Towards a New Social Citizenship in the Swedish Welfare State: Introducing User Choice

In recent years, many European countries have adopted user choice as a new governance method in welfare policy.  User choice can be loosely described an organizational model which enable users of social services to choose freely between a variety of competing social service providers which have been authorized by the state. The providers are financially reimbursed by the state on basis of how many users they attract. This arrangement, which enables private actors to operate within public welfare systems, provides users with consumer power without threatening the solidarity of the system. Choice models in welfare services can also be said to constitute a new, more active form of citizenship as they demand that users of welfare services make active choices with regards to which kind of services they want. At the same time, they represent a privatization of social risks. User choice have been practiced in Sweden and many other countries in a welfare areas such as education, health care, elder care, child care and services for the disabled.  

In this paper, I review the experiences of user choice in Sweden in 1990-2015, exploring its implications for policy goals like service quality, efficiency and social equality. The Swedish case is significant as it is one of the countries were choice was first introduced in the welfare sector in the early 1990s, becoming the hallmark of the new, liberalized Swedish welfare state. The finding in the paper points to that user choice undermines the egalitarian values of universalist welfare systems.