An enhanced high-cost protection for dental care

Linda Lindberg (SD)

Madam Speaker! Today we are debating the Social Affairs Committee's report on an enhanced high-cost protection for dental care. I would like to begin by moving for the approval of the committee's proposal for a decision.

Madam Speaker! Today is a great day for all the country's pensioners. Today we are going to talk about a historic reform in the welfare area here in the Swedish Riksdag. It is actually the largest welfare reform in 20 years here in Sweden.

We are, of course, talking about the ten-percent care (tiotandvården). This is a campaign promise that the Sweden Democrats gave our voters during the 2022 election campaign and which also became part of the Tidö Agreement. I am pleased with the good cooperation we have together with the governing parties and all the good things we are doing and have done for Sweden during this mandate period, but this reform makes me a little extra proud. It is a welfare reform that strengthens dignity, security, and the possibility of living a good, smiling life in old age.

We of course also do other good things for our elderly. For example, we have the language requirement within elderly care so that our elderly can have a dignified old age and be able to understand and make themselves understood. It is actually a different debate, but I still feel somewhat compelled to say it. We know that in the debate it is sometimes said that we, together with the government, are only pushing hard issues. That is obviously not true, and this reform is a clear proof of that.

I also want to take the opportunity to say that the coalition parties during this parliamentary term have implemented and are still implementing the most absolutely necessary reforms for Sweden. Never before have we had such a high pace in the departments. That also bears saying. We want to do a lot to achieve a better society.

Enough of that, Madam Speaker, but it is certainly a bit like this: We often talk in this chamber about healthcare in Sweden, about our queues and about resources and quality. It is an important issue, so of course we shall continue to do so. But it is a fact that dental care often ends up a bit in the shadows despite the fact that oral health affects absolutely everything. It affects how we eat, how we speak, how we smile and how we feel, both physically and mentally. Most of all, it affects us when we get older. It is often then that the problems accumulate, precisely because of age. We receive a different type of medication, which leads to dry mouth. It is also then that the costs most often rise and feel heavier.

That is why the new dental care reform is so important and so significant for people's everyday lives. It makes a real difference in people's wallets, Madam Speaker.

Let me tell you what this is about. From January 1, 2026, which is in a little less than a month, a new high-cost protection is being introduced that has been named special dental care compensation. In a first stage, it concerns persons who turn 67 years or older during 2026. We think it is a dignified and just start to the reform work that those who have been involved in building Sweden and are now pensioners are also those who first get to share in the improvements being made. It is through their work that the foundation has been laid on which we are now continuing to build the Swedish welfare construction. It is also the elderly who most often have the very greatest needs.

The main focus for us has been that teeth are and shall be a part of the body and that we should have a protection that is as similar as possible to the protection we have within healthcare. Dental care should be provided to a greater extent based on need and not based on wallet and ability. This is fundamentally a matter of justice. It means that for many, dental care now becomes more accessible and the costs more predictable. We know that the fear of going to the dentist without knowing what price one will have to pay when leaving the dentist's chair has caused many not to even dare to go there. It is a problem that we are now closing for those whom the reform affects.

The high-cost protection is designed to kick in when there are measures and treatments that need to be carried out so that the population can be given a good and functional dental status. What is not included are the preventive measures such as basic examination, tartar removal, and X-rays. It is quite logical, as the reform aims to subsidize the measures that need to be taken so that one has a fully adequate dental status.

The reform therefore includes all fillings, root canal treatments, repairs of damage to all teeth in the mouth, as well as fixed prosthetics up to tooth position 5. That is to say, if you need fixed dental prosthetics on position 4, we will of course fix that. If you need to repair a molar on position 7, we will of course do that as well.

The patient will, in summary, pay only 10 percent of the reference price for these measures. The state will therefore step in and cover the remaining 90 percent.

Let me give a concrete example. A repair of a tooth costs about 1,200 kronor. From January 1, the patient pays 120 kronor. That is a fairly substantial reduction. The larger the measures that need to be taken, the larger the difference in price for the individual to pay.

I spoke with a woman a couple of weeks ago who, with tears in her eyes, told me this: A while ago I went to the dentist because my denture had become too large as I have lost weight due to my age. Unfortunately, it was not financially possible for me to solve this. But now, thanks to you, thanks to the fact that you have taken action on this, I can finally afford a new one. Otherwise, I would have had to go around with my mouth closed and be toothless. This is not worthy of a welfare country like Sweden, and it is absolutely not a dignified old age, Madam Speaker.

We know that many elderly people have had to refrain and postpone their dental care for economic reasons. For them, dental care is now within reach. This is therefore a reform that is directly visible in the wallet and that truly benefits the individual and makes a difference.

It can also be mentioned in this context that the effect of this is that the average cost for a patient who is 67 years of age or older is estimated to be lowered by approximately 59 percent – from 4,600 kronor down to 1,900 kronor. It is thus the average cost. If we subtract the group that is, so to speak, very treatment-intensive, the average cost lands at approximately 1,400 kronor, which is in line with the high-cost protection we have within healthcare. If one is to break it down further, approximately 75 percent will have an annual dental care cost that is actually lower than 1,400 kronor.

Madam Speaker! It is a fact that there have been governments before the government that rules the realm today – and also parties – that for a very long time have talked about a similar reform but have not succeeded in implementing any major changes within dental care. But now this group is doing it, and that is pleasing.

Let me also take the opportunity to conclude by addressing the somewhat distorted criticism that comes, among other things, from the opposition. I think it is appropriate to do so.

It concerns, among other things, the issue of preventive work and that we are not investing in it. The fact is that it is just as important as before, and we are making no deteriorations as a result of the reform. Everything is basically as it has been before. Thus, it has been free for all parties to submit budget proposals to strengthen the preventive work. I have not seen any clear concrete decision on this, but it may be raised during the debate here today.

I would, however, like to take this opportunity to explain a bit to all of you who are listening and who are not fully informed on how it works. There are different subsidies within dental care. Among others, there are two subsidies – a general dental care subsidy and a special dental care subsidy. These apply somewhat differently. For the general dental care subsidy, from 2025, everyone who has turned at least 20 and at most 23 years old, or who is at least 65 years old, will receive an annual general dental care subsidy of 600 kronor. Other persons receive 300 kronor.

This general dental allowance, which we call ATB, can be saved for two years, and if you, as a 20-year-old, then visit the dental clinic to have your annual basic examination – or in whatever span you now do it – you have a total of 1,200 kronor at your disposal. A basic examination costs about 1,150 or 1,200 kronor, and that means that if you go every other year, you have a cost of virtually zero kronor to be able to go and have your basic examination. This is an important part to take up in this context, as some criticism has been directed at precisely that age category.

In addition to the general dental care subsidy, there is also a special dental care subsidy, which is an additional supplementary subsidy for preventive dental care for persons who, due to certain illness or disability, are at risk of impaired dental health and who have a great need for dental care. This subsidy can be granted for preventive purposes.

The special dental care allowance amounts to 600 kronor per half-year, and we are now increasing it to 1,000 kronor starting from January 1. This can be given, for example, to persons with diabetes or other diseases that the dental care has assessed need this. It can be used in preventive work when it concerns basic examinations or, for example, tartar, which means that we continue to subsidize and focus on preventive work.

For the Sweden Democrats, the idea with this reform is that it should be introduced in stages. It should also cover more age groups to ultimately reach the entire population. Doing it in stages is obviously necessary to secure the profession's ability and capacity to meet increased demand. Now, together with the government, we are carrying out the first stage, and it can hardly be a better Christmas present from politics to our elderly this winter.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Christofer Bergenblock (C)

Madam Speaker! I thank member Linda Lindberg for the speech!

I agree with much of what was said in the speech, and it is good that we are now moving forward with a dental care reform that will ensure that more people will get access to better dental care and ultimately achieve better oral health.

This dental care reform addresses part of the problem. We know that older people generally have poorer dental health than younger people do, and now the reform focuses on that. At the same time, we know that dental health also differs regionally in the country.

What causes people to have poorer dental health in our rural areas and in our sparsely populated areas compared to in our metropolitan areas is largely about access to dental care. If one looks at our 79-year-olds, Madam Speaker, one can see that 75 percent of those living in a large city have 20 teeth left in their mouths when they are 79 years old. In our rural areas, it is only just over 50 percent.

In the investigation into this dental care, it was proposed that a municipality-type supplement should be introduced, which would give urban municipalities compensation exactly according to the system that has now been described, but where rural and sparsely populated municipalities would receive higher compensation for dental care. In that way, one could provide a slightly more equitable dental care across the whole country. But this proposal, Madam Speaker, is not included in the report. The Government is pushing it into the future, and it is very unclear when or if such a supplement will even come at all.

I wonder: Where has the municipality type supplement gone? And do the Sweden Democrats not take the difference we see in the country between city and countryside seriously?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Linda Lindberg (SD)

Madam Speaker! The Sweden Democrats are very concerned about a living countryside and have a very high tone in this. We see it as an important part. It is something that the Centre Party has lost a bit somewhere along the way. I do not know why it has been chosen to focus more on the metropolitan regions.

When it comes to the question of the municipal type supplement, it is exactly as the member says. It is not included in this investigation – or it was included in the investigation, but it is not included in the bill. There are, of course, reasons for this. It is not that we do not think it is important, but we consider that it needs to be handled in a specific order – not least because it tends to lie very close to what could be considered state aid from the perspective of EU law. In that case, we need to handle it in a correct way so that when it finally lands, it is functional and does not conflict with any type of EU law regulation. It is for that reason we choose to remove this, and we will return to the Riksdag at a later time when this has finally landed.

I agree with the problem description regarding that we need to ensure that we have equitable dental care just as we are to have equitable health and medical care across the entire country. It should not matter where in the country one lives or is located in order to be able to access adequate welfare. On that point, we are in complete agreement. There are, like, no disputes in this.

