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National Alliance
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International Caregiving Legislation |
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Eldercare Policy in Sweden |
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The Swedish population is graying and in 2002, out of a total population of 9 million inhabitants, 17.2 per cent were aged 65 years or older and 5.2 per cent had reached the age 80 years or older.
Care of the elderly is a public responsibility in Sweden and the goal is to guarantee a secure economy, good housing, and service and care according to needs. Public help allows freedom of choice and influence for the recipient and maintain high standards. All the elderly have equal access to these welfare goods regardless of age, sex, ethnicity, place of residence, or purchasing power.
In old age care, two pieces of legislation primarily apply. The Social Services Act (1982) emphasizes the right of the individual to receive public service and help at all stages of life. Anyone who needs help to support himself in his day‑to‑day existence can claim assistance if his 'needs can not be met in any other way'. According to the Health and Medical Services Act (1983), health care and medical services aim to maintain a good standard of health among the entire population and to provide care on equal terms for all.
The responsibility for the welfare of the elderly is divided between three principals or levels of government. At the national level, the Parliament and the Government set out policy aims and directives by means of legislation and economic steering measures. At the regional level, the county councils (21 in all) are responsible for the provision of health and medical care. Finally, at the local level, the (290) municipalities are legally obliged to meet the social service and housing needs of the elderly. Both the county councils and the municipalities have a very high degree of autonomy vis‑à‑vis the central government. Both have elected assemblies and have the rights to levy taxes. The county councils and municipalities may, within the limits prescribed by the existing legislation, decide the degree of priority they will give the elderly over other groups.
In return for taxes, people are provided with a broad spectrum of welfare benefits that guarantee a minimum standard of living, service and care and redistribute income more evenly over lifetime and between individuals. The economic security of the elderly is based on a basic old-age pension payable to everyone from the age of 65. The State also pays an income related supplementary pension financed from the employer payroll fees. The pension benefits provide everybody with almost two thirds of former income. Therefore, in general, no one has had to forgo service and care due to economic reasons.
Both the health care and social services are subsidized, with the recipient usually paying only a fraction of the actual cost. Charges vary among the municipalities. At the present, the fees (out‑of‑pocket costs) for health care and social services are increasing. But to limit the cost for the recipient (for out‑patient care), there exists a "high‑cost‑limit," which means that no one has to pay more than a total of 2.200 SEK per year (approximately $250 US) for health care (including prescriptions), regardless of the type and amount of care received. The fees for home help and institutional care are related to how much help is needed and income. In 2002, a new a law came into power, putting a ”ceiling” of maximum level on fees and a ”floor” (guaranteeing a minimum of income left) for users of public elder care. Again, the user pays only a fraction of the cost of providing the services.
Care of the elderly is almost totally financed by taxes. Only a fraction of the costs (5-8 %) is paid by the user; the largest share of the costs (about 82 – 85 %) is covered by local taxes. National taxes cover the remaining costs of elderly care (about 10 %). The fact that health care and social services for the elderly are primarily funded by local taxes further confirms the independent role of the local governments versus the national government.
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