Sweden’s “Care Billions”

www.ordoliberalism.wordpress.com See also The Bureaucratisation of Neoliberalism

Background: As a country with a small population but occupying a large area, plus being dependent on trade and possessing considerable natural resources, it is understandable that exports play an important part in Sweden’s economy. It would be strange if it did not – abundant iron ore, copper, tin, even some silver, and Sweden’s forests – its green gold. Other wealth comes from abundant amber (from the fossilised resin of pine trees), and furs from wild animals (notably mink, lynx and bear). During the Hanseatic League furs and skins from Russia, Finland and Sweden comprised an important and valuable trade. Gotland in the Baltic (note also the goat as part of its county symbol) meant that its city of Visby became a major Hanseatic League trading port, and with its defensive walls and trades and industries based on factories producing fur coats and soft skins. Visby is also an UNESCO world heritage site.

More recently, Sweden has developed industries based on advanced technologies, notably cars, telephones, aerospace industries. Together with its longstanding policy of armed neutrality and close co-operation between government, corporations and labour, Sweden can afford an advanced welfare state. For more on this see Economy of Sweden.

The current Bourgeois Government put together by Frederick Reinfeldt was elected in 2006 and is an alliance of several fractions of capital interests. But as usual there is much in common between this constellation and the Opposition parties, especially the biggest of them, the Social Democrats, led by Stefan Löfven whose political position is very close to that of Frederick Reinfeldt.

Care Billions: One of the measures introduced by the Reinfeldt Government was to provide financial incentives to counties (län) to improve medical services, by using financial incentives to create a more service-oriented culture in the county health services. These financial incentives were the more valuable because in the rural areas young people were increasingly moving to the urban centres to find employment. This in turn reduced the tax base in rural areas, and so Care Billions were a means of staunching the economic bleeding of the countryside.

Sadly, the result has been to bias the care towards the young who can be set on their feet and sent on their way. This looks better in “results”, showing a higher level of “success” in terms of statistics, which is what the whole exercise is based on. And, of course, the entire operation generates a lot of make-work by the counties having to periodically generate and compile statistics to send to the central government in order to prove eligibility for the “care-billions” money. This is a classic case of unintended consequences (another R. K. Merton “first”). There are several articles on the unintended consequences  of this kind of public spending in the Swedish media. The distortions in care-provided efforts can be dramatic. This one reported by Dagens Nyheter is worth reading, showing how healthy young are prioritised over the older who are more often sick and as they age they become more of a burden, while the young generally boost the statistics of “successful” treatment: http://www.dn.se/nyheter/sverige/de-sjukaste-far-vanta-pa-vard/

This kind of make-work is common across all bureaucracies, public and private. Academics will recognise this in their own university departments. In the UK it takes the form of the Research Assessment Exercise, first started during the Thatcher years, the very beginning of the third revert to the new laissez faire.

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