Sweden

   

Social Policies

#3
Key Findings
With its highly developed welfare state, Sweden falls into the top ranks worldwide (rank 3) with regard to social policies. Its score on this measure has declined by 0.2 points since 2014.

A decline in students’ internationally comparative test rankings has been reversed, but the absolute level remains alarmingly low. Debate over causes and solutions has been intense, and a new round of reforms has been proposed. Levels of gender equality are high. Poverty and income inequality rates are low but increasing, and young people are having increasing difficulties in finding jobs.

Recent health-care privatization has produced long wait times and reports of substandard treatments, though care quality is generally good. Family policies are generous, with extensive maternal and paternal leave and ample child-care provision.

Pension-system sustainability has improved. Government and opposition parties have agreed to increase the retirement age. Immigration policies are generous, but integration has proved problematic despite considerable policy commitment to the issue. Rising crime rates, while still at moderate levels, are a concern.

Education

#7

To what extent does education policy deliver high-quality, equitable and efficient education and training?

10
 9

Education policy fully achieves the criteria.
 8
 7
 6


Education policy largely achieves the criteria.
 5
 4
 3


Education policy partially achieves the criteria.
 2
 1

Education policy does not achieve the criteria at all.
Education Policy
7
Education policy remains a subject of heated debate in Sweden. Critics point to how Sweden has slipped in recent years in most international comparisons in terms of student knowledge and analytical skills. Sweden now ranks 19th on PISA (up from 32nd in the previous PISA report), which indicates that the decline appears to have been arrested. Even so, this remains an alarmingly poor ranking for a country relying on knowledge-intensive sectors for its economic growth and competitiveness. Some studies attribute the decline to the decentralization of primary education in the early 1990s; others argue that the teaching profession is not held in high enough regard within society and thus fails to attract highly qualified professionals; while yet others suggest that poor performance could in part be attributed to the fact that many teachers lack the formal qualifications needed to teach the subjects they are teaching. Promisingly, all three potential sources of deterioration in primary education are now on the policy agenda. Overall, it remains clear that Swedish schools continue to deliver high-quality education.

Critics also point to the high level of youth unemployment, which suggests that the education system fails to provide skills and knowledge demanded by the contemporary labor market. A final criticism is that the skills required to enter into a teachers’ education program at universities today are relatively low, hence there is very little competition to enter those programs. As a result, new teachers may have only a limited aptitude to teach successfully.

In its defense, the previous non-socialist government argued that it was extremely active in reforming education at all levels. The former government as well as the current red-green government have shown strong financial commitments to education. To improve the “fit” between education and the labor market, the current government announced to open alternative education programs that provide an avenue of learning other than to prepare for university studies. There are also plans, as mentioned earlier, to develop apprenticeship programs, which have proven successful in other countries like Germany. Finally, the previous government was committed to strengthening the competence and professionalization of teachers by, for example, reforming the university programs and introducing certification for teachers. The newly elected government intends to raise teachers’ salaries and also to increase the number of the staff present in schools. However, due to the current stalemate in parliament, it remains to be seen if the red-green government will be successful in reaching these ambitious goals.

A key means of assessing Sweden’s education policy involves looking at the extent to which the education system successfully provides a skilled labor force. High youth unemployment could be seen as an indicator of failure in this respect but could also be explained by the performance and the specific demand of the economy. Some education policy experts support a two-tier model where apprenticeships facilitate a smooth transition from work-related secondary education programs into employment in industry, and where students who seek to continue their education arrive at universities well-prepared. This model has not been entirely successful elsewhere, but that may be attributable to economic factors or labor market rigidities. Also, as mentioned earlier, the PISA results substantiate the problems in Sweden’s primary education to deliver good quality.

Concerning graduate output of secondary and tertiary education, Sweden’s performance in this respect could be seen as good but not great. Sweden is not as high in the rankings as its need for skilled and well-trained students to enter the research sector would require. Perhaps of greater concern is the combination of a relatively high ranking (11th) in tertiary attainment and poorer PISA ranking (19th), which suggests that institutions of tertiary education may be lowering the bar with respect to entry requirements.

