• Spending overview
• Policy overview
• Diseases overview

Spending overview

Healthcare expenditure is high in Norway, even by regional standards. At an estimated US$7,489 in 2009, spending per head was the second highest in the OECD (after the US) and well above the EU average. Despite the high level of spending on health services, this has still not been sufficient to prevent a rising deficit in the hospital sector. The Norwegian healthcare system is based on the principle of equal access to services independent of social status, location and income. Healthcare is mostly free at the point of access and includes most preventive and curative services. Some services, such as adult dental care and spectacles, are excluded from the statutory health system.

The health service is mainly funded by taxes, through a combination of central and local taxation, as well as national insurance payable by employers and employees, with expenditure divided between central government, the counties and local government. In addition, some parts of the healthcare sector are financed through a national insurance system (NIS). The NIS is funded by contributions from employees, the self-employed and employers, as well as the state. Contribution rates and state funding are determined by parliament. According to Statistics Norway, the national statistics office, around 83% of expenditure is accounted for by the public sector. The private sector’s share of total healthcare spending has risen gradually because of higher co-payments and increasing recourse to private general practitioners (GPs), hospitals and dentists, in particular, as a means of avoiding waiting lists in the public sector.

Policy overview

Norway's municipalities are in charge of local nursing homes and primary care, whereas the hospitals are owned by the central government and run by a general manager and executive board. Most GPs and specialists working outside hospitals are private, but work under contract within the public system in return for grants and fees for service. Implementing changes in the healthcare sector will prove a particular challenge because the main requirement is a change in culture and practice. The government hopes that municipal authorities will take over the management of 20% of specialist health services, which would also improve primary healthcare and reduce hospital admissions. However, to be effective in these tasks, the local authorities need to be over 10,000 inhabitants in size and this only applies to around 100 of Norway’s 430 local authorities. Political resistance to merging municipalities is strong.

The government will continue to implement a programme to modernise medical equipment in hospitals and invest in the construction and renovation of hospitals, nursing homes and assisted-living facilities. It will also increase employment in the sector, especially with regard to care for the elderly. Other recent reforms in the healthcare sector have focused on increasing patient rights and choices. Apart from areas such as dentistry, private healthcare provision is relatively undeveloped in Norway, as is private health insurance. Norway is already one of the most advanced countries in Europe in applying technology to healthcare, and this is reflected in the computer-based medical equipment and software solutions that have been developed for its healthcare industry.

Diseases overview

On the whole, the Norwegian population leads many of its west European neighbours in terms of health and longevity. Life expectancy was an estimated 80 years in 2009. This is lower than in Sweden, but higher than in Finland and Denmark. The infant mortality rate of 3.6 per 1,000 live births compares favourably with other European countries. The most important determinants of disease and death in Norway, as in the rest of Europe, are risk factors such as high blood pressure, obesity and lifestyle factors (for example, physical inactivity and dietary, drinking and smoking habits). The incidence of obesity is rising in most age groups, increasing the risk of heart attacks, strokes, cancers, type 2 diabetes and other conditions.

However, more people are reported to be taking regular exercise and diets have improved (with fat content being reduced), although the improvement is by no means uniform across socio-economic groups. Tobacco consumption has fallen, but remains high by European standards. Alcohol consumption has increased markedly in recent decades and in common with the trend in other northern European countries, Norwegians are increasingly drinking to get drunk. According to Statistics Norway, the national statistics agency, the leading causes of death in 2008 were cardiovascular diseases, cancer and respiratory diseases. Smoking-related lung diseases still account for 10% of all deaths despite a national strategy for tobacco control.