I will stop there, because I believe I have given the member a sufficiently good answer.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Christofer Bergenblock (C)

Madam Speaker! I share the member's opinion that the Sweden Democrats have had a high tone regarding rural policy and that the whole country shall live. It was a very high tone in the election. Then came the time after the election. Then the tone was lowered significantly, and it turned out that the Sweden Democrats' rural policy was only about lowering the price of petrol and diesel. Then it ended.

Now, in connection with this reform, the Sweden Democrats had an opportunity to actually show that welfare is also important to ensure equality across the entire country. You have not taken any initiatives when it comes to making healthcare or schools equal. Now, however, we have a government bill and a committee report concerning dental care. There was a concrete opportunity to ensure that dental care could be given better conditions to become equal between city and country. But that is not being done.

The committee members say that it is due to uncertainty regarding the state aid rules. At the same time, the investigation shows that there is no major uncertainty there, but rather that one is quite convinced that this is compatible with the EU's state aid rules.

It is perhaps rather a matter of that one is not prepared to spend the money required to manage the increased cost for our rural areas in order to provide more equal dental care. The priorities have looked like that even before – one has not wanted to spend the money required to provide an equal welfare in our rural areas. When the Sverigedemokraterna, who have had a high tone regarding the countryside, now had a concrete opportunity, they still did not care.

If a municipal type supplement were to come from the government at some point, when would it come in that case?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Linda Lindberg (SD)

Madam Speaker! Everyone who has followed the work of the government and the Sverigedemokraterna during this mandate period is well aware that the pace of reform in the departments has been historically high. We are doing an incredible amount. This is nothing that has been seen in Swedish politics for a very long time. We are doing an incredible amount in both schools and healthcare, and the member knows that. It is a bit dishonest of him to stand here and claim that we are not doing anything at all in these welfare areas. We certainly are. In healthcare alone, we have many reforms to strengthen equality and increase knowledge in very many areas. I know that the member has full knowledge and awareness of this, Madam Speaker, so it becomes a bit dishonest and nonsense to stand here and claim that we are not doing anything when it is actually visible that we are acting very much.

It is important to lower diesel prices and gasoline prices also for those who live in the countryside, but we are also doing many other things. Now, however, it concerns just this bill. I can assure the members that work is being done intensively on the issue at the ministry, and it will come further forward. I cannot, however, stand here and have that information in this debate, as it does not concern this bill.

I am convinced that we all agree that we want to proceed with some form of municipal type supplement to strengthen the possibility of operating in rural areas and so that also people who live there or in sparsely populated areas can have access to good dental care.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Madam Speaker! Our starting point in this is that teeth are a class issue. Socialstyrelsen's statistics from 2024 show that the socioeconomic differences in dental health are greatest among those born in the 80s, 70s, or 60s and smallest among those born in the 40s or 50s.

I would like to see this reform developed. No party has said no to the reform, even though the parties have different starting points.

During the election campaign, the Sverigedemokraterna promised a reform package that, over a four-year period, would lead to all adults who are Swedish citizens, EU citizens, or EEA citizens having the same cost for going to the dentist as for going to the doctor. I am very curious about what’s next.

Something else that I have thought very much about – even though there are explanations – is that this reform does not concern all teeth. In summary, the investigation argues that a limited number of front teeth can suffice for many elderly people, even though back teeth are important for chewing function. It is seen as a reasonable compromise in order to be able to offer good care at a low cost. It can therefore suffice for the elderly if it concerns teeth far forward in the mouth.

I am quite surprised that you have not included the whole mouth when you have nevertheless produced this reform. I believe you could have afforded it. You have chosen to lower taxes by 120 billion during these three years, so of course you could have afforded to include the whole mouth. What was your thinking here?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Linda Lindberg (SD)

Madam Speaker! When I listen to the Left Party, I often ask myself: How were you thinking here? That question goes both ways.

I will begin with the last question the member raised, namely which teeth are covered by this reform. In my statement just a few minutes ago, I mentioned that all teeth are included in the reform. Fillings, root canals, and treatment of other injuries that can occur on the teeth are covered by the dental care for children. This also applies to fixed prosthetics. The only exception is fixed prosthetics on the teeth located after tooth position 5. If fixed prosthetics need to be made in, for example, tooth position 3, it is covered by the dental care for children. If a filling needs to be made in tooth position 7, that is also included in the dental care for children. I thought I was very clear in my statement from the rostrum just a few minutes ago.

It is clear that one would have wanted to give everything to everyone if there had been an infinite treasury. This is also somewhat of the Left Party's specialty. As long as someone else is paying, one can always give everything to everyone; it is very simple.

The first question concerned something that we went to the election on, Madam Speaker. We wanted to see a dental care reform that spans broadly across the population and covers everyone. I think, at some point, we have begun that work. We understand that this needs to be done in stages. We would stress the entire profession if we were to do this in a single step.

I think this is a reasonable order, partly so that we can get the competence in place, and partly so that the profession is not completely shocked on January 1st.

The speech at riksdagen.se, in Swedish (opens in a new tab)

TREDJE VICE TALMANNEN

I hear that English expressions are being used in the debate. I want to remind all members that it is the Swedish language that applies in the chamber.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Madam Speaker! I shall keep in mind what the Speaker reminded us of.

"Everything for everyone" has not been our slogan. I could throw "everything to the richest" back at the member, but we are going to have many debates here ahead.

One thing you have done in the dental care area is that you have lowered the age limit for free care from 23 to 19 years. You have also lowered the age limit for the state dental care subsidy from 24 to 20 years. Ekot has conducted a survey where they asked regional dental care what has happened after the removal of this. It turns out that there are 66 percent fewer in the age group 20–24 who go to the dentist after this. That clearly shows that something went wrong. Or do you think it is okay and that it should be this way?

At the same time as this reform has been removed, we have an economic situation in Sweden that affects young adults and people with ordinary jobs. We have an unemployment rate of 25 percent in this target group. I am talking about youth or young adults. In times of record-high food prices, rents, and electricity prices, I do not believe that going to the dentist is at the top of the priority list.

Madam Speaker! My simple question to the member is: How did you think here? Why are you pitting group against group?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Linda Lindberg (SD)

Madam Speaker! In this reform, we are primarily targeting an older target group, i.e., people who are 67 years of age or older. We know that there are many in this group who cannot afford to go to the dentist and who have a very neglected dental status. Does the member not agree that this is directing tax funds in the right direction? It is primarily this group that has not been able to afford to go to the dentist for several years, but now they are given the opportunity to get proper oral health.

I think this is a very fine reform. It is aimed at everyone, regardless of what income one has. Above all, however, it is aimed at those who have not had the opportunity to go to dental care for a very long time. I think it is important to highlight this.

Regarding the age range 20–23 years, the profession itself has flagged that there is an untapped resource here. There are many who do not show up at their booked times, and therefore there is an opportunity to free up resources and capacity so that also the group included in the dental care can be treated.

If they have received Swedish dental care during their upbringing, those between 20 and 23 years old generally have good dental health and good dental status. Through the general dental care subsidy, which we increased on January 1st this year, every young person also receives 1,200 kronor over a two-year period to use for a basic examination. I think that is reasonable and good.

The Sverigedemokraternas' underlying meaning is, however, that the reform shall ultimately cover the entire population.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Anna Vikström (S)

Madam Speaker! I move for approval of reservation 4.

The Social Democrats want the financial thresholds for dental care to be lowered through a gradually developed high-cost protection similar to that of health and medical care, starting with the elderly. We therefore support the proposal being debated today regarding a new high-cost protection for dental care for the elderly, but we also want to see specific investments for young people. Therefore, we have submitted a proposal in the budget that ensures the government's removed free dental care for young people aged 19–23 is restored.

Good oral health is an important part of people's well-being and health. At the same time as oral health has improved overall, differences in oral health remain between different groups in society. Those who have higher education and income levels more often rate their oral health as better and visit dental care more often than those who have lower incomes and education levels.

Extensive dental care needs can entail significant costs for the individual. Foregoing dental care despite need or only seeking dental care for acute problems can lead to poor dental health which is not only stigmatizing but can also cause serious follow-up diseases. We know that dental care visits in older ages decrease and do not correspond to dental status and needs. Those who are older will, with this reform, have a better opportunity to pay for their dental care. This is particularly valuable for those who have a low pension, strained finances, and large dental care needs.

An important measure to increase accessibility to good dental care for everyone and thereby contribute to improved dental health in the population is to lower the economic thresholds to dental care. Against this background, the Social Democratic government commissioned a major dental care inquiry, which submitted its conclusions and proposals in March 2021. The current government has not proceeded with the inquiry's proposals for high-cost protection but has now presented the proposal we are debating today.

This bill is, however, a bit like a pig in a poke. It is not stated in the bill that the high-cost protection shall apply from 67 years of age, that the patient shall pay 10 percent of the dental care cost, or which measures shall be discounted and for which teeth. But we simply have to trust that the government does as it has said and that all of this appears in the regulations that the authorities are to prepare after the decision. This uncertainty also applies after the Sverigedemokraten Linda Lindberg's calculation. It is not explicitly stated in the bill. We do, however, believe that it will be the result.

What is stated in the bill, however, is that the person who has the greatest need for dental care shall be given priority for the care, which is good. It also states that the high-cost protection shall be combined with a price regulation so that the high-cost protection truly benefits the patient. The dentist may not, in fact, charge a higher price than the reference price for the procedure included in the high-cost protection for this age group. The reference price is determined by the Dental Care and Pharmaceutical Benefits Agency. Exactly which dental care procedures it concerns will, as mentioned, be published later.

We have asked the Minister for Social Affairs whether it is possible to charge for optional extras because information has appeared in the media that made us hesitant. But we received a very clear answer. Optional extras within special dental care compensation, which is what this high-cost protection is called, alongside the reference price are not permitted.

Madam Speaker! Every fifth patient is not at all aware that prices can vary greatly between different dental clinics – and they really do vary. What it looks like where you live can be seen on an official website called Tandpriskollen. Here, one can search for the prices of different dental clinics in all locations. Prices above the reference price are paid by the patient themselves, and the prices are increasing. Therefore, it is good to have a reform that makes approximately 29 percent of the market price-regulated – something that is necessary if the reform is to have any effect on the patients' fees at all.

