Changes in Swedish Workers' Compensation: An American Perspective.
In response to escalating costs, substantial changes are being made to the Swedish workers' compensation insurance system. They include increased employer responsibility for sick leave payments, longer waiting periods, benefit reductions, tightened criteria for determining work-relatedness, and decreased support for worksite occupational health services. These changes will make Sweden's system more closely resemble the arrangement that has traditionally existed in the United States. Experience in the United States can illustrate the potential benefits and problems inherent in the Swedish changes. Some of the potential dangers are greater difficulty in determining the true costs of work injuries, less emphasis on prevention, increased pressure for the premature return to work of injured workers, and heightened dissention between patients, doctors, and social insurance officers. Collective discussion of these potential problems by Swedish employers, workers, doctors, social insurance officers, and government officials is needed.
Dembe
AE
Occupational Health Program, Department of Family and Community Medicine, University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA 01655, USA. Allard.Dembe@banyan.ummed.edu