2023-06-212022/23:SoU15 · p.8SoUHealth & social services
Rural area subsidies
Rural subsidy for pharmacies
What's at stake: The subsidy affects which rural pharmacies can stay open and qualify for state support, with implications for medicine supply and access to pharmacy services outside major cities.
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 government should conduct a broad review of the rural subsidy scheme for pharmacies given rapid changes in the pharmacy market, or whether the current rules are considered sufficient.
Yes Yes — the committee proposal
The committee notes that there are regulations governing the subsidy for pharmacy services of general economic interest and concludes that there is no reason for the Riksdag to take any initiative toward a review of the rural subsidy scheme.
No No — the reservations
Reservation 12 (C, MP)
The dissenters argue that the number of rural pharmacies with sales revenue above SEK 10 million has grown since 2013 due to expensive medicines, making it harder for them to qualify for support, and want the government to review the rural subsidy scheme to more effectively support pharmacies.
Summarised from the committee report. Party labels in the summary come from the report, not from the vote.
What do the votes mean here?
Yes The committee proposal: rejecting the motions (keeping things as they are).
No Backing the counter-proposal: reservation 12 by C, 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.
| Plan | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | Yes 21/0/0/3 | departs from the plan | confidence: medium | derived |
| S | No | Yes 93/0/0/14 | departs from the plan | confidence: medium | not addressed |
| MP | No | No 0/15/0/3 | follows the plan | confidence: medium | not addressed |
| C | No | No 0/21/0/3 | follows the plan | confidence: medium | not addressed |
| L | No | Yes 14/0/0/2 | departs from the plan | confidence: medium | not addressed |
| KD | No | Yes 16/0/0/3 | departs from the plan | confidence: high | not addressed |
| M | No | Yes 60/0/0/8 | departs from the plan | confidence: low | not addressed |
| SD | No | Yes 63/0/0/9 | departs from the plan | confidence: medium | not addressed |
Committee proposal
Parliament rejects motion 2022/23:905 by Anders W Jonsson et al. (C) claim 79.
Original (Swedish)
Riksdagen avslår motion 2022/23:905 av Anders W Jonsson m.fl. (C) yrkande 79.
Riksdag decision: Parliament said no to approximately 50 proposals relating to dental care and medicines. The proposals were submitted during the general motion period 2022 and relate, among other things, to medicine use, pharmacies, access to medicines and dental care. Parliament rejects the motions and refers, among other things, to the fact that investigative work in the area is ongoing.
Counter-proposals
- The counter-proposal wants to prohibit authorized prescribers from prescribing narcotic-classified medications to themselves and to use real-time prescription data to prevent medication overuse. (C, MP) — Reservation 12
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.
The plan establishes that in large parts of Sweden it is difficult to access medicines while wealthy areas of cities have pharmacies on every street corner, and that privatisation has moved pharmacies from countryside to city.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan establishes that in large parts of Sweden it is difficult to access medicines while wealthy areas of cities have pharmacies on every street corner, and that privatisation has moved pharmacies from countryside to city. Welfare should be for everyone and exist everywhere. A review of rural support so that pharmacies in rural areas can be supported more effectively addresses this, although the plan's own solution goes further than subsidy rules.
Original (Swedish)
Planen slår fast att det i stora delar av Sverige är svårt att få tag på medicin medan storstädernas rika områden har apotek i varje gathörn, och att privatiseringarna flyttat apoteken från landsbygd till stad. Välfärden ska vara till för alla och finnas överallt. En översyn av glesbygdsstödet så att apotek i glesbygd kan stödjas effektivare svarar mot detta, även om planens eget svar går längre än bidragsregler.
- pharmacies throughout the countrydecisive»I stora delar av Sverige är det svårt att få tag på medicin, fast i storstädernas rikare områden finns det flera olika apotek i varje gathörn.« (2022 manifesto ↗)“In large parts of Sweden it is difficult to access medicines, while in wealthy areas of cities there are several different pharmacies on every street corner.”
