title: The reactions to macro-economic crises in Nordic health system policies: Denmark, Finland and Sweden, 1980-2013.
abstract: Denmark, Finland and Sweden have experienced two major recessions during the last 25 years. The adjustments to the earlier crisis in the late 1980s (Denmark) and early 1990s (Finland and Sweden) resembled the policies in many other European countries during the present crisis. The analysis of relationship of deep economic crises and growth period between them to the health system policies and institutions in the three countries from the 1980s to 2013 is based on a categorisation of reactions to external shocks as path conforming or path breaking. The results of the empirical long-term trends show that the reactions to deep recessions have been mainly temporary adjustments and acceleration of changes already prepared before economic crisis. The economic crisis in the three countries has not been 'good enough' to enable paradigmatic changes in the Nordic public, decentralised and equity-oriented health systems. Changes such as the slow privatisation in care funding and production and the adoption of new management practices indicate an ongoing paradigmatic change related to longer-term societal, ideological and political developments rather than directly to economic crises or growth.
authors: 1Professor of Social and Health Policy,School of Health Sciences,University of Tampere,Tampereen yliopisto,Finland.
authors: Juhani
authors: J
authors: Lehto
authors: 2Professor of Health Policy and Economics,Departments of Political Science and Public Health,University of Copenhagen,Denmark.
authors: Karsten
authors: K
authors: Vrangbæk
authors: 3Associate Professor of Health Services Research,Uppsala University,Sweden.
authors: Ulrika
authors: U
authors: Winblad
mesh_terms: D017047:Cost Sharing; D003718:Denmark; D057172:Economic Recession; D017598:Efficiency, Organizational; D005387:Finland; D019981:Health Care Sector / Q000191:economics / Q000458:organization & administration*; D005102:Health Expenditures; D006291:Health Policy; D006801:Humans; D008483:Medical Assistance; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D011057:Politics; D012959:Socioeconomic Factors; D013548:Sweden