In June 2022, the government submitted a proposal to the parliament that when regions enter into an agreement with a private health care provider, which in addition to the region also has private insurance companies as clients, the agreement must ensure that the private provider’s other tasks do not negatively affect the region’s tasks to the care provider. The proposal primarily aims to ensure increased equality in cases where a private care provider provides both publicly and privately funded care.
The market for voluntary health insurance (VHI) in Sweden is mainly considered as supplementary to the publicly financed care sector and the proportion of health care expenses funded via VHI amounts to approximately 1%. The demand for VHI has been explained by the long waiting times for publicly funded health care, or that the care is not sufficiently person-centred. The health care production within the VHI-market is then provided by private care providers who also may offer publicly funded care on behalf of one or more regions.
The background to the proposal is that the ethical platform – which constitutes the basis for the priorities within health care – states that those with the greatest need should be given priority. However, private health care providers who have agreements with both the region and private insurance companies often have different agreed time limits for treatment. In the agreements with the insurance companies, the waiting time for visiting a specialist is often a maximum of 7 working days and for surgery a maximum of 14–21 working days. These agreements thus differ from the agreements with the regions, which are often based on the waiting time guarantee stipulating the right to receive care within 90 days. Evaluations of the VHI-market also indicate that people with VHI on average receive care more quickly, probably without differences in medical needs. However, it is difficult to assess the overall effects of VHI on health care capacity and wating times for patients in publicly funded care.
One interpretation of the proposal is that a care provider who provides both publicly and privately funded care must fulfil the national waiting time care guarantee in order to be able to receive voluntary insured patients. A requirement is also that care providers who provide both publicly and privately funded care need to distinguish their reimbursement between public and private sources. The law intends to enter into force in January 2024, but it has not yet been passed by the parliament and it is uncertain how the 2022 election results will affect its implementation.