The End of a Trend? Retraction of Choice in Swedish Elderly Care

In 2009, Sweden launched a freedom-of-choice reform that gave municipalities the option to introduce standardized quasi-markets in social services. The reform was initially popular to adopt in home care until the share of adopting municipalities leveled out just above 50 percent. In recent years, the trend has reversed, and several municipalities have abolished their choice system. Compared with municipalities with choice systems, the abolishing municipalities are more rural with fewer inhabitants. A fixed-effects regression suggests that decreases in the market share of private providers, political shifts towards the left, and increasing costs are related to the abolition of choice systems.