A third and final way to assess Sweden’s education policy concerns equitable access to education. Education policy has performed rather well in this respect. Coming back to a previous point, if anything, the system is “too equitable” in that requirements to enter some programs in university are so low that basically anyone who applies is admitted, resulting in a “race to the bottom” in tertiary education standards. Nevertheless, equitable access to education is realized to a great extent for adult education. Sweden is rather successfully targeting the ambitious goals of life-long-learning as a high percentage of adults are regularly in contact with further education organizations.

In sum, the data shows that resources are not the key problem, and public debate shows no shortage of ideas and inclination to reform. In the spring of 2017, a major Royal Commission on education presented its findings and recommendations; these are likely to shape education policy in 2018. Education remains at the very top of the political agenda.

Citations:
SOU 2017: 35: Samling för skolan. Nationell strategi för kunskap och likvärdighet (http://www.regeringen.se/498092/contentassets/e94a1c61289142bfbcfdf54a44377507/samling-for-skolan—nationell-strategi-for-kunskap-och-likvardighet-sou-201735.pdf).

Social Inclusion

#3

To what extent does social policy prevent exclusion and decoupling from society?

10
 9

Policies very effectively enable societal inclusion and ensure equal opportunities.
 8
 7
 6


For the most part, policies enable societal inclusion effectively and ensure equal opportunities.
 5
 4
 3


For the most part, policies fail to prevent societal exclusion effectively and ensure equal opportunities.
 2
 1

Policies exacerbate unequal opportunities and exclusion from society.
Social Inclusion Policy
8
An analysis of Sweden’s social inclusion policy probably yields different results depending on whether it is conducted diachronically or synchronically. In the first approach, which observes Sweden over time, it is not difficult to see that social inclusion in some areas, particularly gender equality, works extremely well while other aspects of social inclusion are more problematic. Young people find it very difficult to find a job; large groups of immigrants are far from being integrated in Swedish society (see “integration policy”); poverty is low, but increasing; and the Gini coefficient measuring the distribution of wealth is still low but rapidly increasing. Thus, the empirical data point at significant problems in the areas of intergenerational justice and justice between native Swedes and immigrants.

If we compare Sweden with other countries, we find that recent developments challenge the country’s historical position as a leader in the public provision of welfare through wealth redistribution and as a country with extremely low levels of poverty. Together, the data and recent developments suggest that Sweden is gradually losing its leading role in these respects and is today largely at par with other European countries in terms of its poverty levels and income distribution. If Sweden could previously boast an egalitarian and inclusive society, there is less justification to do so today. Reflecting on the 2014 general elections, Bo Rothstein concludes that “the days of Swedish exceptionalism are over.” Not only does Sweden now have a strong anti-immigration party in its parliament, core data on Sweden’s welfare state are moving toward levels found among comparable, average-performing countries. It remains to be seen whether the current red-green government will be able to reverse this development.

Citations:
Kvist, Jon et al. (eds.) (2012), Changing Inequalities. The Nordic Countries and New Challenges (Bristol: Policy Press)

Pierre, Jon (ed) (2015), The Oxford Handbook of Swedish Politics (Oxford: Oxford University Press).

Rothstein, Bo (2014), “The End of Swedish Exceptionalism,” Foreign Affairs, September 18.

Health

#14

To what extent do health care policies provide high-quality, inclusive and cost-efficient health care?

10
 9

Health care policy achieves the criteria fully.
 8
 7
 6


Health care policy achieves the criteria largely.
 5
 4
 3


Health care policy achieves the criteria partly.
 2
 1

Health care policy does not achieve the criteria at all.
Health Policy
7
The health care system continues to be a problem area for Sweden, as is the case for most European countries. The media regularly reports on excessive waiting times in emergency rooms and scandals in long-term care, in which patients received sub-standard treatment. These weaknesses may be the consequence of far-reaching privatization measures during the most recent past. Another problem is that the administrative oversight of health care quality is weak.

The general account of Swedish health care is that once you receive it, it is good. The problem is access. Regional governments (“landsting”) provide health care, allocating about 90% of their budgets to this purpose. Health care is divided into primary care, which is delivered locally (albeit under the auspices of regional government), and advanced care, which is provided by the hospitals.

The key challenge, as pointed out in previous assessments, is a governance problem. Health care is driven by three contending sources: elected officials, the medical profession and the market. These three sources governing the health care system send different signals, make different priorities and allocate resources differently. This bureaucratic split at the top has the effect of reducing quality, inclusiveness and cost efficiency.