Dental care must also be accessible to everyone in the entire country. But the inequality regarding access to dental care is growing, especially in rural areas, in smaller towns, and in socioeconomically disadvantaged areas. Therefore, we want to see higher compensation for rural municipalities and mixed municipalities, which the investigation behind this bill proposed but the government is not presenting. We have heard that the EU's state aid rules are a reason, but the government's comments are vague. Despite the fact that we have asked questions about when a decision on this can be expected, we receive no answers.

Madam Speaker! There are major problems with the supply of competence in dental care. In 18 of 21 regions, there is a shortage of dentists and dental hygienists, and in some counties, the shortage is particularly serious. We cannot have a major shortage of dentists and dental hygienists in a majority of Sweden's municipalities while there is over-establishment in Stockholm. Here, several different measures need to be taken. For example, the National Health Competence Council should be given a new mandate when it comes to the supply of competence in dental care. The special support to rural municipalities and mixed municipalities that I mentioned earlier must therefore become a reality.

We also want this reform to be properly evaluated. There are risks with all reforms within the dental care system, and both desired and undesired effects can arise. It is quite unfortunate that the debate and decisions on the issue are being taken so late in the year because the reform is to enter into force already after New Year. It is currently unclear for both patients and healthcare providers what is included, and misunderstandings are rampant, which is unfortunate. It would have been good if it had been clear earlier so that everyone could have known in detail what will actually be included.

Unfortunately, dental care is described as generally affected by over-treatment and incorrect billing. Unprofessional and criminal actors occur, and the state dental care support is particularly vulnerable. During a check, it was discovered that a significant number of providers who received compensation were not even dental care personnel. Therefore, this must be followed up, especially now that the system is being supplied with a lot of new tax money. A licensing law is in place, which is good, and it is important that more measures are taken to counteract fraud and crime within the dental care system.

In conclusion: We want a need-based dental care on equal terms for the entire population. Today's reform is an important step in the right direction but for a limited group. Now it is important to move forward towards a model where dental care needs in all age groups are in focus and where everyone in the whole country gets access to dental care.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Thomas Ragnarsson (M)

Madam Speaker! Today we are debating the report SoU10, which concerns the bill on an enhanced high-cost protection for dental care. I would like to begin by moving for approval of the committee's proposal for a decision.

Madam Speaker! Politics is always about making trade-offs based on different interests, and it can be stated that this is an issue that has stirred up emotions, both positive and negative, in different parts of society.

It is an expensive reform, and the Moderate-led government therefore allocates 3.4 billion kronor for the purpose. When it comes to the economic upside, the hope is that improved oral health will prevent other medical conditions.

The starting point for the reform has been to make dental care accessible for the elderly in society regardless of what economy they have. That the reform is directed towards the elderly part of the population is linked to the fact that the risk of illness increases with increasing age.

Madam Speaker! The link between human oral health and other medical conditions is something that research in recent years has been able to prove, and extensive research continues to be conducted in the field. Severe medical conditions such as certain types of cancer, cardiovascular disease, dementia, and certain types of systemic diseases have been able to be linked directly to oral health.

Besides that, there is the purely human aspect of good oral health, where pain and the risk of subsequent malnutrition are reduced, while at the same time there is a great added value for the patient in purely aesthetic terms. For many elderly people, the economic situation has been completely decisive as to whether they seek care or not, and given this, we have patients who have developed severe illness because they have not sought dental care.

Madam Speaker! In the reform work regarding dental health care, free dental care for 19–23-year-olds was removed. It was a completely relevant measure that created financial space for the investment that is now being made. There are, of course, those who think it was bad, but considering that we have the world's best pediatric dental care, the group of 19–23-year-olds is likely to have very good dental health. Therefore, the investment there was not relevant.

At the same time, there are insurance policies that can be taken out in one's youth where the premium is based on the dental health at that time. When we had free dental care up to 23 years of age, an overconsumption of dental care was seen in precisely that group, which had a displacement effect that primarily affected the public dental care in Sweden.

Madam Speaker! Folktandvården today has the responsibility for the education of new dentists while simultaneously being responsible for children's dental care. This has had the effect that new dentists experience that they do not get to learn the craft, which is a contributing cause to the fact that there is a lack of dentists at very many Folktandvården clinics today.

The lack of competence is great in both private and publicly run dental units in rural areas. Many think of northern Sweden, but the problem also exists in northern Skåne and the inland of Småland. Access to dental care must be evenly distributed across the country so that everyone has the opportunity to receive care in a reasonable geographical area.

Competence supply problems are something that most industries talk about, and I believe that private and publicly run dental care must sit down and help each other solve this issue.

Madam Speaker! Over time, Swedish dental care has functioned very well, and there, public and private actors have been an important factor for the generally good dental health that prevails in Sweden. Free pricing has functioned, but when a high-cost protection for dental care is introduced, it is given that free pricing is limited. Otherwise, the costs could skyrocket and the economic consequences would be large.

That is why there are calculated reference prices, and TLV has developed a model for pricing. I know that many believe the model does not work, but from what has been presented, it appears that there is an economic margin even in dental care, even if it is obviously limited.

Madam Speaker! This type of reform will naturally entail increased administration, but that is also included as an item in TLV's calculation model. Försäkringskassan has received funds to update its systems so that it will be as simple as possible for those who are to work in the systems.

Unfortunately, these systems must both ensure that the correct compensation is paid out and prevent criminal gangs from nesting in and trying to steal money. Another factor linked to the criminal networks is that a permit requirement is introduced for private dental providers, as part of preventing tax money from ending up in the wrong pockets.

Madam Speaker! Such a reform must, of course, be followed and evaluated so that the invested money achieves the effect that is intended. The goal is an improved public health among our elderly, but the synergy effect will hopefully be reduced costs for treatment of other medical conditions and a reduced burden on health and medical care. At the same time, one must follow how the dynamic effects are affected by a high-cost protection and how this affects dental care in Sweden.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Christofer Bergenblock (C)

Madam Speaker! Thank you, Member Thomas Ragnarsson, for the speech!

We heard a speech earlier from the Social Democrats' Anna Vikström, who said that it is necessary to price-regulate the market. Now it concerned dental care, but we can sense that on that side, they believe there are many markets where it is important to price-regulate.

The Moderate member also gave a speech on how important it is to price-regulate the market, and it is clear that even I, as a market-liberal member of the Center Party, realize that regulations of market mechanisms are needed if a high-cost protection is to be introduced. From this follow the reference prices that have been criticized very harshly by both the public dental care and the private practitioners, as these prices are considered to be calculated very low generally and risk leading to the use of cheaper materials and poorer prosthetics than would otherwise be the case and what the dentists themselves in many cases want to use.

In such a system, where the starting point is reference prices, we in Centerpartiet point out that it should be possible to make additional purchases as a patient and that one should retain a certain freedom of choice when undergoing a procedure or treatment in one's mouth. But the Moderaterna do not agree to leave that small possibility of choice so that one can use one's own money to pay for a slightly more aesthetically pleasing or more durable intervention.

How is it that the Moderaterna, which has traditionally been a conservative and at times even a liberal party, has such confidence in state price regulation that they cannot even allow patients to make their own choices within the framework of dental care?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Thomas Ragnarsson (M)

Madam Speaker! I am quite sure that the member was present at the visit that the Social Affairs Committee made to TLV, where we were given an explanation of how the reference price was calculated.

Just as the member mentions, criticism has been voiced both from the private market and from Folktandvården that the reference price is set too low. What is often raised in the discussion is that even Folktandvården has a price 15 percent higher than the reference price. It has its reasons, if I may say so. The overhead cost within our regions is immense. It is a cost that is also factored into the treatment price, which naturally means that it does not add up. For Folktandvården, this does not become a problem at the end of the year. I can swear that not a single Folktandvården has gone bankrupt, because the deficit is adjusted at the end of the year.

How does this then affect the private dentists? I assume that there is not a single private practicing dentist who has built up such an OH cost as we have managed to build up in our regions. In that case, I understand that the price is not sufficient. But otherwise, the calculation model is based on a median value.

When it comes to paying extra, it will not be possible to do so initially in the reform. That is because we must be able to ensure that patients receive the correct dental care at the right price. Otherwise, it could easily happen that the dentist pushes a different dental crown on the elderly person because it yields a larger profit for the company. Initially, one cannot pay extra, but I do not see it as an impossibility in the future that one could adjust this.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Christofer Bergenblock (C)

Madam Speaker! The criticism regarding the reference prices is among the parts that need to be followed up once the dental care reform has been launched and we can see what the effects will be. It is something that must be monitored over time to see what it entails.

That this should be an incentive for the regions to reduce their overhead costs is possibly a novelty for them. In the regions' world, the risk instead is great that low reference prices through the new system lead to an increase in the tax financing of regional dental care.

For the private [providers], there is naturally a risk, which has been raised from several sides, of the closure of dental clinics, especially in rural areas. This applies particularly because the municipal type supplement that would be needed to secure dental care in our rural and sparsely populated areas, where accessibility is most difficult, is not being introduced.

Madam Speaker! The Member of Parliament says that initially, they will not contribute to allowing patients to make additional purchases. At the same time, this is a government with three parties on paper that are conservative, which perhaps is largely governed by another party that is not conservative at all. Nevertheless, there is a certain possibility of influence on the bills even from the Moderates' side, and I find it very difficult to understand why it is being done this way. All private practitioners I have spoken with also find it very difficult to understand why the Moderates, as an old conservative party, cannot allow patients the freedom of choice to make additional purchases from day one when they receive dental care according to the new ten-dental-care system. Please explain in more detail why the Moderates cannot accept it!

The speech at riksdagen.se, in Swedish (opens in a new tab)

Thomas Ragnarsson (M)

Madam Speaker! Thank you, Member, for the question!

It has surely not escaped anyone that the criminal networks have nestled themselves into almost everywhere. For a long time, they have been able to establish operations without any of the political parties that have governed during this time having done anything about the problem.

