title: Is patient choice democratizing Swedish primary care?
abstract: Choice and competition reforms in healthcare often involve the idea of empowering patients through the mechanism of 'exit'. Using Swedish healthcare as an example, this article illustrates that this kind of efforts to empower patients may not only affect patients' chances of influencing healthcare but also those of citizens, who may lose 'voice' as a result. Thus, it is an example of the conflict between representative democracy and the customers' control over welfare services; a conflict that may be overcome by providing new forms of collective decision-making. This was not the case when introducing a patient choice reform in Swedish primary care in 2010.
authors.affiliation: Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Box 564, 751 22 Uppsala, Sweden. mio.fredriksson@pubcare.uu.se
authors.forename: Mio
authors.initials: M
authors.lastname: Fredriksson
mesh_terms: D002755:Choice Behavior; D003709:Democracy; D004465:Economic Competition; D018166:Health Care Reform / Q000458:organization & administration; D006801:Humans; D009111:Local Government; D057240:Patient Preference; D011057:Politics; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D013548:Sweden