Government in new bid to fix health insurance

The Swedish government has proposed a number of changes to its reforms of the country's health insurance system, admitting its current efforts have left some people in a jam.

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Sweden's new, tougher health insurance rules, which were adopted several years ago, have been the subject of near constant criticism and in response, the government launched a review of its reform efforts last autumn.

A memo is set to be circulated for comment shortly which is expected to lay the groundwork for a Riksdag decision scheduled for the autumn of 2011, social insurance minister Ulf Kristersson of the Moderate Party wrote in a debate article in the Dagens Nyheter (DN) newspaper on Monday.

Representatives from the four centre-right governing parties who sit on the Riksdag's social insurance committee also signed the article.

"Health insurance reforms have, for the most part, been successful," the group writes.

"But not everything has been good and certain people have been put in a bind."

Among other things, the proposed changes included increased scope for individual assessments of those who reach the outside limit of 2.5 years

If such people are so ill that it would be unreasonable to force them off health insurance benefits, they would be allowed to continue receiving payments.

The government also wants to increase economic security for those who leave time-limited disability pension payments, previously referred to as 'early-retirement' benefits (förtidspension).

People who go off health insurance payments but don't qualify for sickness benefits (sjukpenning) because they had no previous income, should no longer be directed to basic welfare benefits, but would instead receive a new special benefit payment.

They would also be able to qualify for housing support payments.

Other proposed changes included earlier measures for rehabilitation, better coordination between the agencies involved, and that Sweden's National Public Employment Service (Arbetsförmedlingen) receive money to create 3,000 new positions for people with reduced working capacity.

"Health insurance has always primarily been a transitional insurance aimed at returning people to work, according to their abilities," the authors write.

"A society which high welfare ambitions must, at the same time, create clear requirements to utilise everyone capable of working to the extent possible."

In a press conference later on Monday, Kristersson pointed out that, prior to the reforms, Swedes appeared to be sick during economic downturns and healthy when the economy was booming.

At the same time, the number of people receiving long-term disability benefits was increasing.

"This is about many and difficult conversations," he said in reference to discussions carried out by Sweden's Social Insurance Agency (Försäkringskassan) with people whose benefits claims were being assessed.

Kristersson argued that many of the reforms had worked well, citing figures showing a reduction in the number of people receiving long-term sickness benefits as well as a reduction in the average length of time people received those benefits.

Nevertheless, he promised improvements included in the draft legislation set to go out for comment, including more flexibility in making individual assessments.

He also promised earlier and better cooperation between the Public Employment Service and the Social Insurance Agency.

In addition, the entire benefits chain will be reviewed in order to help rebuild confidence in the system.

Kristersson said he was disappointed that state agencies received such low marks in the eyes of the public, explaining that exactly how appeals were adjudicated varied widely in the first instance.

The draft proposal's comment period will last through the summer, with a Riksdag decision on the adjustments expected in the autumn.

The opposition political parties, however, weren't particularly impressed.

"It's good that the government admits that there are problems in the health insurance system, but it's too bad that they aren't putting forward proposals that will fix the problems," said Social Democrat Tomas Eneroth, vice chair of the Riksdag's social insurance committee.

According to Eneroth, the proposals put forward by Kristersson in the debate article would have a marginal effect and amounted to too little, too late.