Swedish experiences with more freedom in the practice sector

Sweden implemented a health care reform which creates the opportunity for more effective competition in the practice sector. With the reform, health care providers received the right to freedom of establishment, and ownership restrictions have been removed, allowing anyone to own a health centre.

After the reform, there are more health centres, and many Swedes have thus seen reduced travel times to the
centres.

There are no immediate signs that the reform has caused increased expenses. Since the reform, there has been approximately zero growth in the number of consultations, and the cost per consultation follows the general wage development. Furthermore, the patients’ experienced quality remained largely unchanged in the period 2009‑2013.

These lessons from the reform of the Swedish practice sector have been compiled as a follow-up to an analysis of the markets for private chiropractors and physical therapists, published by the Competition and Consumer Authority in 2013.

The analysis shows that the regulation of the Danish practice sector resembles the one the Swedes had before the reform, and simultaneously points to there being potential societal gains from easing restrictions on the establishment and ownership in physiotherapy and chiropractic, respectively.