Today, all the changes we make in the welfare system must actually be built on an approach to ensure that criminal networks and individuals do not gain access to the systems. I am the first to say that this is extremely regrettable. Surely no one thinks it is fun to have to spend both time and money on precisely that work. But it is necessary, because we see that for a long time, money has leaked from the state treasury to the gangs. We have financed and fed them, but that ends now.

When making changes, they must be very restrictive in order to be able to have this control. It is one of the reasons why one now chooses to say that what is included in the tiotandvården is precisely this and that it is replaced in this way – period.

The committee members are talking about including other things, for example that one should be able to pay extra for a special crown. I think that is laudable, and for me as a Moderate, it is a matter of freedom of choice. But for the system to be able to handle this, we cannot have that freedom of choice for the time being. What happens in the future we will have to see; this is a process that we will work on jointly. It is nevertheless pleasing that there is no one in here who is against the reform itself. We must not forget that!

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Madam Speaker and Member! Just as the Member said, none of the parties are against the reform, but we have slightly different starting points.

It sometimes sounds a bit [geschwint] when you talk about young adults and mean that they have good dental health and that they can afford to go to the dentist. It is roughly as if you have not kept up with reality. There is incredibly high unemployment in this group; 25 percent of young adults are unemployed. They are also squeezed from different sides. Housing costs and food costs have increased, so it is clear that it would have been good to keep the reform. Now, instead, you are pitting group against group.

I also have another question. Socialstyrelsen's investigations show that it might not be all elderly people who have difficulty paying, but rather that there are different segments. This is about class, as I see it.

The Swedish Dental Association has had Novus conduct an opinion poll on the Swedish people's ability to pay, and it shows that 1 million Swedes cannot afford to go to the dentist. And it really is not just about the elderly, but it is four out of ten Swedes who cannot afford it. They state that they have not prioritized dental visits for four years or longer. Every second person who cannot afford to go to the dentist cites increased food, electricity, and fuel prices and increased interest rates as a result of inflation as the cause.

I wonder therefore: How does the member intend to proceed with this? All of us who go to the dentist know that it can become insanely expensive, and that applies specifically if one has a very thin wallet. Then it will be felt. What is the continuation of this journey?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Thomas Ragnarsson (M)

Madam Speaker! Thank you, Member, for the question!

As I mentioned in my opening remarks, this is an expensive reform. It costs 3.4 billion, and one should have an enormous respect for that. I do.

It feels, however, as if the Left Party does not always have respect for money, but instead one goes down into the basement, loads the printing press with a bit of paper and cranks it away. So one arranges this a bit quickly and easily without actually having any long-term thought on how to handle this type of cost.

Sometimes I get the feeling that there would be no help for anyone outside the children's group and, now after the reform, those who are over 67 years old. That is not true. We have the dental care allowance, which is deposited into your account and which you can use for examination and minor treatment. It is still 600 kronor a year for the group of 19–23-year-olds. If you, for example, go to the dentist every other year, it might even cover some small treatment.

For the rest of the population, there is also a high-cost protection that the state covers. If a treatment costs over 3,000 kronor, the state covers 50 percent of the cost up to 15,000 kronor and then 85 percent of the cost over 15,000 kronor. There is, therefore, a support.

At the same time, there is actually an opportunity for the least well-off to seek support through social services. It is not the intention that anyone should be unable to eat because they have such pain that they cannot chew. There is a system for that.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Madam Speaker! I want to start with the constant nagging that Vänsterpartiet has a printing press in the basement. We have strictly followed the budget framework that you have presented, haven't we, but made other priorities. We have not prioritized the richest.

You have made tax cuts of 150 billion during these years. My God! Who has been hit? Well, it has been healthcare, people living in rental apartments, you name it.

Okay, back to the teeth. It is clear that one wonders when looking at various surveys, including those from Socialstyrelsen, that very large groups cannot afford to go to the dentist. Even though this is a reform that benefits people aged 67 and over, like myself, there are very many who are left out. 600 kronor is what one now gets for an examination, where X-rays are not included.

This is a rather complex reform with very many entry points – the member must surely agree with that. If you are 67-plus, you can get paid for these teeth. They are included. If it concerns other teeth, you can go to that fund, additional other teeth to another fund. It is a rather confusing reform, I think myself, even though we have stood behind it.

I still want to go back to all the 700,000 poor in Sweden today. There has been an enormous increase. These are people who live very frugally, perhaps on social services. Does the member have any reference to when they pay for dental care? That is what I wonder. Where is that reference?

We live in a Sweden where the gaps are widening and where very many actually cannot afford to go to the dentist. It is good that those aged 67 and over now partially get help with the costs, but the rest? Young people? The 25 percent who are unemployed?

It is tough times under the Tidö parties, I'll just say.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Thomas Ragnarsson (M)

Mr. Speaker! Thank you for the question, member! Here it was words and no songs.

The fact remains that we have the world's best dental care for children, which has led to the dental health of the younger ones being extremely good.

We were at a debate in Älvsjö, and then I mentioned myself as an example. I was born in 1970. When we went to the dentist, they drilled everything. As soon as there was the slightest cavity, they drilled, and they drilled heavily. My mouth is a disaster area. I am aware of it, and I go to the dentist when there is an opportunity. Unfortunately, however, the burden on our dental clinics today is extremely high.

Something I also mentioned in my speech is that one must look at the dynamic effects of all the reforms one makes. What then is a dynamic effect? Say that 1,000, to take a figure, 67-year-olds go to the dentist today when they pay themselves. If that figure after this reform increases to 2,000 people who go to the dentist, this will obviously have an enormous impact on dental care in Sweden. This applies to both the public dental care and the private dental care units.

We must balance this. I have no magic hat from which we can conjure up dentists just because there is a shortage. This is a long-term task. For that reason, I believe that such reforms must be carried out in stages. I do not believe that anyone in here can predict the future. I certainly cannot. If one does too many things at once, the consequences can become very bad.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Mr. Speaker! You understand what I believe: The teeth are a class issue.

Vänsterpartiet believes that the entire dental care system needs to be reformed. We think that teeth should be seen as a part of the body and that dental care should, in the long run, be included in healthcare with a high-cost protection.

Our goal is that everyone should be able to afford good teeth, not just those who can pay for the expensive treatments. Prices within dental care have risen sharply over a number of years, which has meant that those who earn very little money – those who simply have poor finances – choose to refrain from going to the dentist.

For the sake of safety, I should say that we stand behind this reform, while at the same time we have completely different views on it – so that there are no misunderstandings about that.

The National Board of Health and Welfare has produced statistics that are very recent, from 2024. They show that the socioeconomic differences in dental health are greatest among those born in the 60s, 70s, and 80s and lowest among those born in the 40s and 50s. Then perhaps one can wonder why the government is directing this initiative solely to those aged 67 and over, even though it is in itself good that they receive it. I have already asked the Sweden Democrats what happened along the way, since they in the 2022 election campaign spoke precisely about dental care for everyone.

Mr. Speaker! When the government, together with the Sweden Democrats, lowered the age limit for state dental care support from 23 to 19 years, they removed the possibility for many young people to establish routines for basic good dental health.

When one has investigated what happened thereafter, it has shown that within regional dental care, there are 66 percent fewer in the age group who go to the dentist. Then you say that everyone has fantastic dental care, so to speak, that there is no danger on the horizon and that it will be great. However, we live in a reality that is quite tough in many ways – also towards young people, Mr. Speaker. We have 700,000 more poor people. I am thinking of the unemployment, which continues in the age group young adults – 25 percent unemployment. Then one has no fat wallet to go to the dentist with. Then one might have to wait for several years. And what happens then?

That the government is now trying to remedy parts of Sweden's dental care problems by developing yet another reimbursement system that will only benefit a fairly small part of the population and which only covers procedures in parts of the mouth, even though there are systems for the rest of the mouth, sounds a bit peculiar.

I am still curious as to why the inquiry's proposal was purchased, which I think had a frightening view of the elderly: "In summary: even though back teeth are important for chewing function, the inquiry argues that a limited number of front teeth can suffice for many elderly people. It is seen as a reasonable compromise in order to be able to offer good care at a low cost."

"Can be enough for many elderly" – I must say that I am astonished when I read this.

The name of the reform is also the tithe care. It is still a bit clever.

Vänsterpartiet wants, as you understand, to go much further in the investments in dental care than the government and the Sverigedemokraterna do. We want to introduce a real high-cost protection. We have made calculations on it, and we also have the finances to be able to develop it over the years. We hope that this will be able to be implemented with the next government.

This is a very important reform. Teeth are completely outside the body. When you have pain in your knees, you eventually get a free pass. If you go to the dentist, that is not the case.

Since then, we have been very clear regarding the number of trained individuals, i.e., that one should take that with them into the work ahead.

We also want the private dentists to accept young people and children. I have traveled extensively in Sweden and met various dentists, even in the northern regions. It has shown that if the public dental care (folktandvården) takes full responsibility for children and young people, they also receive no competence reinforcement when it comes to the rest of the population, and they need it.

I mean that you would have had the means for a larger reform considering the enormous tax cuts you have made for certain very privileged groups.

Despite the new reform, the elderly will have gaping holes in their wallets because it does not fully cover preventive treatment. Yes, there is other money for that, for example for X-rays and dental hygienists. This becomes a messy reform for me, and it will also be messy for the dentists. They will have to keep track of all the different papers and the administration of the reform. It must be evaluated, so that we can see what happens along the way.

We would rather have seen a gradual reform for the entire population from 19 years old where there is a real focus on the group with the worst dental health and the thinnest wallets. This is more of a pre-election move. We also stand behind the proposal for 67-plus – it is good – but so much else was needed.

You have raised the question of reference prices, and we think that is good. But just as the dentists say, the question must be followed up. Where should work with advanced bridges and other dental measures be carried out? Should everything be bought from China, or should one be able to afford domestic production? That question we must follow up.

Will we get equitable dental care with the reform? No. Will we be able to rectify the regional shortage of dental care personnel? No. Will care needs be prioritized? Doubtful.

