Universal Healthcare: Scandinavian Countries

Published 2023-05-15 15:23:25
Hospital sign in Sweden - Image by Pasi Mämmelä from Pixabay

The Scandinavian countries have some of the best healthcare systems in the world. Although there are many common aspects of healthcare within this region, there are also some pertinent distinctions as each country adapts to individual budgetary constraints and demographics.

Norway, Sweden and Denmark have very similar healthcare systems. They are all publicly funded and universal, and they all rely on the fundamentals of equal access to high-quality healthcare for all, irrespective of income, social class or place of residence.

Their healthcare systems follow a decentralised public model which means that each municipality (local government) is responsible for managing its healthcare provision. They are funded by taxation and may require co-payments from patients for hospital care and medicines.

However, there are also some differences between the systems. For example, Sweden has a single-payer system, while Denmark and Norway have multi-payer systems. This means that in Sweden, the government is the sole payer for healthcare, while in Denmark and Norway, there are both public and private insurers.

Why are Scandinavians so healthy?

Healthcare in Scandinavian countries is ranked among the best in the world. All Scandinavian countries have universal healthcare systems, ensuring that all residents have access to essential healthcare services. They have high-quality medical facilities, well-trained medical professionals and equal access to excellent healthcare for all.

Scandinavian healthcare systems provide comprehensive coverage, including preventive care, hospital services, specialist consultations, prescription medications, and rehabilitation. Most services are provided free of charge or with nominal fees.They prioritize primary care as the foundation of their healthcare systems. Primary care physicians act as gatekeepers, coordinating patient care and referring to specialists when necessary.

The governments of Denmark, Norway, and Sweden are primarily responsible for the administration and funding of healthcare services. They heavily subsidize healthcare costs and manage the infrastructure and healthcare facilities. However, while the healthcare systems are nationally funded and regulated, there is a considerable degree of local autonomy and decentralised administration. This allows regions and municipalities to tailor healthcare services to their specific needs.

The healthcare systems in Scandinavia are primarily funded through taxation and social security contributions. Citizens and residents pay taxes, which are then used to finance healthcare services.

People in these countries are very satisfied with the healthcare they receive. In 2018, 85% of Norwegians, 84% of Danes and 79% of Swedes said they were satisfied with the healthcare they received.

Additionally, the Scandinavian culture is very focused towards an active lifestyle. Many exercise regularly and it is a way of life. For example, about 30% of Danes and Swedes cycle to work, which for many, can be a journey of about 8 miles long each day. Most companies also have health policies which may include providing healthy food for employees, social sports groups, gym memberships, etc.


Denmark has a tax-funded healthcare system with a high degree of government control. Although the healthcare system is a decentralised structure which is administered by the State, the regions and local municipalities, the government sets healthcare priorities, manages hospitals, and negotiates prices with pharmaceutical companies. Primary care is provided by general practitioners, and there is a strong focus on preventive care.

The Ministry of Health and Prevention, established in 2007,  administers all financing and organisation related to the healthcare system. This includes approvals of medicines, health insurance and psychiatry.

The State drafts and promulgates regulations while the local government is responsible for operating health services. Ownership of most hospitals in Denmark is with the local counties.

Some private hospitals are contracted to their county to provide medical services to the public but there are also a few small hospitals that operate completely privately, out of the public hospital system.

Patients visit their general practitioner as their primary point of contact within the healthcare system except if it is an emergency, in which case the patient will have access to a hospital.

Patients who require specialist care are referred to specialist physicians by the GP.  Specialist physicians have contracts with the health insurance scheme.

Healthcare budget increasing over the years

To improve services and reduce waiting times for access to healthcare, the government has been steadily increasing funding over the years. The health budget is growing regularly to incorporate steps to improve healthcare delivery. This included instances where certain private hospitals can treat patients to reduce waiting times, or patients receiving treatment at accredited overseas hospitals when wait times exceed 2 months.

This has resulted in backlogs for major surgical procedures declining significantly. Typical waiting times from 2002 were on average 27 weeks, this dropped to 21 weeks 3 years later. However, one out of eight chronic patients is treated overseas.

Other reforms have included shifting funds management to hospitals themselves which have significantly improved the efficiency of these hospitals and also reduced patient waiting times.