Partly as a result of these problems, a rapidly increasing number of people in Sweden purchase private health insurance. Estimates in 2015 suggest that more than 700,000 Swedes, or about 15% of the working population, have a private health insurance policy, either purchased privately or provided by the employer. The rapidly increasing number of private health insurance policies clearly suggests a lack of faith in the expediency and quality of public health care.

Specific assessments:

• The quality of advanced medical care is generally quite good. The care provided by hospitals draws on close access to research centers and is of high standard.

• Concerning inclusiveness, eligibility to health care is generously defined in Sweden. Instead, the big problem is the waiting time from diagnosis to treatment. The previous, non-socialist government introduced a “care guarantee,” (“vårdgaranti”) which entitles a patient to seeing a GP within 90 days. Evaluations suggest that the guarantee has somewhat improved the situation but also that a large number of patients still have to wait beyond the stipulated 90 days for treatment, or that patients are offered a brief consultation with a medical doctor, which means that the 90-day rule on service delivery is met.

• Properly assessing cost efficiency in the health care sector is extremely difficult. The medical profession advocates that evidence-based assessment of costs for treatment and medication are used to a greater extent than is presently the case, that is, costs should be related to expected patient utility.

Citations:
Socialstyrelsen (2012), Vårdgaranti och kömiljard – uppföljning 2009-2011 (Stockholm: Socialstyrelsen).

Kollega, 20 February 2014: “Sjukvård som förmån ökar” (http://www.kollega.se/sjukvard-som-forman-okar).

Dickinson, H. and J. Pierre (2016), “Between substance and governance: Healthcare governance and the limits to reform,” Journal of Health Organization and Management 30:1-9.

Families

#2

To what extent do family support policies enable women to combine parenting with participation in the labor market?

10
 9

Family support policies effectively enable women to combine parenting with employment.
 8
 7
 6


Family support policies provide some support for women who want to combine parenting and employment.
 5
 4
 3


Family support policies provide only few opportunities for women who want to combine parenting and employment.
 2
 1

Family support policies force most women to opt for either parenting or employment.
Family Policy
10
Sweden has been politically and economically committed to strong family policy for the past 50 years. Major features of Sweden’s policy have been the separation of spouses’ income and individual taxation, the expansion of public and private day care centers and a very generous parental leave program provided to both women and men, which has created much better possibilities to combine a professional career with parenthood. The parental leave program is expected to be expanded further, adding another month which can only be used by the father (a so-called “daddy-month”), thus incentivizing fathers to take more time off to engage in the care of their children.

The basic difference between the Social Democratic and Green parties in government and the non-socialist Alliance parties is that the former emphasize gender equality whereas the latter emphasize freedom of choice. Both constellations of parties are, however, fully committed to the overarching goals of family policy and see it as integral to promoting gender equality.

Citations:
Eydal, Guđný Björk/Rostgaard, Tine (eds.) (2015): Fatherhood in the Nordic Welfare States. Comparing Care Policies and Practice (Bristol: Policy Press).

Pierre, Jon (ed) (2015), Handbook of Swedish Politics (Oxford: Oxford University Press), esp. Section 1.

Pensions

#8

To what extent does pension policy realize goals of poverty prevention, intergenerational equity and fiscal sustainability?

10
 9

Pension policy achieves the objectives fully.
 8
 7
 6


Pension policy achieves the objectives largely.
 5
 4
 3


Pension policy achieves the objectives partly.
 2
 1

Pension policy does not achieve the objectives at all.
Pension Policy
8
Sweden’s pension system succeeds in preventing poverty among senior citizens, but those living only on the very basic pension have problems making ends meet. In fact, Sweden has twice as many pensioners living at or below the poverty line as in Denmark and three times as many as in Norway, two comparable Nordic countries. Pensioners living on a baseline pension with limited savings and no private pension insurance are, however, eligible for additional support from social welfare programs.

The stability of the pensions system was a problem for a long time but appears to have improved over the last several years, due to major reforms of the whole pension system in Sweden. One result of the pension reforms is a new public-private mix, strengthening capital funded occupational and private pension schemes. The distributional principles appear to be sound but the volatility of the stock market during the most recent past has meant a major source of uncertainty about how stable and sustainable the system will be in the future.

