2023-05-032022/23:SoU14 · p.10SoUHealth & social services

Marketing of healthcare services

Regulating how digital healthcare providers market their services

What's at stake: Digital healthcare providers that market themselves aggressively can attract more patients, but can also sharply drive up costs for regions, since a patient's home region has to pay for care delivered by providers based elsewhere. How marketing may be designed therefore affects both patients' choice of care and regions' finances.

Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.

What the vote decides

The question is whether the marketing of healthcare services - particularly by digital providers operating across region boundaries - should be regulated through stricter legislation and a ban on aggressive advertising, or whether the current arrangement without specific marketing regulation should remain.

Yes Yes — the committee proposal

The committee rejects the call for specific regulation of healthcare marketing. Instead, it points to the ongoing work on a more uniform, national digital healthcare infrastructure, common standards, and easily accessible information on quality and waiting times, and judges that this work - rather than new marketing legislation - is the right way to strengthen the patient's position.

No No — the reservations

Reservation 22 (S, V, MP)

The reservation (S, V, MP) calls for stricter legislation on the marketing of healthcare, requiring moderation and banning aggressive advertising. The reasoning is that digital providers operating across region boundaries have used marketing in new ways to attract patients, which has increased access for some but sharply driven up costs for a number of regions - and that healthcare should not be marketed like any other service.

Summarised from the committee report. Party labels in the summary come from the report, not from the vote.

VSMPCLKDMSD
YesNoAbstainAbsent

What do the votes mean here?

Yes The committee proposal: rejecting the motions (keeping things as they are).

No Backing the counter-proposal: reservation 22 by S, V, MP.

Abstain The party marks a position of its own that is not one of the two final alternatives.

What each plan points to — and how the party voted

For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.

PlanVoteConfidenceEvidence
Vown reservationNoNo 0/20/0/4follows the planconfidence: highnot addressed
Sown reservationNoNo 0/94/0/13follows the planconfidence: highnot addressed
MPown reservationNoNo 0/14/0/4follows the planconfidence: highnot addressed
CYesYes 21/0/0/3follows the planconfidence: mediumderived
LYesYes 13/0/0/3follows the planconfidence: mediumderived
KDNoYes 16/0/0/3departs from the planconfidence: mediumderived
MYesYes 60/0/0/8follows the planconfidence: mediumderived
SDNoYes 63/0/0/9departs from the planconfidence: lownot addressed

Committee proposal

Parliament rejects the motions 2022/23:1566 by Zara Leghissa et al. (S), 2022/23:1725 by Johan Löfstrand et al. (S), and 2022/23:2061 by Fredrik Lundh Sammeli et al. (S) item 14.

Original (Swedish)

Riksdagen avslår motionerna 2022/23:1566 av Zara Leghissa m.fl. (S), 2022/23:1725 av Johan Löfstrand m.fl. (S) och 2022/23:2061 av Fredrik Lundh Sammeli m.fl. (S) yrkande 14.

Riksdag decision: Parliament said no to approximately 110 proposals in motions submitted during the general motion period of 2022 and refers mainly to ongoing work. Some of the proposals concern skills provision in healthcare, patients exposed to violence, register checks, working environment and working conditions, as well as licenses and permits. Other proposals concern digital infrastructure and health data, development of 1177 (healthcare information service) and healthcare preparedness.

Counter-proposals

Plan vs actual vote

Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.

VVänsterpartietNoNofollows the plannot addressed

The plan states that welfare shall be a refuge from commercialized relations and explicitly criticizes that resources are drawn to telemedicine services that attract healthy patients instead of those with major care needs.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan states that welfare shall be a refuge from commercialized relations and explicitly criticizes that resources are drawn to telemedicine services that attract healthy patients instead of those with major care needs. Care shall be provided according to need, not according to market logic, and companies' marketing is entering more and more arenas. Stricter rules for marketing of care services therefore follow from the plan.

Original (Swedish)

Planen slår fast att välfärden ska vara en fristad från kommersialiserade relationer och kritiserar uttryckligen att resurser dras till nätläkartjänster som lockar friska patienter i stället för till dem med stora vårdbehov. Vård ska ges efter behov, inte efter marknadens logik, och företagens marknadsföring tar sig in på allt fler arenor. Strängare regler för marknadsföring av vårdtjänster följer därför av planen.