Since we are Left Party members, we think, on the other hand, that the price regulation is good. Everyone understands that. The newspaper Dagens ETC has taken up what Social Minister Jakob Forssmed has said, namely that there has been an influx of venture capital-owned dental care companies, which has resulted in prices being driven up.

He is right, the good Jakob. He sounds almost like any left-wing party member, I must say.

I move for the approval of reservations 1 and 5.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Linda Lindberg (SD)

Mr. Speaker! It is always a little bit amusing to listen to Member Karin Rågsjö. The Member argues that we are creating increased gaps and that we are not contributing to the poor receiving good and healthy dental care, but that is precisely what we are doing now. By subsidizing dental care for all persons who are 67 years of age or older, we make dental care more accessible and fairer. This is a matter of justice, not a matter of the wallet. It is precisely what the Member is most often after in the debates, namely that it should not be about which wallet one has but that it should be a right.

Now we are doing incredibly well with the reform. I have listened to the member say that she does not criticize the outcome of the reform in itself, but that she instead criticizes different system parts. It is a way of creating a problem picture that is actually not so important. Somewhere, the goal must be seen from a patient perspective – the population's perspective. Now, people will get access to dental care that means that life and dental health will become so much simpler and more pleasant.

The member usually talks about class differences and the increased division in society. I must ask the member a question. It is your policy that has caused the country to go in completely the wrong direction. It is the policy you have pursued for many years when you have been a coalition partner to the social democratically governed government that has increased class differences and segregation in society, which has increased in many of those parts of society that people do not want to talk about. It is not us who have done that.

Now we will see to it that we get order in Sweden, that we get order in the country. We will get order and clarity in both benefit fraud as well as welfare crime and so on.

What good has Vänsterpartiet done for Sweden?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Mr. Speaker! Member Linda Lindberg and I have to go on a tour around Sweden.

What has happened during these four years? 700,000 poor people. Were they there before? No. What else has happened? Unemployment that is astronomical – 9 percent. It was a long time ago that we had that high unemployment, and it is 25 percent in the youth groups.

Excuse me! I don't think things are moving forward in Sweden.

But let us go back to dental care. It is still about dental care. When Novus and the National Board of Health and Welfare have looked at the issue, it has shown that it is the absolutely poorest, those who have the worst finances, who do not go to the dentist. Four out of ten of those who cannot afford it state that they have not been able to prioritize. It is about the extremely increased food prices and electricity prices that were supposed to be fixed. Nothing of that has happened. The inflation is enormous. There are many unemployed people whom you are impoverishing with the politics you pursue. My God, I say!

The Swedish Dental Association's survey shows that people aged 35–49 who live in rented apartments, who have a household income lower than 300,000 kronor per year, who reside in northern Sweden and who work to a lesser extent are the population that does not go to the dentist. Then one must still say that teeth are a class issue.

This is a reform that benefits those 67-plus. It is very good. But there is a rest of the population. There are young unemployed – people without jobs. There are 700,000 more poor people. Someone said earlier that they can call the social services. Well – excuse the English expression – I do not think it will go so well for those who call. We have completely different starting points in this. I believe that Sweden is heading in absolutely the wrong direction.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Linda Lindberg (SD)

Mr. Speaker! It is a majority of the population who are of the opinion that we are now getting Sweden on the right track, in contrast to the member's voter support. That is quite small at the moment. It could be a signal that one perhaps should take to heart.

The fact is that during the previous parliamentary term, when Vänsterpartiet was a coalition partner to the social democrat-led government, an investigation was conducted – among other things by Veronica Palm. Why did you not proceed with that investigation, which was actually on the table, and get something done? It is not just about talking a hell of a lot about wanting to do a hell of a lot about these injustices in society. Why did you not deliver a dental care reform that was everything the member now desires? Or was it not so important when the question actually came to the table?

This government, together with the Sweden Democrats, wants to deliver. We are delivering on what we have told our voters we would do. We have achieved a first step in a dental care reform aimed at the group that has generally seen the worst oral health. We also know that there is a large group with a tough and strained economy who cannot afford to go to the dentist – just like the lady I told you about. She now pays 10 percent of the bill at the dentist. It is a fantastic reform, and it would have been nice to hear the member say that themselves.

Then the reform shall be developed and reach broadly across the population. It shall reach the 20-year-old, and it shall reach the 40-year-old. One cannot claim anything other than that this is a historical welfare reform for the country. It is strange that one cannot join that line.

We are now lowering the food VAT, and we are doing many other good things. A typical family with children now has approximately 5,000 more in their wallet per month. We are doing a lot in this area so that Sweden will become a much better country to live in, and the dental care reform is a step in the welfare area.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Mr. Speaker! The reform itself is okay, but it is not the world's welfare reform. We would have gladly seen that the reform that was in the drawer had been developed. So that is how it is.

Regarding the opinion polls ahead of the election, it is the Sverigedemokraterna who are ticking up slightly, but the other parties in your group are sinking steadily. Perhaps you in your group should reflect on that, but I do not intend to go into that question further.

You rarely look at research material. You in the Tidö group are not known for looking at what the research or the Socialstyrelsen says. When you pull out the figures that show that this is about class and poor people, it becomes completely obvious that they cannot afford to go to the dentist. It is so obvious.

It would have been very classy of you – if I may put it that way – if you had presented a slightly larger reform. You have, in fact, had the opportunity to choose. Shall we lower the tax for the richest? Shall we lower the taxes by 120 billion, or shall we invest it in welfare? That is a choice that you have been able to make for nearly four years now.

You have chosen something else. This reform could have become a stellar reform. I could have entered here with a flag and waved it in joy if you had broadened the reform. If you had chosen to put the money into welfare, into doing something about inequality, I would have cheered. I do not do that today.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dan Hovskär (KD)

Mr. Speaker! I would like to begin by expressing my approval of the committee's proposal in the report.

Today we are speaking about a historic reform for the elderly, regarding the reinforced high-cost protection for dental care. The Christian Democrats and the Tidö parties are now proceeding with one of the most significant dental care reforms in many years: a reinforced high-cost protection that in practice makes dental care more similar to healthcare.

For this, the government now allocates 3.4 billion kronor for 2026. We also reinforce the appropriation with an additional 379 million to meet increased reference prices.

What does this mean in practice? Well, people who are 67 years and older will pay significantly less for necessary dental care. Today, many elderly people are forced to prioritize away treatments because the finances do not suffice. But with this reform package, the state will cover 90 percent of the cost while the patient only pays 10 percent of the reference price. If the reference price for a major dental treatment for, for example, Inger, 75 years old, from Falköping were to be 10,000 kronor, Inger now only needs to pay 1,000 kronor. That is a big difference and a substantial improvement.

This applies to treatments linked to illness, pain, broken teeth, as well as rehabilitation and habilitation. For remaining treatments, the current high-cost protection continues to apply.

Mr. Speaker! This is a reform that will improve oral health and thus also the general health for thousands of elderly people. Good oral health is not a luxury. It is part of the quality of life and can even be completely life-saving. No elderly person should have to refrain from going to the dentist because their wallet is thin.

The investigation into an enhanced high-cost protection for dental care, which was commissioned in 2023, was tasked with analyzing how the dental care reimbursement system should be developed and how to best prioritize the oral health of the elderly. The investigation was clear: today's system causes many elderly people to refrain from treatment for economic reasons, despite having the greatest need. That investigation is the basis for what we are now carrying out.

Mr. Speaker! The change of the free dental care from age 23 to 20 is an issue that is sometimes misinterpreted but which is important to clarify. When young people leave the free child and youth dental care, their treatment needs have essentially been completed. There is normally no requirement for an annual examination for healthy 20-year-olds. The National Board of Health and Welfare's guidelines clearly state that healthy adults can wait at least two years between examinations. In addition, young adults have an enhanced dental care subsidy of 600 kronor per year, which can be saved up to 1,200 kronor. And the average cost for a visit is between 1,200 and 1,500 kronor. The high-cost protection naturally also applies to them.

Mr. Speaker! As we heard earlier, the government at the time appointed an inquiry in March 2018 which was to propose a more resource-efficient and equitable dental care system. The proposed changes would favor regular and preventive dental care. The idea was to reduce the differences in dental health within the population. Veronica Palm, former Member of Parliament for the Social Democrats, was appointed as the investigator.

The investigation proposed in the report *När behovet får styra* that the regions should be responsible for regular and complete dental care for persons up to the year they turn 19. The investigation also showed that the free dental care for 20–23-year-olds has often led to healthy patients consuming more dental care than justified. It has pushed out patients with greater care needs. It is neither equitable nor resource-efficient.

Many of the referral bodies in that investigation, not least Region Östergötland, supported the principle that those with the greatest need should be given priority to dental care and agreed that public resources were not being used in a way that contributed to a more equitable and resource-efficient dental care system. We Christian Democrats share that view.

Mr. Speaker! The Government and the Christian Democrats are now also working to strengthen the control over the dental care sector. We shall stop fraud and misuse of tax money. Every krona shall go to patients, not to unscrupulous actors.

Elderly people with large dental care needs should not have to opt out of necessary treatment for economic reasons. With this proposal, we lay the foundation for a fairer and more accessible dental care. The support is based on the patient's dental care needs, and the patient's cost is kept down.

For us Christian Democrats, this is a matter of the heart. We know that dental health affects people's entire life situation – their ability to eat, speak, participate in social contexts, and feel well. Quality of life and health should never have to be deprioritized. No one should have to choose between fixing a tooth and paying the rent. No one should have to worry about becoming ill due to a lack of dental care. No one should be caught in a bind depending on where one lives or how large the wallet is.

Mr. Speaker! With this proposal, we take a major step towards more equitable and accessible dental care, towards a system where needs take precedence over the wallet, where the elderly are prioritized, and where dental care approaches other healthcare in terms of security and economic management.