- privatisation empties rural areas»Privatiseringar har lett till dyrare elpris, att apoteken flyttar från landsbygd till städer och från fattiga till rika områden« (2022 manifesto ↗)“Privatisation has led to more expensive electricity, pharmacies moving from countryside to cities and from poor to wealthy areas”
- welfare everywhere»Välfärden måste vara till för alla och finnas överallt.« (2022 manifesto ↗)“Welfare must be for everyone and exist everywhere.”
- equitable access»Sjukvården måste vara jämlik, jämställd och tillgänglig, oavsett var i landet du bor och oavsett vem du är.« (2022 manifesto ↗)“Healthcare must be equitable, equal and accessible, regardless of where in the country you live and regardless of who you are.”
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.
The plan's commitment is that the state shall be present throughout the country and that public service of high quality shall be guaranteed even where population base is weak, and the party programme requires equal access to care for all inhabitants throughout the country.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan's commitment is that the state shall be present throughout the country and that public service of high quality shall be guaranteed even where population base is weak, and the party programme requires equal access to care for all inhabitants throughout the country. A rural support that misfires when expensive medicines drive up revenues undermines this. A review of the support is therefore supported in substance.
Original (Swedish)
Planens åtagande är att staten ska finnas närvarande i hela landet och att offentlig service av hög kvalitet ska garanteras även där befolkningsunderlaget är svagt, och partiprogrammet kräver likvärdig tillgång till vård för alla invånare i hela landet. Ett glesbygdsstöd som slår fel när dyra läkemedel driver upp intäkterna undergräver detta. En översyn av stödet stöds därför i sak.
- service throughout the countrydecisive»Staten ska finnas närvarande i hela landet.« (2022 manifesto ↗)“The state shall be present throughout the country.”
- equal access to care»Alla invånare i hela landet ska ha likvärdig tillgång till skola, vård och omsorg.« (party programme ↗)“All inhabitants throughout the country shall have equal access to school, care and health care.”
- equalisation for weak population bases»För att säkra välfärden i hela landet behöver vi se över skatteutjämningssystemet, så att det garanterar offentlig service av hög kvalitet i hela landet, även i små kommuner som kämpar med sitt befolkningsunderlag.« (2022 manifesto ↗)“To secure welfare throughout the country we need to review the tax equalisation system, so that it guarantees public service of high quality throughout the country, even in small municipalities struggling with their population base.”
- the whole country shall live»Alla har ett gemensamt intresse av att hela landet kan leva och utvecklas.« (party programme ↗)“Everyone has a common interest in the whole country being able to live and develop.”
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.
The party programme states that public functions shall be available throughout the country and that the tax system shall provide equivalent economic conditions for social services throughout the country, and the election manifesto that one shall have the right to good healthcare regardless of where in the country one lives.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme states that public functions shall be available throughout the country and that the tax system shall provide equivalent economic conditions for social services throughout the country, and the election manifesto that one shall have the right to good healthcare regardless of where in the country one lives. If the support structure makes rural pharmacies fall out of support, that availability is hollowed out, so a review of rural support is supported. The plan does not take a position on the support's technical form.
Original (Swedish)
Partiprogrammet slår fast att samhällsfunktioner ska finnas tillgängliga över hela landet och att skattesystemet ska ge likvärdiga ekonomiska förutsättningar för samhällsservice i hela landet, och valmanifestet att man ska ha rätt till bra vård oavsett var i landet man bor. Om stödkonstruktionen gör att glesbygdsapotek faller ur stödet urholkas den tillgängligheten, varför en översyn av glesbygdsstödet stöds. Planen tar inte ställning till stödets tekniska utformning.
- public services throughout the countrydecisive»försäkringskassa ska vara till för Sveriges alla invånare och finnas tillgängliga över hela landet.« (party programme ↗)“insurance office shall be there for all Sweden's residents and be available throughout the country.”