  • care resources according to needdecisive»Det är inte acceptabelt att stora resurser, som behövs till människor med komplext eller långvarigt behov av vård istället går till nätläkartjänster för att behandla vanlig snuva och andra mindre åkommor hos friska människor.« (2022 manifesto ↗)“It is not acceptable that large resources, which are needed for people with complex or long-term care needs, instead go to telemedicine services to treat ordinary colds and other minor ailments in healthy people.”
  • decommercalized welfare»Välfärden ska kunna vara en fristad från kommersialiserade relationer.« (party programme ↗)“Welfare shall be able to be a refuge from commercialized relations.”
  • limit marketing's power»att de stora företagen och deras intressen tar sig in på allt fler arenor.« (party programme ↗)“that large companies and their interests are entering more and more arenas.”
  • needs-based care»Vård måste ges efter människors behov och inte efter kapaciteten i felaktigt konstruerade system.« (2022 manifesto ↗)“Care must be provided according to people's needs and not according to the capacity in incorrectly constructed systems.”
SSocialdemokraternaNoNofollows the plannot addressed

The party programme's core principle is that access to healthcare shall never be determined by market price mechanisms, and the election manifesto opposes the drive to make money being put before those whom welfare is meant to serve.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The party programme's core principle is that access to healthcare shall never be determined by market price mechanisms, and the election manifesto opposes the drive to make money being put before those whom welfare is meant to serve. The plan also rejects the idea that private insurance provides faster healthcare in publicly financed healthcare. Stricter rules on moderation and prohibition of aggressive marketing of healthcare services therefore align with the plan's direction, even though marketing rules are not mentioned.

Original (Swedish)

Partiprogrammets bärande princip är att tillgången till vård aldrig får avgöras av marknadens prismekanismer, och valmanifestet vänder sig mot att drivkraften att tjäna pengar sätts före dem välfärden är till för. Planen avvisar också att privata försäkringar ger snabbare vård i den offentligfinansierade vården. Strängare regler om måttfullhet och förbud mot aggressiv marknadsföring av vårdtjänster ligger därför i planens riktning, även om marknadsföringsregler inte nämns.

  • healthcare is not a marketdecisive»Tillgången till skola, vård och omsorg får aldrig« (party programme ↗)“Access to school, healthcare and care shall never”
  • patient before profit motive»Drivkraften att tjäna pengar har fått stå i centrum, istället för dem välfärden är till för.« (2022 manifesto ↗)“The drive to make money has been put at the centre, instead of those whom welfare is meant to serve.”
  • healthcare according to need»Den som har en privat sjukvårdsförsäkring ska inte kunna få bättre eller snabbare hjälp i den offentligfinansierade vården.« (2022 manifesto ↗)“Those with private healthcare insurance shall not be able to get better or faster help in publicly financed healthcare.”
MPMiljöpartietNoNofollows the plannot addressed

The plan's decisive commitment is that welfare services shall not be treated as any ordinary market and that healthcare shall be distributed according to need.

Plan documents: party programme

Reasoning and quotes

The plan's decisive commitment is that welfare services shall not be treated as any ordinary market and that healthcare shall be distributed according to need. The plan furthermore wants to limit the spread of advertising and takes seriously that profit interests control healthcare at patients' expense. Stricter requirements for moderation and prohibition of aggressive marketing of healthcare services therefore follow from the plan.

Original (Swedish)

Planens avgörande åtagande är att välfärdens verksamheter inte får hanteras som vilken marknad som helst och att vården ska fördelas efter behov. Planen vill dessutom begränsa reklamens utbredning och tar allvarligt på att vinstintresset styr vård på patienternas bekostnad. Strängare krav på måttfullhet och förbud mot aggressiv marknadsföring av vårdtjänster följer därför av planen.

  • healthcare is not an ordinary marketdecisive»Välfärdens verksamheter får inte hanteras som vilken marknad som helst.« (party programme ↗)“Welfare services shall not be treated as any ordinary market.”
  • care according to need»kvalitet, vara tillgänglig, fördelas efter behov och« (party programme ↗)“quality, be accessible, be distributed according to need and”
  • limit advertising»Vi vill begränsa reklamens utbredning, särskilt bland barn och unga.« (party programme ↗)“We want to limit the spread of advertising, especially among children and young people.”
  • profit interests harm patients»vinstintresset leder till besparingar som drabbat« (party programme ↗)“profit interests lead to savings that have affected”
CCenterpartietYesYesfollows the planderived

The plan explicitly wants to defend choice in healthcare and care and open up for more care providers so the patient can choose care provider and time.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan explicitly wants to defend choice in healthcare and care and open up for more care providers so the patient can choose care provider and time. Stricter marketing legislation with temperance requirements limits precisely the competition and information that choice is built on. The plan's principle is that choice adapts publicly financed welfare to the individual's needs.