This reform makes the gaps and holes smaller, in both the mouth and the wallet.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Christofer Bergenblock (C)

Mr. Speaker! The Christian Democrats also spoke a lot about the countryside during the election campaign. And after the election, we have been able to follow Minister for Rural Affairs Peter Kullgren as he has traveled around the country and eaten sausages. Perhaps not so much is being done, but it seems, in any case, that there is a constant great interest in talking about rural issues.

The dental care reform also has a clear urban-rural perspective, and there it is about the accessibility to dental care. We see that there are large differences in the country depending on whether one lives in metropolitan areas or in rural and sparsely populated areas. The dental status differs between, on one hand, rural and sparsely populated areas and, on the other hand, the large cities, to the advantage of the large cities.

We have already earlier in the debate here heard that there is a risk that the reference prices could lead to even poorer availability in our rural areas. That was why the investigation came with a proposal to compensate through a municipality-type supplement, where mixed municipalities would receive a 10 percent supplement based on the reference price. Skövde and the member's home municipality Falköping belong there, for example. Rural municipalities such as Åre, Sollefteå, and Vetlanda would receive a supplement of 20 percent. However, nothing will come of this. Nothing will come of it now, and it is very unclear if anything will come of it in the future.

How is it that the Christian Democrats did not fight for the countryside to actually receive the compensation needed to be able to maintain or increase the accessibility to dental care now that a major dental care reform has seen the light of day?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dan Hovskär (KD)

Mr. Speaker! I thank the member for the questions.

Rural areas are an important issue for us Christian Democrats, and I believe that Peter Kullgren does more than just drive around and eat sausages. He has initiated major investments, and we have implemented major reforms. The rural development initiative during the last three years has truly had an effect for the inhabitants of rural areas.

When it comes to dental care, it is the case that there were proposals included here, but it was seen that there were problems with the EU's state aid rules. Therefore, we have to handle this in a special manner; we must monitor the issue and see how we can continue to find opportunities to support rural dentists. We see that there are great needs when it comes to recruitment. We see that there is a shortage of dentists, dental hygienists, and so on, and that the shortage is greater in rural areas. This is an important issue that we now take with us further.

We will therefore follow this closely, and we will see if we can take it in the next step when we look at how we can support the countryside.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Christofer Bergenblock (C)

Mr. Speaker! The member is talking about following closely, monitoring the development and seeing what happens and whether new steps should be taken forward. No promise was definitely given that any steps will be taken or that any municipal type supplement will be introduced.

Regarding the connection to the state aid rules, it has already been mentioned previously that it is very unclear whether there is actually a problem there. That question should have been had time to be investigated in the Government Offices before the bill was submitted, and thus one should have been able to propose a municipality type supplement in the bill. It is very clear that this is not prioritized from the government's side.

Regardless of Peter Kullgren's work, the overall picture of the government's work on rural issues is that no particularly large measures have been taken. This applies in particular to welfare, where we see that there are large differences in access to welfare between our rural areas and our urban areas. The Christian Democrats' only and constant answer has been that healthcare should be nationalized. I have not heard that dental care should also be nationalized, but perhaps that is in the line and will come next.

Since that question has disappeared from the agenda, it would have been expected that other things would be done to level out the differences in access to welfare in the country, but that has not happened. There is much to be done to increase accessibility within dental care. From the Center Party's side, we want to introduce a basic service year for newly graduated dentists, and we want to see economic incentives to take jobs in our rural and sparsely populated areas.

We also want to see a municipality type supplement so that the economic conditions for providing dental care in our rural and remote areas will improve. Why have the Christian Democrats not prioritized it?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dan Hovskär (KD)

Mr. Speaker! We are now making a real major investment regarding the high-cost protection in dental care. It is primarily about strengthening the high-cost protection for the elderly, and here we are making a major investment.

We are also looking further into how we can work with the parts concerning supporting rural areas in the initiative on dental care. We will monitor this and return to it. As I said earlier, the state aid rules have been a problem, and we are monitoring that issue.

When it comes to rural development, the Christian Democrats and the Tidö parties are working hard on many development issues. However, we lack the Centre Party in these issues. We think, from our side, that the Centre Party often finds its own ways that do not develop the countryside.

When it comes to the development of healthcare, we in the Christian Democrats still believe that the right method is to nationalize healthcare. We see that even many doctors and nurses support this. It would ensure that we get more equal healthcare throughout the country, and it would help the residents of the countryside.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Anna Vikström (S)

Mr. Speaker! First, I want to reflect on the fact that Dan Hovskär states with absolute certainty that it is 67 years that applies. I want to point out that we still do not have it in writing in the bill, but that all of that comes after the decision has been made.

When it comes to 19–23-year-olds, Dan Hovskär said that we removed free dental care, or that it was the proposal, but what I want to say is that the investigation also contained very good proposals regarding free examination and a dental care plan for all young people. It was therefore not empty of proposals for young people, as it is in the politics that you pursue, Dan Hovskär.

There are major problems with the competence supply in dental care. Out of 21 regions, 18 say they have a shortage, and there is a particularly serious shortage of dentists and dental hygienists in some counties. This means that reforms like this one, which will likely increase the demand for dental care, will make access very unequal because there is a lack of staff.

You are not presenting any proposals in this bill that counteract the current imbalance between city and countryside regarding staffing in dental care, Dan Hovskär. That imbalance "poses a threat to the entire system's purposefulness and resource efficiency," according to the investigation Tiotandvård. Therefore, this reform should include a minimum of support for rural areas and mixed municipalities, what is called the municipality type supplement, but that proposal is not presented. There will be vague explanations regarding if and when it should happen. I agree with Christofer Bergenblock that you are talking about monitoring and following up, Dan Hovskär, but my question is: Why are you not presenting a municipality type supplement?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dan Hovskär (KD)

Mr. Speaker! I thank the member for the questions.

As I mentioned earlier, this matter regarding the municipality type supplement will be handled in a special order. It is the EU's state aid rules that there have been a lot of question marks surrounding. We believe that one can develop a support around this in the future, but right now it is not included.

When it comes to the supply of skills, I agree that it is a major challenge. We have that challenge in very many different industries, and it also exists in healthcare in general. Here, we therefore have something that we must monitor. We see that we are now getting a large system started, and we need to monitor and see what new parts it brings about.

Therefore, we will monitor this with the municipality type supplement to see if we can get something such as that in place in the future. But it is not something that we can present in this package.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Anna Vikström (S)

Mr. Speaker! I thank Dan Hovskär for the answer. I have also asked the minister about the municipal type supplement, but I actually get no clarity on how justified the government really is when it comes to presenting a proposal for increased support to rural municipalities and mixed municipalities. I have followed all the press conferences to try to figure out where the government's motivation lies. Will there be a proposal? Reference is made somewhat vaguely to the EU's state aid rules, but it does not appear at all how one is working to get clarity or if one has any alternative proposal. If the will really exists, the government should be able to construct a proposal as support for those parts of Sweden where it is difficult to recruit, we believe.

I want to mention that one result of the competence shortage in dental care is the dental insurance that Folktandvården offers, for example here in Stockholm. But this has been removed in several regions for some time and is therefore no longer available. I heard that in the debate it was referred to that young people could get cheaper dental care in that way. But if they live in a region where this does not exist, they have no possibility whatsoever to take out such an insurance. I think it is very important to say that.

There is an over-establishment in Stockholm. We must have significantly better staffing in the rest of Sweden. What does the government intend to do about the current imbalance between city and country regarding personnel availability? That imbalance constitutes a threat to the entire dental care system's purposefulness and resource efficiency. It is that serious. What proposals do you have?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dan Hovskär (KD)

Mr. Speaker! I thank Anna Vikström for the questions.

We are looking at this issue. Dental care is an important pillar in the whole. We are now making a huge investment of 3.4 billion to raise it. We are making an investment so that those over 67 years of age can receive dental care that they can afford.

It is clear that we now must look at the competence supply. As I said earlier, we are looking at how the municipality type supplement could be designed and what the EU's state aid rules provide for opportunities. It is an important issue, but not only for dental care but in many different industries, as I mentioned earlier, not least in healthcare as a whole. It involves, among other things, working with different measures to try to raise the status and make these professions attractive, so that more people want to get educated.

We are following this with precision in order to be able to find new opportunities in step two. I have good confidence. I believe that this initiative will be positive. We must also work on the skills supply in all other industries.

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Karin Rågsjö (V)

Mr. Speaker! First, I have a question for the member regarding young adults. Why does this SD-dependent government constantly leave young adults behind? One can wonder about the fact that there is 25 percent unemployment in that group. Now, the reforms regarding the possibility for young people to receive dental care more cheaply have also disappeared. I think that is a very sad development. It is not the case that young adults have good conditions to pay, take out insurance, and so on. This is a very fragile group economically in various ways.

In all the tags you have taken, young adults have been affected. Are you building cheap rental apartments? No. Are you giving them jobs? No, that cannot be said, considering that there is 25 percent unemployment. I think it is a clear mistake that you also remove the conditions for young adults to receive dental care.

My second question concerns the approach towards people with poorer finances. It appears in the Socialstyrelsen investigation that the question of who has the worst conditions to be able to go to the dentist is about class and not age. Despite that, we stand behind this reform. But it is obvious that we live in different worlds. People are being impoverished – 700,000 people consider themselves poor. There is high unemployment. People have lived under an enormous cost pressure during the years you have governed. I wonder why you have not proceeded with the reform work. You must have had the means. If one chooses to lower the tax for the richest, one also has the means to pay for a larger reform.

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Dan Hovskär (KD)

Mr. Speaker! I thank Member Karin Rågsjö for the questions.

First, I want to point out that we do not have an SD government in this country. We have a government led by Moderates, Christian Democrats and Liberals. Then we have a cooperation with SD. We call it the Tidö cooperation. It is a good cooperation, I want to emphasize.

Regarding the 20–23-year-olds, a number of different surveys show that this group largely consists of quite healthy patients who have consumed more dental care than has been justified, which has pushed out patients with greater care needs. It is neither equitable nor resource-efficient. Therefore, we are investing in people who are 67 years and older, where we see that the needs are usually greater. In this way, we use the resources in a better way, which a large number of investigations have shown.

