The state spends around eight billion kronor this year on dental care subsidies. When the subsidy was introduced in 2008, the idea was that it would limit costs for patients. But because dentists have raised prices, some of the subsidy has ended up with them. The higher the state subsidy has been, the more healthcare providers seem to raise their prices, according to the review.
The support is based on the person who goes to the dentist comparing and questioning prices themselves. But that's not how it works.
A fifth of patients are not aware that prices can vary, says Filippa Hagersten at the National Audit Office, who led the review.
The situation is made worse by the fact that healthcare providers rarely fulfill their obligations to inform patients about price differences. It is possible to go to tandpriskollen.se and compare clinics, but few people know about it.
Confirming the problems
This confirms what we have seen ourselves and which has been guiding us when we designed the new dental care reform for everyone over the age of 67, says Minister of Social Affairs Jakob Forssmed (KD) about the report.
The dental care reform that comes into effect after the New Year means that prices will be regulated for those over 67, while a 90 percent subsidy will be introduced.
But the problems are not over. We must continue to work on more steps in the dental care reform, says Forssmed.
Changes will be required for people under 67 years of age as well.
Another consequence of the design of dental care support is, according to the National Audit Office, that certain procedures, such as extracting a tooth and replacing it with an implant, have increased significantly over the last ten years.
Keep an eye on
One reason for this is likely that dentists receive more compensation for it, even though from a dental perspective it is often better to keep the tooth and have it filled. But it gives less compensation, explains Filippa Hagersten.
The Minister of Social Affairs points out that the Riksdag recently hammered out the government's proposal for increased control over the dental care sector, which makes it easier to suspend and terminate clinics' licenses and which makes it easier for authorities to exchange information when errors are committed.
It's something we need to review and keep an eye on, says Forssmed.
–Control over the dental care sector will increase because unfortunately there are many examples of errors, even though Swedish dental care is generally very good.
To the government:
Take initiatives to strengthen the patient's position in the dental care market. Responsibility for patient information should be concentrated under one authority. Consider introducing a patient survey and regulating so that all dental care providers are obliged to join the complaints function.
Ensure that dental care support benefits patients to a greater extent and that the subsidy more effectively stimulates preventive dental care.
Take the initiative for a regulation that requires the industry to report the information to the Dental and Pharmaceutical Benefits Agency (TLV) that they need to calculate reference prices.
Dismantle the Board for State Dental Support and move decisions to the Director General of TLV.
To the Swedish Consumer Agency:
Work to specify in the industry agreement with the Private Dentists Association how much the price may deviate from a previously stated approximate price.
