Scandinavian Working Papers in Economics

Working Paper Series,
Research Institute of Industrial Economics

No 1238: Telemedicine and the Welfare State: The Swedish Experience

Mårten Blix () and Johanna Jeansson ()
Additional contact information
Mårten Blix: Research Institute of Industrial Economics (IFN), Postal: Research Institute of Industrial Economics, Box 55665, SE-102 15 Stockholm, Sweden
Johanna Jeansson: FEM in Stockholm

Abstract: Sweden combines a vibrant market economy with a large public sector. This combination of public and private also characterizes the country’s comprehensive tax-financed welfare services. More than one-third of primary health care is today produced in the private sector. This substantial share has broad implications for how digitalization reshapes those welfare services. In this paper, we focus on how telemedicine is set to transform primary health care in Sweden, where doctors have been available via video calls on smartphone apps since 2016. The novel element in Swedish health care is that the doctors are available as a public welfare service but by private providers. With some exceptions, patients pay a small fee, but most of the cost is borne by the tax-payers. While the benefits of telemedicine are many – such as easier access to doctors and a reduction of non-essential travel – the downside for public finances is that the demand for care, and hence costs, may increase dramatically. As telemedicine becomes more popular, the tensions in regards to financing and regulation are already in evidence and look set to rise further. We outline steps that could better integrate telemedicine into the health care system.

Keywords: Primary health care; Telemedicine; Welfare state; Digitalization; Privatization; Outsourcing

JEL-codes: H75; I11; I18

25 pages, October 9, 2018

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