Lastly, in regard to equity in the system, the results are mixed. Ideally, a pension system ensures equity among pensioners, the active work force and the adolescent generation. If equity refers to basically similar living conditions, Sweden’s system fails in this respect. If equity however refers to a provision of baseline material goods related to needs, the performance of the system looks better. Some studies state that the new Swedish pension system does not undermine intergenerational equity, as long as the entry into the labor market for the adolescent generation is not blocked. Therefore, high and persistent youth unemployment rates threaten this aspect of equity in the long run.

In Sweden, you can retire as early as 61 years of age, but that will give you a rather low monthly pension. You may continue to work up until 67 years of age; an agreement between the Social Democrats and the conservatives to extend that rule to 69 years was reached in September 2016. In late 2017, a new agreement was reached between the government and most of the opposition parties to increase the retirement age to 69 years of age. The government is expected to introduce this proposal to the parliament (Riksdag) in 2018.

Citations:
OECD (2016), OECD Pensions Outlook 2016 (Paris: OECD).

OECD (2017), Pensions at a Glance (Paris: OECD).

Integration

#30

How effectively do policies support the integration of migrants into society?

10
 9

Cultural, education and social policies effectively support the integration of migrants into society.
 8
 7
 6


Cultural, education and social policies seek to integrate migrants into society, but have failed to do so effectively.
 5
 4
 3


Cultural, education and social policies do not focus on integrating migrants into society.
 2
 1

Cultural, education and social policies segregate migrant communities from the majority society.
Integration Policy
7
By most international comparisons, Sweden has a generous immigration policy. The country has received a large number of refugees from Iraq, Afghanistan, and Syria and, in 1992, from the former Yugoslavia. Indeed, there are individual local authorities (Södertälje) that have received more immigrants from Iraq than has the entire United States. In the European setting Sweden, together with Germany, stands out as one of the most immigration-friendly country.

As is the case across Europe, the war in Syria has triggered huge immigration to Sweden. In 2015 and 2016, Sweden received some 163,000 and 29,000 asylum-seekers respectively; for 2017, as of mid-November, the number is about 22,500. Permanent residency was granted to circa 120,000 refugees between 2015 and 2017. Sweden offers permanent residency for unaccompanied children and for Syrian families with children. These provisions, however, are highly disputed in contemporary public discourse and in the parliament.

The increasing immigration represents a major challenge, unprecedented in size and scope, to Swedish integration policy. These policies cover a wide range of measures, from language training to supportive labor market and housing policies. Most of the policies are implemented locally. Given the extensive autonomy of Swedish local governments, the instruments vary regionally. There are now political signals that local autonomy should no longer prevent individual local authorities from being requested by central government to receive asylum-seekers.

It is difficult to argue that integration policy in Sweden has been successful. In terms of both educational attainment and employment, immigrants in Sweden find it much more difficult to integrate than immigrants in comparable countries. This is not to say that there is a lack of political or economic commitment to integration policy. To the contrary, integration policy remains a very important policy sector and related political activities are far-reaching. The activities of the ombudsman and the minister for immigration and equality ensure that immigration issues have a high public salience.

Sweden’s lack of success in integrating immigrants, despite strong efforts, thus indicates that the problem lies in the design and implementation of its integration policies. It is possible that the same obstacles facing young people as they try to make their way into the labor market also discriminates against immigrants. The current surge in immigration in the wake of the Syrian crisis has exacerbated these problems. Whether this is a short-term phenomenon or a lasting situation remains to be seen.

There is some good news, however. Studies show that second generation immigrants, particularly girls, perform well in secondary and tertiary education. However, for immigrants with low education, entry into a labor market with high standards seems more or less blocked.

Citations:
Kvist, Jon et al. (eds.) (2012), Changing Inequalities. The Nordic Countries and New Challenges (Bristol: Policy Press).

Multiculturalism Policy Index (http://www.queensu.ca/mcp/).

Safe Living

#24

How effectively does internal security policy protect citizens against security risks?

