover, the county councils employ and pay physicians working at the public hospital and the income of the physicians is not dependent on the workload or the number of treated patients contrary to the physicians in the United States whose compensation is determined by the number of patients they attend (MCO salaried and capitation excluded). To ensure that the inexpensive healthcare is not abused or overused, and to ensure the low-income citizen access the healthcare the Swedes are required to pay US$14 when seeking the physician for primary care, and US$35 for other specialized healthcare.
This fee accounts for 2% of the total healthcare expenditures. In Sweden, an annual co-payment of US$ 128 is after which the individuals are given frikort card that enables the holders to get free healthcare for subsequent twelve months. This system is also applied for pharmaceuticals though at US$256 per year. In United States, deductibles and co-payments are only practiced by private insurance programs though they are higher than in Sweden, and are based on the calendar year meaning that they are of no benefit to those who get sick in December.