The reactions to macro-economic crises in Nordic health system policies: Denmark, Finland and Sweden, 1980–2013

TY - JOUR

T1 - The reactions to macro-economic crises in Nordic health system policies

T2 - Denmark, Finland and Sweden, 1980–2013

AU - Lehto, Juhani

AU - Vrangbæk, Karsten

AU - Winblad, Ulrika

PY - 2015/1

Y1 - 2015/1

N2 - Denmark, Finland and Sweden have experienced two major recessions during the last 25 years. The adjustments to the earlier crisis in the late 1980s (Denmark) and early 1990s (Finland and Sweden) resembled the policies in many other European countries during the present crisis. The analysis of relationship of deep economic crises and growth period between them to the health system policies and institutions in the three countries from the 1980s to 2013 is based on a categorisation of reactions to external shocks as path conforming or path breaking. The results of the empirical long-term trends show that the reactions to deep recessions have been mainly temporary adjustments and acceleration of changes already prepared before economic crisis. The economic crisis in the three countries has not been 'good enough' to enable paradigmatic changes in the Nordic public, decentralised and equity-oriented health systems. Changes such as the slow privatisation in care funding and production and the adoption of new management practices indicate an ongoing paradigmatic change related to longer-term societal, ideological and political developments rather than directly to economic crises or growth.

AB - Denmark, Finland and Sweden have experienced two major recessions during the last 25 years. The adjustments to the earlier crisis in the late 1980s (Denmark) and early 1990s (Finland and Sweden) resembled the policies in many other European countries during the present crisis. The analysis of relationship of deep economic crises and growth period between them to the health system policies and institutions in the three countries from the 1980s to 2013 is based on a categorisation of reactions to external shocks as path conforming or path breaking. The results of the empirical long-term trends show that the reactions to deep recessions have been mainly temporary adjustments and acceleration of changes already prepared before economic crisis. The economic crisis in the three countries has not been 'good enough' to enable paradigmatic changes in the Nordic public, decentralised and equity-oriented health systems. Changes such as the slow privatisation in care funding and production and the adoption of new management practices indicate an ongoing paradigmatic change related to longer-term societal, ideological and political developments rather than directly to economic crises or growth.

U2 - 10.1017/S1744133114000243

DO - 10.1017/S1744133114000243

M3 - Journal article

C2 - 25662197

SN - 1744-1331

VL - 10

SP - 61

EP - 81

JO - Health Economics, Policy and Law

JF - Health Economics, Policy and Law

IS - Special Issue 01

ER -