JANUARY

The Danish Health Care System, 2015
Karsten Vrangbaek
University of Copenhagen
What is the role of government?
Universal access to health care is the underlying principle inscribed in Denmark’s Health Law, which sets out the
government’s obligation to promote population health and prevent and treat illness, suffering, and functional
limitations. Other core principles include high quality; easy and equal access to care; service integration; choice;
transparency; access to information; and short waiting times for care. The law also assigns responsibility to
regions and municipalities for delivering health services.
The national government sets the regulatory framework for health services and is in charge of general planning
and supervision. Five administrative regions governed by democratically elected councils are responsible for
the planning and delivery of specialized services, but also have tasks related to specialized social care and
coordination. The regions own, manage, and finance hospitals and the majority of services delivered by general
practitioners (GPs), office-based specialists, physiotherapists, dentists, and pharmacists. Municipalities are
responsible for financing and delivering nursing home care, home nurses, health visitors, some dental services,
school health services, home help, and treatment for drug and alcohol abuse. Municipalities are also responsible
for general prevention and rehabilitation tasks; the regions are responsible for specialized rehabilitation.
Who is covered and how is insurance financed?
Publicly financed health care: Public expenditures in 2013 accounted for 84 percent of total health spending,
representing 10.4 percent of GDP in 2013 (OECD, 2015a). It should be noted, however, that Danish cost
reporting with regard to the “gray zone” of long-term care tends to include more activities (services) than
reporting requirements do in many other member countries of the Organisation for Economic Co-operation and
Development (OECD) (Søgaard 2014).
All registered Danish residents are automatically entitled to publicly financed health care, which is largely free
at the point of use. In principle, undocumented immigrants and visitors are not covered, but a voluntary,
privately funded initiative by Danish doctors, supported by the Danish Red Cross and Danish Refugee Aid,
provides this population with access to care.
Health care is financed mainly through a national health tax, set at 8 percent of taxable income. Revenues are
allocated to regions and municipalities, mostly as block grants, with amounts adjusted for demographic and
social differences; these grants finance 77 percent of regional activities. A minor portion of state funding for
regional and municipal services is activity-based or tied to specific priority areas, usually defined in the annual
economic agreements between the national government and the municipalities or regions. The remaining 20
percent of financing for regional services comes from municipal activity-based payments, which are financed
through a combination of local taxes and block grants.
Private health insurance: Complementary voluntary insurance, purchased on an individual basis, covers
statutory copayments—mainly for pharmaceuticals and dental care—and services not fully covered by the state
(e.g., physiotherapy). Some 2.2 million Danes have such coverage, which is provided almost exclusively by the
not-for-profit organization Danmark (Sygeforsikringen “Danmark,” 2014).
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