The younger people may indeed have it tough with the economy and so on. But even continuing, they can get their dental care allowance, and there is a high-cost protection for the younger people as well. I feel secure with this initiative. It is a good first step that we invest in the elderly.

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Karin Rågsjö (V)

Mr. Speaker! No, SD is not in the government. But you are completely dependent on the Sweden Democrats, member. If they take the car from your cooperation, it will collapse like a house of cards. The member knows that too, don't they?

Back to dental care! The Swedish Dental Association has conducted a survey of the Swedish people's ability to pay for dental care, and there, the question of class shines through all the time. Four out of ten of those who cannot afford it state that they have not been able to prioritize the dentist for four years. It has been about high costs for food, electricity, and so on, and increased interest rates. It has been difficult for them because of the inflation that has occurred and your non-existent investments in the group of people with poorer finances, I want to assert.

This thing with 67-plus is very good – sure. But what about the others? Let us look at the group of workers in northern Sweden who are in the age group 35–49, live in rented housing, and have an income of 300,000. For them, it is the worst situation when it comes to being able to go to the dentist. It is a fairly high proportion, 25 percent, who believe that they cannot go to the dentist.

This is simply about class and about how one invests their resources. One can do their work to achieve a potentially equal Sweden, which I am for. But that is not what you have worked for for nearly four years; instead, you have worsened the conditions for poor people. 700,000 are estimated to be poor in Sweden. In that case, there is no dentist, I can promise you. This is a great failure for the SD-dependent government, I believe.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dan Hovskär (KD)

Mr. Speaker! Thank you, member, for the questions!

It is obvious that one must cooperate. We cooperate very well with SD, but they do not sit in the government. That was what I pointed out and clarified. Then we have a good cooperation with them.

When it comes to the economy, we have lowered the taxes. Everyone benefits. It also benefits young people, middle-aged people, and the elderly. If we just take one example, an average family gets 42,000 kronor more per year in their wallet. That means one gets resources to be able to go to the dentist, and one can do various other things. It is about giving freedom.

If we look at the Left Party's policy, we can observe that they want to raise taxes so that it becomes much more expensive for everyone, and not least for the elderly. Here we are making an investment, which we admittedly agree on, when it comes to dental care, which is good primarily for our elderly.

That initiative means that many who previously did not have the opportunity to go to the dentist can now do so. The state covers 90 percent of the costs, and the individual pays 10 percent. It will make a difference. It is a good proposal that I feel very proud to present today. It is a positive reform.

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Christofer Bergenblock (C)

Mr. Speaker! First, I would like to move for approval of the Center Party's reservation 3 under point 3 in the report.

Oral health is of great importance for people's well-being and quality of life. Therefore, everyone shall be offered high-quality dental care at reasonable prices. In 2008, a dental care reform was implemented which ensured that more people could afford dental care, and in 2013, it was followed by further reinforcements for persons with extra needs due to illness or disability.

At the same time, there has been an obvious need to further reform dental care. Swedish dental care is characterized by several challenges regarding accessibility and equality, with large differences in oral health between different regions and residential areas and between different socioeconomic groups as well as different age groups. For Centerpartiet, it is clear that dental care, like all care, should be based on need.

With the new dental care reform, steps are taken in the right direction by incorporating the needs principle into the Dental Care Act. The major change, however, is that the high-cost protection is strengthened for the group aged 67 and older, where oral health is generally poorer than it is among younger people. The Centre Party welcomes that we can now implement a dental care reform that makes it significantly cheaper for seniors to go to the dentist for treatments and that more people thus get the opportunity to take care of their teeth.

At the same time as we support the dental care reform as such, we also have views on it. One of the things that the government completely misses in its reform concerns the large geographical differences in our country.

According to the dental care investigation, the proportion of those over 79 years old who have at least 20 remaining teeth is 75 percent among residents in our metropolitan regions, but only 56 percent among residents in our sparse rural municipalities.

The reason for the difference is related to both the economic circumstances of the individual and the accessibility of dental clinics. It is no secret that there are plenty of clinics in central Stockholm and that there are significantly fewer in our rural areas.

For that reason, the investigation proposed the introduction of a municipality type supplement that would provide a higher dental care allowance in rural areas. But the government does not present that proposal in its bill, but instead postpones it to a highly uncertain future.

Thus, the new reform risks reinforcing the differences between city and countryside instead of leveling them. This is very irresponsible of the government. From the Center Party's side, we argue that the municipality type supplement rather needs to be introduced to provide better conditions for providing dental care even in our rural areas.

At the same time, we see a number of other measures that also need to be taken to strengthen access to dental care in our rural areas. It is about reintroducing a basic service year in the dental education so that more can get to try working at a clinic located in rural or remote areas.

It is also about reviewing the possibility of economic incentives for the individual, such as relocation grants and writing off student debts. We believe, in fact, that it is better to spend the state's money on getting people to move to where the jobs are than to pay them to leave the country.

Another problem that the government has chosen to neglect in the bill is that private dentists risk being driven out of the market, which in that case affects both accessibility and competence.

According to the dental care investigation, there are around 2,800 private clinics in Sweden compared to 830 clinics within the public dental care. Taken as a whole, 65 percent of adult patients go to private dental care, and in Jämtland it is as many as three out of four. Among seniors, the proportion is even higher.

Access to private-practice dentists is therefore not just about freedom of choice; in large parts of the country, there is simply no public dental care available near where people live.

In today's system, dentists can set their own prices in a competitive market. But with the new system, pricing will be regulated via state reference prices. Warnings have been issued – both from public dental care and from private dental care – that the reference prices are calculated far too low and that it will lead to cheaper solutions with poorer quality and poorer aesthetics.

In the extension, it also risks leading to increased tax costs in the regions to finance the public dental care and to cost shifts or closed clinics within private dental care.

Even more noteworthy is that the patient is deprived of the possibility to choose a more expensive material or a better prosthesis than what the reference price allows, as this may not be exceeded. It thus risks becoming bad for both dentists and patients.

Centerpartiet argues that as a patient, one should have the opportunity to choose whether one wants a more costly treatment, but that one must then bear the difference oneself. This can be compared to glasses subsidies for children and young people, where one can add extra to get a more expensive frame or a specially treated lens.

For a government that calls itself bourgeois – and where at least one of the parties before the mandate period began called itself liberal – such an opportunity should be a matter of course, but so it is not for the Moderaterna, Liberalerna, and Kristdemokraterna. Perhaps it is because they are steered by a fourth party.

The new dental care reform also entails a number of other risks that are difficult to predict but that need to be thoroughly monitored already during the first year. A follow-up is needed where it is analyzed whether the free dental care leads to the displacement of other patient groups, whether it leads to threshold effects where patients postpone treatments while waiting to turn 67, and whether availability has been negatively affected, particularly in terms of competence supply and access to dental care in our rural areas. Centerpartiet wants to see such a follow-up in the near future.

Mr. Speaker! In summary, it is good that we are now implementing a reform that makes dental care cheaper for seniors. The Center Party stands fully behind it. It will lead to more people, in the long run, having better dental health.

At the same time, we are concerned that the Tidö parties are not taking the issue of geographical inequality seriously, that private dental clinics risk being wiped out, that patients are deprived of the opportunity to make additional purchases, and that there is no planning for a short-term follow-up of the reform.

Dental care is a part of our common welfare. From the Center Party's side, we argue that it must be both accessible and equal, regardless of where in the country one lives.

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Lina Nordquist (L)

Mr. Speaker! Until now, those with healthy mouths have thus received more subsidies than those who have the greatest need in our country. The oldest and sickest have been forced to choose between either a somewhat sustainable private economy or their own health. It is not acceptable.

Quality of life and health should never have to be deprioritized. Therefore, five or six years ago, the Liberals made a decision to push for a dental care reform. It became part of the Tidö Agreement. It was investigated, and we agreed on a multi-billion investment in dental care. This is the largest dental care reform in decades.

Mr. Speaker! Those who are over 66 years old and who need procedures to treat dental problems will, from January 1, in less than a month, usually have to pay 10 percent of the cost while the state – we together – will cover the rest. The exception is fixed prosthetics far back in the mouth. But when it comes to fillings and root canals in the entire mouth, those who are 67 years old or older will receive greater support in just a few weeks.

Mr. Speaker! On average, seniors' expenses for dental care will therefore be reduced by more than half – from today's approximately 4,600 kronor in a year to under 2,000.

Now we are fixing the holes in Swedish dental care, my friends. People shall receive the dental care they need throughout their entire lives, regardless of their wallet.

But it does not stop there. It is also crucial that we invest more in preventive work. In the government cooperation, we therefore strengthen the special dental care subsidy. It is simply a matter of making preventive dental care less costly for risk groups, for example those with poorly controlled diabetes or with dry mouth due to certain medications. Additionally, staff within elderly care shall learn to help elderly people maintain good oral and dental health. This is naturally extra important within the dementia area.

A very important part regarding what we are now debating is to introduce the principle of need and solidarity into the Dental Care Act. This means that dental care becomes more similar to other health and medical care. Dental care receives a clear mandate to prioritize those patients who have the greatest need. This is why I warmly urge approval of the committee's proposal, Mr. Speaker.

All this constitutes important steps for equitable dental care and for oral health for the entire population.

The Liberals want to introduce sensible risk assessments in dental care in upcoming reform steps and link them to the high-cost protection, so that even younger people with large health risks get a better opportunity to take care of their teeth and their oral health.

As residents, we must be able to know that society and help are there when needs increase. To have good health, to avoid malnutrition, to avoid disease, and to avoid infections caused by not being able to eat as one should be able to must not be a matter of the wallet. Every gap must be repaired in Swedish dental care.

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Christofer Bergenblock (C)

Mr. Speaker! Thank you, Member Lina Nordquist, for the speech! I share the opinion on much of what was said there.

It is good that we are now implementing a reform where more people will gain access to dental care through lower prices. At the same time, there are parts of the bill and the committee report that have been criticized, and there are parts of these that we from the Center Party are critical of. One of the parts that has received criticism from both the public dental service and from privately practicing dentists is the reference pricing. It is TLV that controls that pricing, and it is clear that it is something that must be followed up in the future.