10
 9

Internal security policy protects citizens against security risks very effectively.
 8
 7
 6


Internal security policy protects citizens against security risks more or less effectively.
 5
 4
 3


Internal security policy does not effectively protect citizens against security risks.
 2
 1

Internal security policy exacerbates the security risks.
Safe Living Conditions
7
The crime rate in Sweden is slightly higher than it is in comparable countries. Assessing the effectiveness of the internal security police is a complex undertaking. Sweden has experienced substantial problems with organized crime for a long time. Despite increased efforts to address this problem during the period of review, organized and/or gang-related crime shows no sign of waning, rather the opposite. Many media accounts of homicides and assaults relate these incidents to rivalry among competing organizations.

In terms of solving and preventing crime, there has been extensive debate about police effectiveness. Studies suggest that the police do not use their resources effectively and that only 2% of their working time is spent on actual crime prevention or resolution. These problems appear to have been exacerbated during the last couple of years: Sweden is falling in international rankings on the number of homicides, the percentage of crimes which have been resolved and brought to trial is decreasing, and media reports argue that gang-related violence in distressed suburbs and neighborhoods is rapidly increasing.

In 2015, regional police districts and core national staff were merged into one police authority. A recent evaluation conducted by the Swedish Agency for Public Management (Statskontoret 2017:10) found that the organizational reform has not improved performance and that the organization remains fragmented.

Both the red-green government and the opposition argue that recruiting more police officers is an important part of the response to this situation. There is also a growing understanding that some percentage of rising crime levels in metropolitan areas reflect a failure of integration programs.

An additional problem is related to the emphasis on performance measurement and management which, critics argue, has led the police to focus on high performance scores rather than crime prevention. Pre-emptive police work which may observers argued is the best way to prevent crime does not show up in performance measures. Also, given the performance targets some aspects of police work such as checking automobile drivers’ sobriety is conducted with almost more attention to getting the numbers in than actually bringing criminals to court.

The percentage of “smaller” crimes, particularly petty crimes such as theft and burglary that are solved is still lower than deemed acceptable by many Swedish citizens.

Citations:
Holgersson, S. and J. Knutsson (2012), Vad gör egentligen polisen? (Institutionen för ekonomisk och industriell utveckling. LIU-IEI-Research Report 12/0004. Linköping: Linköpings Universitet).

Statskontoret (2017), Ombildningen till en samlad polismyndighet – Delrapport 2 om den nya organisationens genomslag (Stockholm: Statskontoret).

Global Inequalities

#1

To what extent does the government demonstrate an active and coherent commitment to promoting equal socioeconomic opportunities in developing countries?

10
 9

The government actively and coherently engages in international efforts to promote equal socioeconomic opportunities in developing countries. It frequently demonstrates initiative and responsibility, and acts as an agenda-setter.
 8
 7
 6


The government actively engages in international efforts to promote equal socioeconomic opportunities in developing countries. However, some of its measures or policies lack coherence.
 5
 4
 3


The government shows limited engagement in international efforts to promote equal socioeconomic opportunities in developing countries. Many of its measures or policies lack coherence.
 2
 1

The government does not contribute (and often undermines) efforts to promote equal socioeconomic opportunities in developing countries.
Global Social Policy
10
Promoting global social justice is an overarching policy goal for Swedish governments regardless of their ideological orientation. Sweden combines bilateral strategies with an active involvement in multilateral efforts toward those objectives. Additionally, public spending for development issues is comparable high. There has been a gradual shift from conventional aid to developing countries, mainly sub-Saharan countries, toward aid directed at countries that are closer to Sweden. This involves, for instance, promoting democratization and civil society in Eastern Europe. There are growing concerns about the effectiveness and efficiency of some foreign aid programs and the risk of aid being used for unintended purposes by actors in the receiving country. That said, the commitment to international solidarity and aid to developing countries remains very strong.

The post-2014 red-green government has launched a campaign of “feminist foreign policy” which has gained international attention. International solidarity has a gender dimension, the argument goes, which has long been ignored. This foreign policy approach has been introduced in different international venues such as the UN and the EU. The new government has also become known for showing less tolerance than its predecessors with what it describes as “medieval” punishment techniques employed in Middle East countries, something which has caused some diplomatic friction. More broadly, the return of the Social Democrats to government has reenergized Swedish foreign policy. It has become more visible, but also more controversial.

Citations:
Pierre, Jon (ed) (2015), The Oxford Handbook of Swedish Politics (Oxford: Oxford University Press), esp. Section 7.
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