- healthcare regardless of place of residence»Du ska ha rätt till en bra vård, oavsett var i landet du bor.« (2022 manifesto ↗)“You shall have the right to good healthcare, regardless of where in the country you live.”
- equivalent service throughout the country»Ett väl fungerande skattesystem ska ge likvärdiga ekonomiska förutsättningar« (party programme ↗)“A well-functioning tax system shall provide equivalent economic conditions”
The plan's core commitment is that public service shall be close and reliable throughout the country and that all residents shall have equivalent welfare regardless of where they live.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan's core commitment is that public service shall be close and reliable throughout the country and that all residents shall have equivalent welfare regardless of where they live. If the design of rural support causes rural pharmacies to fall out of that support, it counteracts precisely that commitment, which argues for a review. The plan does not mention pharmacy support, so the conclusion is derived.
Original (Swedish)
Planens bärande åtagande är att offentlig service ska vara nära och pålitlig i hela landet och att alla invånare ska ha en likvärdig välfärd oavsett var de bor. Om utformningen av glesbygdsstödet gör att apotek i glesbygd faller ur stödet motverkas just det åtagandet, vilket talar för en översyn. Planen nämner inte apoteksstödet, varför slutsatsen härleds.
- close service throughout the countrydecisive»Offentlig service ska vara nära och pålitlig i hela landet.« (2022 manifesto ↗)“Public service shall be close and reliable throughout the country.”
- equivalent welfare regardless of residence»Alla invånare ska ha tillgång till en likvärdig och pålitlig välfärd oavsett var de bor, och den offentliga servicen ska finnas där när man behöver den.« (2022 manifesto ↗)“All residents shall have access to equivalent and reliable welfare regardless of where they live, and public service shall be there when needed.”
- the whole country shall thrive»Alla ska kunna leva och förverkliga sina drömmar oavsett var man vill bo.« (party programme ↗)“Everyone shall be able to live and realize their dreams regardless of where they wish to live.”
- diversity of providers close to people»Vi vill försvara valfriheten inom vård och omsorg och bedriva verksamheten nära vårdtagarna.« (2022 manifesto ↗)“We want to defend freedom of choice in healthcare and conduct operations close to those receiving care.”
The plan stipulates that individuals regardless of residence have the right to equivalent quality in healthcare and that access to healthcare in sparsely populated parts of the country shall increase, as well as that public service shall be secured throughout the country.
Plan documents: party programme
Reasoning and quotes
The plan stipulates that individuals regardless of residence have the right to equivalent quality in healthcare and that access to healthcare in sparsely populated parts of the country shall increase, as well as that public service shall be secured throughout the country. A rural support scheme that works poorly so that pharmacies in rural areas cannot receive support undermines exactly that equivalence, which is why a review aligns with the plan's line. The structure of pharmacy support is not explicitly addressed.
Original (Swedish)
Planen slår fast att individer oavsett bostadsort har rätt till likvärdig kvalitet i vården och att tillgången till hälso- och sjukvård i landets glest befolkade delar ska öka, liksom att statlig service ska säkras i hela landet. Ett glesbygdsstöd som slår fel så att apotek i glesbygd inte kan få stöd underminerar just den likvärdigheten, varför en översyn ligger i planens linje. Apoteksstödets konstruktion behandlas inte uttryckligen.
- equivalent healthcare regardless of residencedecisive»Oavsett bostadsort har individer rätt att få likvärdig kvalitet på vården, omsorgen, socialtjänsten och andra« (party programme ↗)“Regardless of residence, individuals have the right to equivalent quality in healthcare, care, social services, and other”
- healthcare access in rural areas»sällsynta diagnoser och ökar tillgången till hälso- och sjukvård i landets glest befolkade delar.« (party programme ↗)“rare diagnoses and increases access to healthcare in sparsely populated parts of the country.”
- service throughout the country»Tillgången till statlig service ska säkras i hela landet.« (party programme ↗)“Access to public service shall be secured throughout the country.”
