The institutionalized model for political decision making in Sweden is based on the notion of rationalism. This formalized way of politics is not always consistent with real politics. The study of the governmental decision not to subsidize medicine for obesity gives an example of what practical political decision making looks like in Sweden. The state is regulating the health sector in Sweden, as it is offering subsidies for prescribed medicine. The state’s cost for the medical subsidies has grown continuously during the 1980´s and 1990´s, and in the year 2001 was equal to about 15 percent of the Swedish GDP. Therefore, the question regarding this financial support has been on the political agenda in the Swedish parliament for many years. In 1999, a medicine for obesity was introduced on the Swedish market. The cost of the medicine was financially supported by the state. The medicine was labeled “lifestyle medication”, and was topic of discussion. The yearly cost for the medicine was about 350 MSEK, which represented 2 percent of the state’s total medicine cost. Many actors interpreted the decision not to subsidize medicine for obesity was made in an effort to reduce costs. However, the government never clarified why the decision was made. This paper applies the “garbage can model” of decision theory to interpret the process of political decision making. The model shows how several streams of participators, problems, solutions, and politics circulated the medicine for obesity. This theoretical model gives us an interpretation of a policy process that does not correspond with the notion of rationalism.
Stockholm, 2003. , 42 p.