Healthcare in Iceland

Iceland has universal healthcare. The healthcare system is largely paid for by taxes (85%) and to some extent by service fees (15%) and is administrated by the Ministry of Welfare. A considerable portion of government spending is assigned to health care. There is almost no private health insurance in Iceland and no private hospitals.[1]

Healthcare providers in Iceland fall into one of the following legally defined categories of healthcare providers:

  • Healthcare Clinics (Icelandic: heilsugæslur)
  • Health Institutions (Icelandic: heilbrigðisstofnanir)
  • University Hospitals (Icelandic: háskólasjúkrahús)
  • Teaching Hospitals (Icelandic: kennslusjúkrahús)

Financing and funding

Health care system in Iceland relies on general taxation, instead of local funding. This is affected by the Nordic welfare state model, in which public service is heavily funded through taxation to support the general public, in order for the population to have equal access to health care and welfare system.[2] Although local authorities have limited influence over the national health care system, Iceland has recently adapted to similar structures to other Nordic countries, implementing decentralized structure by dividing the country into seven local health care regions.[3] The health care regions were implemented to promote cooperations between institutions, and to provide quality care through regional provisions. However, this has not affected the financial responsibility of the central government. Although health care is usually funded through taxation, some out-of-pocket expenses are still required, such as service fees.[3] Iceland does not operate its health care system based on financial need, but some disadvantaged groups, including disabled and elders, generally receive discounts on personal health expenses.[4]

As of recently, out-of-pocket expenditure has increased significantly, resulted in approximately 76% increase in private expenditure from 1995 to 2010. By 2011, Iceland's out-of-pocket payments have become an important financial source for the universal health care system, which made up 18.2% of total health expenditures.[5] The general population, however, still showed overwhelming support for governmental funding and providing the health care system at the same time. Through a research survey conducted in 2013 focused on Icelandic adults, in which 94% of the respondents want the government to spend more on public health care, and 81% of the respondents prefer and supports primary health care to be provided by the government.[6] Although the government aimed to provide easy and accessible health care to all population regardless of income and social status, there are still some problems faced due to benefits given to disadvantaged groups. Some people without additional help face postponement or even cancellation to medical treatment.[7]

Health care services

Primary care

Health centers that provide primary health care are located throughout the country, while some runs along smaller institutes and hospitals, all are funded and administered by central government.[8] In accordance with the 1973 Health Care Act, which established universal primary health care and increase the amount of health personnel and institutes in the country, all patients are required to register and access through a primary care center and a general practitioner of their choice.[9] Specialist services are provided mainly by general practitioners, privately operated or publicly funded.

Hospital services

There are a total of 6 regional hospitals and 16 health institutions throughout the country, funded through fixed global budgets. The main hospital is located in Reykjavik. Most hospital professionals and doctors are salaried employees, and are paid through hospital budgets. Doctors can also see private patients outside of the hospitals if they receive 80 percent of less.[9]

Long-term care

Long-term care can be accessed through institutions or at home. These includes personal assistance and domestic care, including nursing homes or child care. These services are provided by either private institutes or public services, and are funded through national budgets.[9] Part-time and home-based child care are payable but subsidized, priority are given to special interest groups.[10]

Medical training

Iceland does not have its own specialist medical training system, so Icelandic doctors typically spend 8 or 10 years working abroad before returning to the country. They often use the relationship established in training for ongoing support.[11]

Healthcare districts
The regions of Iceland. 5 and 6 correspond to the Northern District

The country is divided into 7 healthcare districts which correspond to the 8 regions of Iceland with the exception of the Northwestern Region and the Northeastern Region which are a single healthcare district.

  • Capital Region Healthcare District (Icelandic: Heilbrigðisumdæmi höfuðborgarsvæðisins)
  • Western Region Healthcare District (Icelandic: Heilbrigðisumdæmi Vesturlands)
  • Westfjords Healthcare District (Icelandic: Heilbrigðisumdæmi Vestfjarða)
  • Northern Healthcare District (Icelandic: Heilbrigðisumdæmi Norðurlands)
  • Eastern Region Healthcare District (Icelandic: Heilbrigðisumdæmi Austurlands)
  • Southern Region Healthcare District (Icelandic: Heilbrigðisumdæmi Suðurlands)
  • Southern Peninsula Healthcare District (Icelandic: Heilbrigðisumdæmi Suðurnesja)

List of hospitals

There are two hospitals in Iceland, both of which are general and specialised.