- equitable healthcare»Vården ska vara jämlik. Var och en har rätt till god vård och omsorg oavsett bakgrund, kön, ålder, ekonomi« (party programme ↗)“Healthcare shall be equitable. Everyone has the right to good healthcare and care regardless of background, gender, age, or economic circumstances”
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.
The manifesto explicitly promises to save rural trade by broadening operational support to grocery stores, which is the same kind of rural support now being questioned for pharmacies.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The manifesto explicitly promises to save rural trade by broadening operational support to grocery stores, which is the same kind of rural support now being questioned for pharmacies. The plan establishes that all shall have access to society's basic rights regardless of residence and that healthcare shall be equitable and accessible throughout the country. A review of rural support follows from this.
Original (Swedish)
Manifestet lovar uttryckligen att rädda lanthandeln genom att bredda driftstödet till dagligvarubutiker, vilket är samma slags glesbygdsstöd som nu ifrågasätts för apotek. Planen slår fast att alla ska få del av samhällets grundläggande rättigheter oavsett bostadsort och att vården ska vara jämlik och tillgänglig i hela landet. En översyn av glesbygdsstödet följer av detta.
- broadened operational support in rural areasdecisive»Rädda lanthandeln genom att bredda driftstödet till dagligvarubutiker.« (2022 manifesto ↗)“Save rural trade by broadening operational support to grocery stores.”
- service regardless of residence»Alla människor ska oavsett bostadsort kunna få del av« (party programme ↗)“All people regardless of residence shall be able to have access to”
- equitable care»Vården ska vara jämlik och tillgänglig för hela« (party programme ↗)“Healthcare shall be equitable and accessible for the whole”
- public service throughout the country»den statliga servicen är tillgänglig i hela Sverige.« (party programme ↗)“public services are accessible throughout Sweden.”
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.
The plan states that all of Sweden must function for people to be able to live and work in the whole country, and that welfare shall function regardless of where in the country you live.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan states that all of Sweden must function for people to be able to live and work in the whole country, and that welfare shall function regardless of where in the country you live. A review of rural support so that it more effectively supports pharmacies in rural areas is in line with that principle. However, the documents do not address pharmacy support, so the position is inferred.
Original (Swedish)
Planen slår fast att hela Sverige måste fungera för att man ska kunna bo och verka i hela landet, och att välfärden ska fungera oavsett var i landet man bor. En översyn av glesbygdsstödet så att det effektivare stödjer apotek i glesbygd ligger i linje med den principen. Dokumenten behandlar dock inte apoteksstödet, varför ställningstagandet är härlett.
- all of Sweden must functiondecisive»Moderaterna vill ta vara på hela Sveriges möjligheter. Men ska det gå att bo och verka i hela Sverige måste också hela Sverige fungera.« (2022 manifesto ↗)“The Moderate Party wants to make use of all of Sweden's possibilities. But for it to be possible to live and work in all of Sweden, all of Sweden must function.”
- equivalent welfare in the country»Du ska kunna känna dig trygg med att välfärden fungerar oavsett var i landet du bor.« (2022 manifesto ↗)“You shall be able to feel secure that welfare functions regardless of where in the country you live.”
- access to care»Medborgarna ska kunna förvänta sig tillgång till« (party programme ↗)“Citizens shall be able to expect access to”
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.
The election manifesto states that citizens have the right to expect good and accessible healthcare even outside major cities and criticizes that public services have been dismantled in rural areas.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto states that citizens have the right to expect good and accessible healthcare even outside major cities and criticizes that public services have been dismantled in rural areas. The party programme makes the principle that all of Sweden shall live central. To review rural support so that pharmacies in sparsely populated areas can actually get support serves therefore the plan's commitments on society services throughout the country.
Original (Swedish)
Valmanifestet slår fast att medborgare har rätt att förvänta sig en god och tillgänglig sjukvård även utanför storstäderna och kritiserar att offentlig service monterats ned på landsbygden. Principprogrammet gör principen att hela Sverige ska leva central. Att se över glesbygdsstödet så att apotek i glesbygd faktiskt kan få stöd tjänar därför planens åtaganden om samhällsservice i hela landet.
