Former Swedish cabinet minister speaks about how his country approached health reform, which holds lessons for Canadian medicare

OTTAWA, February 19, 2014 – When Sven Otto Littorin was a minister in the Swedish government, he oversaw a major overhaul of social services. He sat down with the Macdonald-Laurier Institute recently to share his views about the Swedish approach to public policy. Today, MLI releases the first of a two-part Q&A with Littorin in our Straight Talk series.

In this Straight Talk, Littorin focuses on health care reforms in Sweden. MLI has released a series of reports about reforming the Canadian health care system in 2013-14, titled Medicare's Midlife Crisis, and previous instalments of Straight Talk on health policy issues featuring former Saskatchewan Finance Minister Janice MacKinnon and Globe and Mail columnist Jeffrey Simpson.

In the interview with MLI, Littorin spoke of Swedes' "no-nonsense approach" to things, which has helped lead to gradual, practical reforms of what had been a "socialist planned economy" structure. "[I]t doesn't really matter to people whether the doctor you have in front of you is privately employed or publicly employed as long as you get the care that you are paying for through taxes", says Littorin.

He says that increased private operation of care facilities has led to greater choice for both patients and health care professionals, greater efficiency and improved outcomes. He also notes that even left-wing parties in Sweden have accepted user fees for those who can afford them as necessary to reduce frivolous use of the system and provide some funding.

"I'll tell you, I've had a couple of extremely positive encounters with the Swedish health care system", says Littorin.

MLI has drawn three recommendations for health care reform from Littorin's comments:

1)      Implementing modest user fees for those who can afford them would give people an understanding of the price of care and discourage frivolous use.

2)      Introduce greater competition from private operators to improve choices for care and employment options for health professionals.

3)      Broaden coverage to include pharmaceuticals and different kinds of health care professionals to provide the appropriate level of care.

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Sven Otto Littorin was Sweden's Minister for Employment from 2006-2010. He was in charge of major policy reforms, including an overhaul of the unemployment insurance system and a complete renovation of the Public Employment Service. During the Swedish presidency of the European Union, he was President of the European Council of Ministers responsible for employment, social policy, health and consumer affairs, and as such he oversaw the EU response to the financial crisis of 2008-09. He is currently an independent adviser on change management, policy reform and related issues.

The Macdonald-Laurier Institute is the only non-partisan, independent national public policy think tank in Ottawa focusing on the full range of issues that fall under the jurisdiction of the federal government. For more information, please contact David Watson, managing editor and communications director, at 613-482-8327 x. 103 or email at On Twitter @MLInstitute

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