Name (English) Name (Icelandic) Founded Type Healthcare district Municipality
National University Hospital of Iceland Landspítali - háskólasjúkrahús 3 March 2000 General and specialised
university hospital		 Capital Region Reykjavíkurborg
Akureyri Hospital Sjúkrahúsið á Akureyri General and specialised
teaching hospital		 Northern Akureyrarkaupstaður

List of health institutions
Name (English) Name (Icelandic) Founded Healthcare district Municipality
Healthcare Institution of Blönduós Heilbrigðisstofnunin Blönduósi Northern Blönduósbær
Healthcare Institution of Eastern Iceland Heilbrigðisstofnun Austurlands Eastern Region Fljótsdalshérað
Healthcare Institution of Fjallabyggð Heilbrigðisstofnunin Fjallabyggð Northern Fjallabyggð
Healthcare Institution of Patreksfjörður Heilbrigðisstofnunin Patreksfirði Westfjords Vesturbyggð
Healthcare Institution of Sauðárkrókur Heilbrigðisstofnunin Sauðárkróki Northern Sveitarfélagið Skagafjörður
Healthcare Institution of South Iceland Heilbrigðisstofnun Suðurlands 1 September 2004 Southern Region Sveitarfélagið Árborg
Healthcare Institution of Southeast Iceland Heilbrigðisstofnun Suðausturlands Southern Region Sveitarfélagið Hornafjörður
Healthcare Institution of Southern Peninsula Heilbrigðisstofnun Suðurnesja Southern Peninsula Reykjanesbær
Healthcare Institution of the Westfjords Heilbrigðisstofnun Vestfjarða Westfjords Ísafjarðarbær
Healthcare Institution of Vestmannaeyjar Heilbrigðisstofnunin Vestmannaeyjum Southern Region Vestmannaeyjabær
Healthcare Institution of Western Iceland Heilbrigðisstofnun Vesturlands 1 January 2010 Western Region Akraneskaupstaður
Healthcare Institution of Þingeyjarsýslur Heilbrigðisstofnun Þingeyinga Northern Healthcare District Norðurþing

See also

References
  1. http://archsurg.ama-assn.org/cgi/content/full/141/2/199#SEC8
  2. Esping-Andersen, Gøsta (1990). The Three Worlds of Welfare Capitalism. Princeton, NJ: Princeton University Press. ISBN 9780069028573.
  3. Young, Marchildon, Kue, Gregory (2012). "A Comparative Review of Circumpolar Health Systems" (PDF). The Circumpolar Health Supplements. 2012 (9).
  4. Vilhjalmsson, Runar (2009). "Out-of-pocket health care expenditures among population groups in Iceland". Laeknabladid.
  5. Maresso, Anna (2014). "Iceland: Health System Review" (PDF). Health Systems in Transition.
  6. Vilhjalmsson, Runar (2016). "Public views on the role of government in funding and delivering health services". Scandinavian Journal of Public Health.
  7. Vilhjalmsson, Runar (2005). "Failure to seek needed medical care: Results from a national health survey of Icelanders" (PDF). Social Science & Medicine. 61 (6): 1320–1330. doi:10.1016/j.socscimed.2005.01.024. PMID 15970241.
  8. Young, Marchildon, Kue, Gregory (2012). "A Comparative Review of Circumpolar Health Systems" (PDF). The Circumpolar Health Supplements. 2012 (9).
  9. Sigurgeirsdóttir, Sigurbjörg (2012). "International Profiles of Health Care Systems, 2012" (PDF). The Commonwealth Fund.
  10. Jonsson, Gudmundur (2001). "The Icelandic Welfare State in the Twentieth Century". Scandinavian Journal of History. 26 (3): 249–267. doi:10.1080/034687501750303873. PMID 17844641.
  11. "Outcomes in EHCI 2015" (PDF). Health Consumer Powerhouse. 26 January 2016. Retrieved 27 January 2016.
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