Funding of 75% by the federal state

Each region or county is allocated a subsidy by the federal state which is determined by factors such as demographics, social structure, etc. This constitutes about 75% of the total health budget. The rest is made up of funds from local contributions. This encourages local governments to operate more efficiently and implement more preventative health measures for their respective populations.

The value of the basic contribution differs in the various regions with a legislated maximum limit. On average the basic contribution is DKK 1,000 per person. The activity-related contribution varies and depends on how frequently health services are used. This is the incentive to get municipalities to control costs and encourage preventative treatment and care.


The healthcare system in Sweden is decentralised where the local or municipal governments administer and control all aspects. There are 21 regional councils and 290 municipalities and each regional council is responsible for providing high-quality healthcare and promoting preventative care in their respective regions.

Local government is elected every four years by the constituents of that region and voting occurs on the same day as the national general elections.

The central government, through the National Board of Health and Welfare which is a branch of the Ministry of Health and Social Affairs, regulates the healthcare system by establishing the parameters and principles through the Health and Medical Service Act. This branch of the central government sets standards of social welfare and healthcare for the residents of Sweden.  

Care of the elderly and disabled, both physically disabled and those with psychological disorders is the responsibility of the local municipalities. They provide support and services to patients released from hospital care and additionally provide for school healthcare.

Funding largely coming from regional and municipal taxes

Healthcare costs in Sweden are comparable to other European countries at around 11% of GDP.

Funding for the healthcare system comes largely from regional and municipal taxes. The national government supplies a portion and patient contributions cover the remaining small shortfall.

Private healthcare options are also available

There are both public and private healthcare services available. Regional councils can contract private providers and pay them for services.


The healthcare system in Norway is funded by taxes and payroll contributions which are made by both employees and employers. It covers patients comprehensively and even includes prescription medication. While patients have to make co-payments for some services, this is capped depending on the type of service.

Main services are the responsibility of the national government

Access to healthcare is automatic for all residents.

Norway has a mixed healthcare system that combines public and private providers. The national government ensures the provision of healthcare according to the laws that regulate equal access regardless of economic, geographic or social status. It is also responsible for funding and regulation of the NIS. Local municipalities share the administration responsibilities with the national government.

Local municipalities are responsible for coordinating primary health care but hospital services and other services are the responsibility of the national government. The latter is achieved through four Regional Health Authorities (RHAs) which operate at the local level. These authorities implement national health policy by coordinating with local healthcare trusts in their region.

In a nutshell, the government funds and regulates healthcare services, but private providers also play a significant role in delivering care.

The 1997 National Insurance Act and the 1999 Patient Rights Act govern the National Insurance Scheme (NIS), or Folketrygd, which is the universal health and social insurance coverage for the population.

Primary healthcare, prevention and nursing care are coordinated at the local municipal level. Local municipalities receive their funding from taxes and grants from the national government. About 52% of their total budget is allocated to healthcare and social services.

Healthcare costs in 2016 were approximately 10.5% of GDP which is very similar to other Scandinavian countries.

Private healthcare

A small percentage of the population (approximately 10% of Norwegians) have private health insurance and a majority of these are covered by employers. Private insurance offers easier and quicker access to healthcare with a wider range of providers to choose from.

Despite their differences, the healthcare systems of the Scandinavian countries are all highly effective. They provide high-quality care at a relatively low cost. This is due in part to the strong emphasis on prevention and early intervention, as well as the high level of public trust in the healthcare system.

Here is a table that summarizes the similarities and specificities of the healthcare systems in the Scandinavian countries:

Despite their differences, the healthcare systems of the Scandinavian countries are all highly effective. They provide high-quality care at a relatively low cost. This is due in part to the strong emphasis on prevention and early intervention, as well as the high level of public trust in the healthcare system.


Here is a table that summarises the similarities and specificities of the healthcare systems in the Scandinavian countries:

Similarities Specificities
Publicly funded Single-payer system (Sweden)
Universal Multi-payer system (Denmark and Norway)
Decentralised Patient co-payments (Denmark and Norway)
Strong emphasis on prevention and early intervention High level of public trust

Overall, the healthcare systems of the Scandinavian countries are a model for other countries. They provide high-quality care at a relatively low cost, and they are highly effective in improving the health of their populations.

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Author: KashGo
Expat Mum in the Desert and content writer for EasyExpat.com

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