Social Security, Health and Health Services in Norway

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Social Security, Health and Health Services in
Norway

• BRANKO KOPJAR

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PPP in EU and Scandinavia
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Life expectancy in EU and Scandinavia
4
Infant mortality in Scandinavian countries
5
Norwegian paradise?

• Government provides for
• Health services for everyone
• Education, including college education
• Unemployment benefits
• Social security including invalidity pension
• Basic pension
• Child benefits
• Maternity leave
• Subsidized mortgage and loans
• Future expenses

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Catch?

• Collective decisions
• Limited individual choice
• Sacrifice individual interest (e.g. waiting
  lists)
• High taxes and duties

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How can it function?

• Culture
• Economic background
• Source of revenues (oil 29 of the government
  budget,)
• Oil Fund
• Governmental management of economy (vs market)
• 25,00030,000 US per person in the national
  budget
• 7,000 US per person in the local budgets
• (US cca 13,000 per person)
• BNP
• 60,000 US per person
• (USA 40,000 US)

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Norway a just society?

• Egalitarianism
• Everyone gets the same share. No inequalities
  allowed.
• Rawls egalitarianism (maximin)
• Inequalities allowed as long as they benefit the
  worst off (John Rawls,Theory of Justice 1972).
• Utilitarianism
• Just distribution is the one that results in the
  greatest total happiness (J Bentham and JS Mill,
  19th century).

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Priority Setting in Norwegian Health Care Services

• Utilization
• Example CABG rate is 10x less in Norway
• Types
• Capacity planning and restrictions
• Budget allocations
• Individual health care decisions

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Principles for priority setting in Norway

• Just distribution
• All patients in a similar situation (severity,
  cost-effectiveness) should receive same access.
• Differential severity, differential (cost-)
  effectiveness may lead to different access.
• Gender, ethnicity, risky behavior, productivity,
  religion, sexual orientation and, social status
  should not be used to guide priority setting.
  (Age?)