Original (Swedish)

Planen vill uttryckligen försvara valfriheten i vård och omsorg och öppna upp för fler vårdgivare så att patienten kan välja vårdgivare och tid. En strängare marknadsföringslagstiftning med måttfullhetskrav begränsar just den konkurrens och information som valfriheten bygger på. Planens princip är att valfriheten anpassar den offentligt finansierade välfärden till individens behov.

  • defended choice in healthcaredecisive»Vi vill försvara valfriheten inom vård och omsorg och bedriva verksamheten nära vårdtagarna.« (2022 manifesto ↗)“We want to defend choice in healthcare and care and conduct activities close to those receiving care.”
  • more care providers»Vi vill öppna upp för fler vårdgivare och öka valfriheten« (2022 manifesto ↗)“We want to open up for more care providers and increase choice”
  • choice drives welfare»Människors rätt till valfrihet är det som ska trygga att den offentligt finansierade välfärden anpassas till individens behov.« (party programme ↗)“People's right to choice is what shall ensure that publicly financed welfare is adapted to the individual's needs.”
LLiberalernaYesYesfollows the planderived

The plan builds healthcare on patient choice and requires a digital choice reform where online medicine is here to stay and where private and public providers operate on equal terms.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan builds healthcare on patient choice and requires a digital choice reform where online medicine is here to stay and where private and public providers operate on equal terms. A stricter marketing law with requirements for moderation limits the information spread that the plan instead wants to develop through comparable patient information online. The plan therefore speaks against the counter-proposal's demands.

Original (Swedish)

Planen bygger vården på patientens val och kräver en digital valfrihetsreform där nätläkare är här för att stanna och där privata och offentliga utförare verkar på lika villkor. En strängare marknadsföringslag med krav på måttfullhet begränsar den informationsspridning som planen i stället vill utveckla via jämförbar patientinformation på nätet. Planen talar därför mot motförslagets krav.

  • digital choice reformdecisive»Vi vill se en digital valfrihetsreform och vårdgaranti där alla regioner ska åläggas att erbjuda en minst lika bra digital tillgänglighet som fysisk, där du utifrån din situation alltid ska välja hur du vill möta vården.« (2022 manifesto ↗)“We want to see a digital choice reform and care guarantee where all regions shall be required to offer at least equally good digital accessibility as physical, where you based on your situation shall always choose how you want to meet healthcare.”
  • comparable patient information»Patientinformationen ska utvecklas och vara tillgänglig via nätet så att det blir enklare att göra jämförelser« (party programme ↗)“Patient information shall be developed and be accessible online so that it becomes easier to make comparisons”
  • equal terms for providers»Privata och offentliga utförare ska verka på lika villkor och ska omfattas av samma ersättningsregler och« (party programme ↗)“Private and public providers shall operate on equal terms and shall be covered by the same reimbursement rules and”
  • digital care shall continue»Nätläkaren är här för att stanna.« (2022 manifesto ↗)“Online medicine is here to stay.”
KDKristdemokraternaNoYesdeparts from the planderived

The plan states that solidaristically financed care is the core of welfare and shall be needs-based, and that demand-driven care violates the human dignity principle.

Plan documents: party programme

Reasoning and quotes

The plan states that solidaristically financed care is the core of welfare and shall be needs-based, and that demand-driven care violates the human dignity principle. Aggressive marketing methods shall be prevented and moderation is a core virtue, which directly supports the counter-proposal's requirement for moderation and ban on aggressive healthcare advertising. The plan's freedom of choice for the patient limits how far regulation can go.

Original (Swedish)

Planen slår fast att den solidariskt finansierade vården är välfärdens kärna och ska vara behovsstyrd, och att en efterfrågestyrd vård bryter mot människovärdesprincipen. Aggressiva marknadsföringsmetoder ska motverkas och måttfullhet är en bärande dygd, vilket direkt bär motförslagets krav på måttfullhet och förbud mot aggressiv vårdreklam. Planens valfrihet för patienten begränsar hur långt regleringen kan gå.

