Private health insurance in the United States and Sweden: A comparative review.

Udit Dave, Emma G Lewis, Jenilkumar H Patel, Nikhil Godbole
Author Information
  1. Udit Dave: Tulane University School of Medicine New Orleans Louisiana USA. ORCID
  2. Emma G Lewis: Tulane University School of Medicine New Orleans Louisiana USA. ORCID
  3. Jenilkumar H Patel: Tulane University School of Medicine New Orleans Louisiana USA. ORCID
  4. Nikhil Godbole: Tulane University School of Medicine New Orleans Louisiana USA. ORCID

Abstract

Background and Aims: The United States of America and Sweden both contain a public and private component to their healthcare systems. While both countries spend a similar amount per capita on public healthcare expenditures, the United States spends significantly more in the private healthcare sector. Sweden has a social democratic model of health care, and given its identity as a welfare state, private health insurance providers have a small and nuanced role.
Methods: This paper was completed after searches were queried for "Sweden," "United States," and variants of the words "insurance," "public," "private," "Medicare," "Medicaid," "public," and "costs." A preliminary search in May 2022, yielded 78 articles, of which 45 were ultimately considered relevant for this review. Inclusion criteria consisted of English language articles, topic relevance, and verification of MEDLINE-indexed journals. These searches were performed in PubMed, Google Scholar, Embase, and Cochrane. Summary findings of these searches are compiled in this review.
Results: Sweden guarantees low-cost appropriate care to all citizens with equitable access; however, drawbacks of its system include high financial burden, lack of primary care infrastructure, as well as geographical and socioeconomic inequities. On the other hand, the United States' healthcare system is built around the private sector with public health insurance reserved only for the most vulnerable patient populations.
Conclusion: Our goal is to provide an overview, compare the role of private health insurance in both countries, and highlight policies that have had beneficial effects in each nation. Possible solutions to the drawbacks of each nation's health insurance policies could be addressed by additional support to Sweden's vulnerable population by developing a program similar to the US' Medicare Advantage program. Conversely, the United States may benefit from increasing access to public health insurance, especially in instances where families face unemployment.

Keywords

References

Am Econ J Appl Econ. 2019 Apr;11(2):302-332 [PMID: 31131073]
Health Econ. 2005 Sep;14(Suppl 1):S237-54 [PMID: 16161198]
Health Policy. 2002 Dec;62(3):329-41 [PMID: 12385854]
JAMA. 2018 Mar 13;319(10):1024-1039 [PMID: 29536101]
Health Aff (Millwood). 2015 Aug;34(8):1399-406 [PMID: 26202057]
Health Policy. 2018 May;122(5):485-492 [PMID: 29573826]
Health Aff (Millwood). 2015 Oct;34(10):1779-88 [PMID: 26395215]
Int J Evid Based Healthc. 2015 Sep;13(3):170-8 [PMID: 26288063]
Milbank Q. 2017 Sep;95(3):554-601 [PMID: 28895227]
BMC Health Serv Res. 2018 Mar 7;18(1):166 [PMID: 29514637]
Issue Brief (Commonw Fund). ;2017:1-14 [PMID: 28990747]
BMJ. 2000 Jan 1;320(7226):15-8 [PMID: 10617517]
JAMA. 2017 Nov 7;318(17):1668-1678 [PMID: 29114831]
Issue Brief (Commonw Fund). 2015 Oct;15:1-15 [PMID: 26591905]
Health Policy. 2019 Aug;123(8):737-746 [PMID: 31300174]
JAMA. 2020 Mar 03;323(9):844-853 [PMID: 32125404]
PLoS One. 2020 Jun 24;15(6):e0235021 [PMID: 32579571]
CMAJ. 2003 Feb 18;168(4):413-6 [PMID: 12591780]
Ann Rheum Dis. 2004 Nov;63(11):1483-9 [PMID: 15479899]
JAMA. 2016 Aug 2;316(5):525-32 [PMID: 27400401]
JAMA. 1991 Oct 23-30;266(16):2268-71 [PMID: 1920727]
Health Serv J. 1999 Sep 9;109(5671):20-1 [PMID: 10623144]
Health Sci Rep. 2024 Mar 14;7(3):e1979 [PMID: 38495896]
Health Policy. 2017 Apr;121(4):442-449 [PMID: 28228243]
JAMA. 2005 Sep 21;294(11):1333-42 [PMID: 16174691]
Health Aff (Millwood). 2003 May-Jun;22(3):89-105 [PMID: 12757275]
Int J Health Serv. 2014;44(3):507-24 [PMID: 25618987]
JAMA Intern Med. 2017 Apr 1;177(4):588-590 [PMID: 28241266]
J Public Health (Oxf). 2004 Mar;26(1):56-60 [PMID: 15044576]
Health Econ Policy Law. 2022 Oct;17(4):380-397 [PMID: 33752779]
CMAJ. 2008 Jul 15;179(2):129-31 [PMID: 18625979]
Soc Sci Med. 2014 Oct;119:18-26 [PMID: 25137644]
Inquiry. 2020 Jan-Dec;57:46958020910305 [PMID: 32349581]
Health Policy. 2009 Oct;92(2-3):180-6 [PMID: 19394106]

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