Opinions of Swedish citizens, health-care politicians, administrators and doctors on rationing and health-care financing.
OBJECTIVE
To compare the views of citizens and health-care decision-makers on health-care financing, the limits of public health-care, and resource allocation.


METHODS
A postal survey based on a randomized sample of adults taken by the national registration and stratified samples of health-care politicians, administrators, and doctors in five Swedish counties.


METHODS
A total number of 1194 citizens (response rate 60%) and 427 decision-makers (response rate 69%).


RESULTS
The general public have high expectations of public health-care, expectations that do not fit with the decision-makers' views on what should be offered. To overcome the discrepancy between demand and resources, physicians prefer increased patient fees and complementary private insurance schemes to a higher degree than do the other respondents. Physicians take a more favourable view of letting politicians on a national level exert a greater influence on resource allocation within public health-care. A majority of physicians want politicians to assume a greater responsibility for the exclusion of certain therapies or diagnoses. Most politicians, on the other hand, prefer physicians to make more rigorous decisions as to which medical indications should entitle a person to public health-care.


CONCLUSIONS
The gap between public expectations and health-care resources makes it more important to be clear about who should be accountable for resource-allocation decisions in public health-care. Significant differences between physicians' and politicians' opinions on financing and responsibility for prioritization make the question of accountability even more important.
Rosén
Per
P
Nordic School of Public Health, Gothenburg, Sweden. per.rosen@skane.se
Karlberg
Ingvar
I
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005260:Female; D005380:Financing, Government / Q000706:statistics & numerical data*; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006270:Health Facility Administrators / Q000523:psychology; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology; D011639:Public Opinion; D013548:Sweden