  • needs-based caredecisive»hälso- och sjukvården är välfärdens kärna och ska vara behovsstyrd« (party programme ↗)“health and medical care is the core of welfare and shall be needs-based”
  • aggressive marketing prevented»aggressiva marknadsföringsmetoder ska motverkas« (party programme ↗)“aggressive marketing methods shall be prevented”
  • moderation as a virtue»Måttfullhet innebär att förnuftet bör råda över alltför vidlyftiga« (party programme ↗)“Moderation means that reason should prevail over excessive”
  • freedom of choice in care»Medborgarna ska ges frihet att själva välja vårdgivare.« (party programme ↗)“Citizens shall be given freedom to themselves choose healthcare provider.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MModeraternaYesYesfollows the planderived

For the plan, choice is a central part of the welfare model and a diversity of providers a prerequisite for renewal.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

For the plan, choice is a central part of the welfare model and a diversity of providers a prerequisite for renewal. The plan's answer to queues and unequal accessibility is strengthened care guarantee and a national care mediator that directs patients to free capacity, not restrictions on how providers can inform patients. Stricter marketing legislation with proportionality demands would counter the patient mobility the plan is built on.

Original (Swedish)

För planen är valfrihet en central del av välfärdsmodellen och en mångfald av vårdgivare en förutsättning för förnyelse. Planens svar på köer och ojämlik tillgänglighet är förstärkt vårdgaranti och en nationell vårdförmedling som styr patienter till ledig kapacitet, inte begränsningar av hur vårdgivare får informera patienter. En strängare marknadsföringslag med måttfullhetskrav skulle motverka den patientrörlighet planen bygger på.

  • choice in welfaredecisive»För Moderaterna är valfrihet en central del av den svenska« (party programme ↗)“For the Moderate Party, choice is a central part of the Swedish”
  • diversity of providers»En mångfald av aktörer är också en förutsättning för förnyelse och innovation.« (party programme ↗)“A diversity of actors is also a prerequisite for renewal and innovation.”
  • right to choose another provider»Införa en förstärkt vårdgaranti för cancerpatienter« (2022 manifesto ↗)“Introduce a strengthened care guarantee for cancer patients”
  • patient mobility across region borders»Inrätta en nationell vårdförmedling som ska hjälpa patienter med lång väntetid att få vård i en annan del av landet där det finns ledig kapacitet« (2022 manifesto ↗)“Establish a national care mediator that shall help patients with long waiting times to get care in another part of the country where there is free capacity”
SDSverigedemokraternaNoYesdeparts from the plannot addressed

The plan says nothing about marketing of care services.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan says nothing about marketing of care services. The closest lying commitments are that public funds should be directed to the welfare core and that citizens have the right to good and accessible care on equal terms throughout the country. To require moderation and prohibit aggressive healthcare advertising, which drives up costs, aligns with these principles.

Original (Swedish)

Planen säger inget om marknadsföring av vårdtjänster. Närmast liggande åtaganden är att offentliga medel ska riktas till välfärdens kärna och att medborgarna har rätt till god och tillgänglig vård på likvärdiga villkor i hela landet. Att kräva måttfullhet och förbjuda aggressiv vårdreklam, som driver upp kostnaderna, ligger i linje med dessa principer.

  • funds to the welfare coredecisive»Se över offentliga utgifter och rikta om medel till välfärden och rättsväsendet« (2022 manifesto ↗)“Review public expenditures and redirect funds to welfare and the justice system”
  • accessible care throughout the country»Sverigedemokraterna anser att medborgare i ett högskatteland har rätt att förvänta sig en god och tillgänglig sjukvård, även utanför storstäderna.« (2022 manifesto ↗)“The Sweden Democrats believe that citizens in a high-tax country have the right to expect good and accessible healthcare, even outside the major cities.”
  • equal care»Alla människor ska bemötas likvärdigt i landstingens och regionernas verksamheter.« (party programme ↗)“All people shall be treated equally in county councils' and regions' activities.”
  • care according to need»Avskaffa vårdköerna och införa en riktig vårdgaranti« (2022 manifesto ↗)“Abolish waiting times for care and introduce a genuine care guarantee”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

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Sources and documents

Documents under consideration

Source: The Swedish Parliament