- accessible healthcare outside major citiesdecisive»Sverigedemokraterna anser att medborgare i ett högskatteland har rätt att förvänta sig en god och tillgänglig sjukvård, även utanför storstäderna.« (2022 manifesto ↗)“Sweden Democrats believe that citizens in a high-tax country have the right to expect good and accessible healthcare, even outside major cities.”
- dismantled services in rural areas»Skolresultaten har sjunkit, köerna till sjukvården har vuxit, polisen kommer allt mer sällan till den som utsatts för vardagsbrott och offentlig service har monterats ned på landsbygd och i stora delar av landet.« (2022 manifesto ↗)“School results have fallen, queues for healthcare have grown, the police come increasingly rarely to those who have been victims of everyday crime, and public services have been dismantled in rural areas and in large parts of the country.”
- all of Sweden shall live»Principen om att hela Sverige skall leva är mycket viktig för Sverigedemokraterna.« (party programme ↗)“The principle that all of Sweden shall live is very important to Sweden Democrats.”
- policy for the whole country»Bedriva en politik för hela Sverige« (2022 manifesto ↗)“Pursue a policy for all of Sweden”
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
- The committee report on riksdagen.se (2022/23:SoU15)
- Committee report full text (HA01SoU15)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2022/23:1031 — Stärkt epilepsivård av Lars Mejern Larsson (S)
- Motion 2022/23:1141 — En tillgänglig sjukvård i världsklass av Linda Lindberg m.fl. (SD)
- Motion 2022/23:1229 — En förbättrad och jämlik barnhälsa av Karin Rågsjö m.fl. (V)
- Motion 2022/23:1292 — Demokratisk kontroll för jämlik tandvård av Sanna Backeskog m.fl. (S)
- Motion 2022/23:1377 — Högkostnadsskydd inom tandvården av Linnéa Wickman m.fl. (S)
- Motion 2022/23:143 — Tandvård för alla av Niklas Karlsson (S)
- Motion 2022/23:1486 — Uppdrag åt TLV att fortsätta förhandla om läkemedelsföretagens prissättning av Heléne Björklund och Adnan Dibrani (båda S)
- Motion 2022/23:153 — Jämlik tandvård av Hanna Westerén (S)
- Motion 2022/23:1636 — Fler beredningsformer för cytostatika av Martina Johansson (C)
- Motion 2022/23:1714 — Regelverket kring bolagskoncerner vid ägande av appläkartjänster, apotek och vårdcentraler av Johan Löfstrand m.fl. (S)
- Motion 2022/23:1742 — Tänderna är en del av kroppen av Laila Naraghi (S)
- Motion 2022/23:1846 — Tandvårdskostnader för asylsökande och tillfälliga besökare av Sten Bergheden (M)
- Motion 2022/23:1848 — Sjukvård och tandvård för alla av Sten Bergheden (M)
- Motion 2022/23:2047 — Evidensbaserad vård saknas för barn och unga vuxna som får diagnosen könsdysfori av Mikael Oscarsson (KD)
- Motion 2022/23:2061 — Utgiftsområde 9 Hälsovård, sjukvård och social omsorg av Fredrik Lundh Sammeli m.fl. (S)
- Motion 2022/23:2089 — Sexuell och reproduktiv hälsa och rättigheter för alla av Ulrika Westerlund m.fl. (MP)
- Motion 2022/23:2276 — Korsägande mellan apotek och förskrivare av Nicklas Attefjord (MP)
- Motion 2022/23:286 — Insyn i barns läkemedelslista av Ann-Christine From Utterstedt (SD)
- Motion 2022/23:311 — Läkemedelsförmånen och kommitté mot bristande läkemedelshantering av Markus Wiechel (SD)
- Motion 2022/23:312 — Vaccinationsfrågor av Markus Wiechel (SD)
Source: The Swedish Parliament