Access to health care in the scandinavian countries: Ethical aspects

The health care systems are fairly similar in the Scandinavian countries. T he exact details vary, but in all three countries the system is almost excl usively publicly funded through taxation, and most (or all) hospitals are a lso publicly owned and managed. The countries also have a fairly strong pri mary care sector (even though it varies between the countries), with family physicians to various degrees acting as gatekeepers to specialist services . In Denmark most of the GP services are free. For the patient in Norway an d Sweden there are out-of-pocket co-payments for GP consultations, with upp er limits, but consultations for children are free. Hospital treatment is f ree in Denmark while the other countries use a system with out-of-pocket co -payment. There is a very strong public commitment to access to high qualit y health care for all. Solidarity and equality form the ideological basis f or the Scandinavian welfare state. Means testing, for instance, has been wi dely rejected in the Scandinavian countries on the grounds that public serv ices should not stigmatise any particular group. Solidarity also means devo ting special consideration to the needs of those who have less chance than others of making their voices heard or exercising their rights. Issues of l imited access are now, however, challenging the thinking about a health car e system based on solidarity.