Restructured welfare service provision: For‑profit and non-profit providers in residential substance use treatment in Denmark, Finland, Norway and Sweden

Abstract

Abstract The welfare state has been found to be highly resilient and protected from retrenchment by institutional and popular support. However, marketization with restructuration of publicly funded health and welfare services is changing the composition of service providers in the Nordic welfare model, heavily relying upon public provision. Sweden has been the Nordic country most favourable for the establishment of for-profit private welfare providers. The present article uses the case of residential substance use treatment (SUT) to outline and elaborate upon the mix of public, for-profit and non-profit private providers in Denmark, Finland, Norway and Sweden in 2019–2020. The comparison takes its point of departure in Sweden, which, as expected, presented the biggest and most profit-oriented SUT market. The other countries presented smaller markets, measured by the number of units. Denmark and Norway had the highest presence of NGOs, while Norway stood out with a high share of public provision and few for-profit units. The article identified the market-friendly Sweden, ambivalent Finland, stable, market-regulating Denmark and stable, welfare-corporatist Norway, and investigated the country-specific factors potentially influencing the different developments. Implications for the future development of SUT within the Nordic welfare state were discussed.

Keywords

• Welfare state reform
• residential substance use treatment
• privatization
• profits
• Nordic countries
• Welfarestatereform