Centerpartiet is a liberal party. We believe in people's own agency and the opportunity to make wise decisions themselves. Therefore, we have raised a proposal in our reservation to enable patients to make additional purchases. The reference price also indicates which material type and prosthesis has been calculated. We think it is reasonable that as a patient, one should have the opportunity to choose for oneself whether one wants to spend a little extra money on a better solution, with higher quality or better aesthetics.

Before this parliamentary term started, the Liberals also defended people's freedom of choice. My question, Mr. Speaker, is: Why can the Liberals not let an adult human being with an entire professional life behind them decide for themselves whether they want to pay the difference for a more expensive treatment or not?

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Lina Nordquist (L)

Mr. Speaker! Repetition is the mother of knowledge, so I repeat what many of my colleagues have said during this debate to the member regarding precisely this issue.

The Liberals are truly a market-liberal party, but when we use tax revenue together, it is no longer a regular market. Then it is a market where we need to be careful with the funds. When the state takes 90 percent of the cost for procedures, so that people can have good oral and dental health, the state cannot write a blank check – hence the reference prices.

When it comes to the development of these reference prices, it has been incredibly important for us that TLV truly uses a high standard. It must, for example, be about the possibility of Swedish-manufactured crowns of high quality. As the member knows, TLV has certified that this is how they have calculated. It must be about having good margins so that one can have well-educated staff, use good materials, and use the time required for the different procedures.

Don't you also think it is strange that the price for the exact same procedure today can differ by many thousands of kronor? That is the case, for example, in my county. For example, a root canal can cost between 3,000 kronor and 6,000 kronor. It cannot solely be about the material. There are other things behind it.

They are, therefore, large, large differences. When the state steps in and takes nine-tenths of the cost, the state must set limits on how high the cost may become. In that case, we have set the level at that which TLV has developed.

It is about good material. It can be Swedish-made material. There must be plenty of time to perform the procedure, and there must be well-educated employees.

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Christofer Bergenblock (C)

Mr. Speaker! I note that the member does not answer the question at all but instead proceeds to debate the reference prices. The Centre Party has not questioned that we should have reference prices. However, we have noted that there is criticism of the reference prices from both public dental care and private dental care. But we have not put forward any proposal to remove them.

What we have put forward a proposal for – a liberal proposal for – is people's freedom of choice. It means that as a patient with an entire professional life behind them, one should have the opportunity to say: "I want a better crown. I want a different filling that is of higher quality. I want a different form of repair that provides better aesthetics." We think it is perfectly reasonable. The Liberals, especially as they now claim to also be a market-liberal party, should give the patient that opportunity.

We heard the Moderate member say earlier that this is about crime within the welfare system and that the country's 2,800 private dental clinics might be run by criminal networks. But that is a completely different issue. It concerns the granting of permits. The Center Party wants permit granting within dental care, which has not existed previously. So we handle that issue. But this is about freedom of choice.

Why can't people have freedom of choice? It doesn't cost the system more. It doesn't cost the taxpayers more. But it gives people the opportunity to have a bit more control over the treatment they receive.

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Lina Nordquist (L)

Mr. Speaker! Now it itches a bit under the skin, I must say. It feels unpleasant and also very sad with the increasingly common exchanges where one party tries to debate substantive issues and explain what it is we want to do, and another party, in this case the member, spends time saying that some other member in another party recently would have claimed that several thousand skilled professionals would be criminals. That is simply not true. That one participates in a substantive debate with dishonest insinuations about others' intentions and choice of words that do not befit this chamber, I regret.

In response to the member's question, I can say that the reference prices are developed based on the highest material standard, i.e., Swedish-made crowns and so on. It is contained within TLV's reference prices that the quality is as high as one could ever wish for.

I hope that the member in future exchanges of remarks – perhaps not in this debate, but in another – listens to the answers and takes them into account.

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Nils Seye Larsen (MP)

Mr. Speaker! Good dental care should not be a class issue. But in today's Sweden, where the gaps are increasing significantly between the poor and the rich and between city and countryside, where relative poverty has increased markedly, it is more and more people who cannot afford the dental care they need. It is completely unacceptable.

For Miljöpartiet, it is obvious that it should be the need and not the size of the wallet that governs access to good dental care. Teeth are a part of the body, and our long-term goal is a high-cost protection for dental care in line with healthcare in general. We place the focus on preventive measures and on the greatest need going first. We improve dental care for particularly vulnerable groups and ensure good access to dental care throughout the country.

The government's proposal for an enhanced high-cost protection for dental care, the so-called "tiotandvården," is a step in the right direction. Therefore, we will support it. There are some challenges and shortcomings that we will go into, but we share the Swedish Dental Association's view in that it is a step in the right direction.

We would have wished that one had dared to proceed with the proposal in the dental care investigation *When need takes the lead – a dental care system for more equal dental health*, which we in Miljöpartiet and the Social Democrats in government commissioned. It was a more unified reform proposal to restructure the entire dental care system for more equal dental health.

There are things that the Folktandvårdsföreningen highlights that we share. A needs principle should be introduced and written into the Dental Care Act, and a common risk assessment system for the dental care actors in order to be able to manage resources and prioritize preventive care and better cooperation between public and private actors.

When it comes to dental care, I intend to highlight some challenges we see. It is a good reform for those over 67, but it is also a reform where one has fundamentally chosen to prioritize age over need. We see that as problematic. The reform does not cover aspects such as examination and preventive care. Prosthetic treatment – crowns, bridges, implants, and other – behind the fifth tooth is not included. I can really see that it will become a gigantic information challenge for dentists all over Sweden to explain why one thing is included and the other is not. One should have been much clearer about that. I am also a bit questioning why the line was drawn at exactly the fifth tooth, as the molars behind are extremely important even for our elderly.

Regarding the compensation, I share the view on the risk that dental technicians have highlighted. There are a number of dental care operations that have their own production with dental technicians in-house. There, there is a real focus on quality. It is a challenge with the fixed price levels that exist. They risk increasing the amount of imported [products] with lower quality.

There has been debate about the reference price. I agree somewhat with the concern. There is variation in competence, experience, and quality in the dental care that is performed. There are also different challenges depending on where in Sweden one is, i.e., if one is in a large city with great competition and many customers close at hand or, for example, in rural areas. This should be better taken into account going forward, because with tiotandvården one is bound to deliver for the reference price that exists.

Another thing that perhaps has not been highlighted as much here, but which I know we will need to discuss, is the major competence challenge within dental care throughout Sweden. I would like to take this opportunity to extend a big thank you to our new residents who work in dental care and who are studying dental care. It is probably thanks to them that we might be able to manage dental care in the future.

This is a reform that needs to be evaluated and followed up. That is also what we have demanded. There are deficiencies in the proposal regarding dental care, but it is still a first step towards a more comprehensive high-cost protection for dental care.

In conclusion, I want to express the Green Party's strong concern regarding the lowering of the age limit for free dental care for young adults. We were against it, because as everyone knows, good habits start early. It is already seen that the young are dropping out because of the price, and that makes me very worried about the oral health of the population moving forward and for the risk of an increased need for dental care as people get older.

I vote in favor of reservation 2.

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Christian Lindefjärd (SD)

Mr. Speaker! I want to begin by moving for the approval of the proposition One reinforced high-cost protection for dental care.

We went to the polls on this in 2022, and now the first step in the right direction is being taken. On January 1, we take an important step for Swedish pensioners. For people who have turned 67 and who have worked and struggled their whole lives, it will become significantly cheaper to go to the dentist. It is about dental care. It is a clear example of how society prioritizes those who have built the country.

Teeth are a part of the body. They are not a luxury. Yet many elderly people have been forced to live with pain, infections, and shame. The pension is not always enough. It is unfair. If one has worked their whole life, it should not mean that one cannot afford to go to the dentist.

Today we take responsibility. The reform means that the state pays 90 percent of the cost and the patient 10 percent. It is secure, predictable and right. This reform puts Swedish pensioners first, because those who have built the country should not have to choose between fixing their teeth or buying food. Tax money shall be used for people and not for unnecessary bureaucracy.

The reference prices have been developed by the Dental and Pharmaceutical Benefits Agency, TLV, in dialogue with the dental care industry. Some have said that the prices are too low, but without clear frameworks, the reform would not have been possible. Care providers may not charge more than the reference price. If one is connected to the Försäkringskassan system, one must accept the patients, and this creates order and security. Thus, 29 percent of the market becomes price-regulated. The rest functions as before. The dental care subsidy and the high-cost protection remain. Stability and freedom of choice continue. Examinations are not included in the ten-dentistry, but the general dental care subsidy still applies.

At the same time, Ivo shall carry out stricter controls, and there shall be clearer requirements on who operates the clinics. It is necessary when the state invests such large sums of money. The tentacles of welfare crime are creeping in everywhere, and we must always stay one step ahead.

Mr. Speaker! Folktandvården bears a great responsibility for children's dental care. That must continue to be the case, but the private dental care must take its responsibility and relieve Folktandvården. It is also about the staff. Dentists must be able to develop, work with all ages, and want to stay in the profession and perhaps not just work with children.

The shortage of dentists and dental hygienists is great, especially outside the major cities. Long-term and sustainable solutions are required here so that Sweden can offer dental care across the entire country.

We have today a very strong dental care for children thanks to preventive work, clear summons, and free dental care for children and young people. It works and shall continue to work, but the responsibility is shared. Guardians must ensure that children attend check-ups. The preventive work reduces suffering and future costs, and this is a saving for the whole society.

Mr. Speaker! Many over 67 years old are now waiting with their dental visit until after January 1. This shows how long-awaited the reform is, and it shows that politics makes a difference when it focuses on the right priorities. The Sweden Democrats stand for safe, fair, and responsible welfare. Swedish elderly are prioritized. Tax money is used with common sense. Therefore, I move for approval of the bill.

The deliberation was hereby concluded.

(Decisions were made under § 16.)

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