Health insurance On the first of March this year, the government inquiry “Health insurance in change – an evaluation” will be presented. Dagens Arena can already tell you that the investigators will aim to repeal the changes made in 2020-2022 and return to more restrictive rules.
In 2020 – 2022, a number of changes were made to health insurance. For example, the sharp limit at 180 days was softened and when taking out insurance, the administrator had to give a concrete example of what work the person on sick leave can work on.
In 2022, the then government appointed a state inquiry that would evaluate how these changes have worked. But when there was a change of government, the inquiry’s directives were changed and a new investigator was appointed in 2023. Instead of an evaluation of the new regulations, the focus would be on investigating how many return to work and how long it takes.
According to Dagens Arena’s sources, the investigation will make proposals aimed at returning the health insurance system largely to the 2019 regulations. Dagens Arena has also taken part in an internal presentation made by the investigators, where they share their preliminary assessments, among other things. The presentation is from December 2023 and it states that the investigators want most of the changes implemented to be removed.
A person Dagens Arena spoke to, who has insight into the health insurance system and the investigation, believes that the proposals are worrying because the old system did not work.
– The aim of getting people back to work did not work. They became poor instead and had to try to find other ways to support themselves.
Health insurance changes
For the past 15 years, the processing of health insurance has been largely governed by something called the rehabilitation chain. This means that it becomes more difficult to get compensation the longer you have been sick. The holding points are 30 days, 90 days and 180 days. This model led to many getting out-insured at the 180-day mark. Something that, according to critics, took place on a loose basis. This when the sick person’s ability to work was compared to “normally occurring work”. What that work would be did not need to be specified.
In 2020-2022, after much criticism of how the health insurance system looked, changes were made to the legislation. As of the changes, it was necessary to specify in the refusal which work the person previously on sick leave could take. This, combined with making it easier to get the tougher assessment at 180 days postponed, has meant that the number of rejections at the 180-day limit has dropped drastically.
– It is one thing to ask how many are on sick leave in Sweden and another to ask how many are sick or able to work. Because it is not certain that the groups overlap, there may be lots of people who are very ill without being on sick leave. The gap between the groups risks getting bigger if the system becomes less flexible again, says a person Dagens Arena spoke to who worked for a long time with health insurance issues.
Another view on the health insurance issue
The change of investigator has also contributed to the investigation’s new direction. Robert Sjunnebo, the first investigator appointed by the then Minister of Social Affairs, has previously worked with health insurance at LO-TCO Legal Protection and pronounced positively about a more “generous” health insurance. When a new special investigator was appointed, the accountant Per Johansson was hired. He has had a different stance on the health insurance issue than Sjunnebo. Johansson means that it shouldn’t pay to not work and is in favor of a more “restrictive” health insurance.
It is not unusual for a special investigator to have a previously known opinion on the issue they are investigating. Especially in matters that can be considered “hot” politically. That’s according to one of the people with access to the investigation that Dagens Arena spoke to.
– In the past, it was more common for it to be an investigation group, which made it more time-consuming but perhaps also more objective.
Dagens Arena has spoken to several people with insight into the investigation who believe that the investigation after the change of special investigator has been handled poorly. There has been a bad atmosphere, but above all, those leading the investigation should not have taken outside opinions or wanted to cooperate with the reference group.
Lack of rehabilitation
But the new investigators don’t want to change everything. One thing they want to keep is the possibility for the elderly to get sick pay more easily. Something that was introduced to counteract the trend of many taking early retirement, when sickness benefits were difficult to obtain.
A person with insight into the health insurance issue that Dagens Arena has been in contact with believes that it is likely that the government will include the proposed changes in the next budget. The reason in such cases would be that the decision would go more unnoticed than if it was presented as an individual proposal.
Overall, the people Dagens Arena spoke to are critical of how the health insurance system works today. They generally believe that the changes made by the previous government were positive, but that more comprehensive changes should be implemented.
Can become part of the budget
One of the people Dagens Arena spoke to says that the idea with the rehabilitation chain was that it would include rehabilitation in the process. Instead, it was almost exclusively about talking to employers about when the person on sick leave could return to work. But with the changes implemented in 2020-2022, more focus has been placed on rehabilitation. Now the person fears that the more active processing will disappear and that those on sick leave will end up in the same situation as before the changes were implemented.
– Those on sick leave have had to take full responsibility for their own rehabilitation. A study from 2018 showed that a third of those who were insured were sick again after one year. Then you have missed rehabilitating the person.
