Social insurance issues

Caroline Högström (M)

Mr. Speaker! Today we are debating a motion report with a broad palette, to say the least. The social security benefits span support for those who are ill, support for those who care for a close relative, financial support due to, for example, a disability, and funding for collective measures.

The sickness insurance shall provide financial security in the event of illness. It shall be there when life changes and needs are at their greatest. But equally important is that it supports a return to work, because security is not just about money but also about feeling community and empowerment.

The sickness insurance has to an all too high degree become a solution to several problems that society has failed to solve. All too many people get stuck in long sick leaves because there are deficiencies in other systems. It can be about deficiencies in healthcare, in the work environment, or in preventive work. Often it is women in the middle of life working in the public sector who are hit hardest.

Mr. Speaker! The Moderates' starting point is clear: We see people's potential and not just their problems. We know that sick leave should be avoided in many cases for the individual's sake.

A full-time sick leave can lead to lost social contact, impaired mental health, and a longer path back. In the worst case, persons with mental ill-health can fare even worse in an excessively passive sick leave when the social safety net is withdrawn and the workplace and the community with colleagues move further and further away from them. Therefore, it is so important that it is not merely a sick leave for the sake of the sick leave, but that it is an active care effort with the aim of getting the insured person back on their feet again. We safeguard a sickness insurance system that both provides support when needed and promotes a return to work.

Mr. Speaker! It is pleasing that sickness absence in many places is historically low from a longer perspective. But at the same time, the number of long-term sick leaves is increasing, especially due to mental ill-health. This worries us – and it requires action.

The government has therefore already taken several important measures that I would like to take the opportunity to mention here in the chamber today.

The budget for workplace-based rehabilitation support has been increased.

A clear mandate has been given to Försäkringskassan to improve cooperation with healthcare, the employer, and occupational health services.

The Government has held round-table discussions on sick leaves with municipalities and regions, which is particularly important given that it is in those sectors that we see the largest proportion of those on sick leave.

Within the area of the Committee on Health and Welfare, important investments have been made in research on women's diseases such as endometriosis and menopausal symptoms.

In January this year, the government presented a national strategy for mental health and suicide prevention.

The government has also reached an agreement with Sveriges Kommuner och Regioner that the work shall be developed to promote mental health and prevent ill health and suicide, as well as to improve the living conditions for persons with mental ill health.

In the budget amendment, the government is making an increased investment in specialized mental health care.

Försäkringskassan is tasked with strengthening the follow-up of employers' plans for return to work as well as improving the coordination of rehabilitation.

The government has also taken the initiative for Sweden's first national strategy against loneliness, which is an important piece of the puzzle for promoting mental health.

What I have described is only some parts of a holistic approach. We Moderates are convinced that the solution lies in not only extending the period of sick leave but also reducing the causes behind why people become ill. This is ultimately a question of people's lives and health, and therefore it is very positive that we have a government that takes this issue seriously.

Mr. Speaker! I also want to briefly comment on the Swedish National Audit Office's review of the work to prevent sick leave and facilitate return to work, which is addressed in this report.

It is an important review that shows there is potential for improvement, to say the least, among other things when it comes to governance and follow-up within Försäkringskassan and healthcare. It strengthens the Moderate line. Clearer cooperation, better coordination, and a focus on returning to work are required. The Government has already taken initiatives that respond to this, not least by developing the work with insurance medicine and the rehabilitation chain. But continued follow-up is required, not least with women's health in focus.

The opposition often paints a dark picture of Moderate politics within the social insurance system. But the fact is that we focus on legal certainty, accuracy, and return to work. The left's solution tends to be to have more people on sick leave and to extend those sick leaves. Our solution is that more people should return faster. While the left condemns people from the labor market to loneliness in long sick leaves, we see the potential in people and want them to be part of a work community – to the extent that they are able.

We shall have a health insurance that is proactive in a crisis but which also expects both the individual and the surroundings to act for recovery. It requires responsibility from the individual and from the healthcare, the employer, and the authorities. Collaboration is the key.

Mr. Speaker! Since we are talking about cooperation, I would like to take the opportunity to say a few words about the coordination unions. There, Försäkringskassan, Arbetsförmedlingen, and municipalities and regions gather to cooperate around individuals who are often far from the labor market and whose journey to return is often long.

With successful interventions, the coordination associations can make a big difference for the individuals. A couple of weeks ago, I had the opportunity to visit Surahammar and Samordningsförbundet's intervention there. There, I met committed employees and a participant who described their journey from being homebound to now having a job – incredibly inspiring! When we collaborate and provide society's collective support to come back, we can make an enormous difference for the individual.

Mr. Speaker! I also want to say something about equality. Women are overrepresented when it comes to care of relatives and close relatives' allowance. They are taking an ever-increasing responsibility for unpaid parental leave, and above all, women are overrepresented in the sickness absence statistics.

This image is worrying. But the solution lies in improvements of the work environment, care chains, and investments in research and preventive work. That is exactly where this government is making a difference.

The Moderates believe in reforms, not retreats. We believe in freedom under responsibility – also within the social security systems.

I therefore wish to vote in favor of the committee's proposal for a decision.

(Applause)

In this speech, Magnus Resare, Mats Sander and Viktor Wärnick (all M) concurred.

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

Malte Tängmark Roos (MP)

Mr. Speaker! There has been a proposal from an inquiry on the government's desk for a couple of years now regarding enabling students to be partially signed off on sick leave. There are also several completed inquiry proposals that would lead to, among others, cultural workers, athletes, and entrepreneurs receiving stronger protection in the sickness insurance – quite simply, greater security.

The government has, however, not yet proceeded with any of these investigation proposals, and I want to ask Caroline Högström why the government is not acting so that more entrepreneurs, students, cultural workers, and athletes, among others, can receive stronger protection in the Swedish sickness insurance. These should be quite uncontroversial issues, but unfortunately, we see no action from the government.

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

Caroline Högström (M)

Mr. Speaker! Thank you, Malte Tängmark Roos, for the question!

I can, of course, not provide more insight than to say that the issue is being prepared in the Government Offices, but I would like to take the opportunity to highlight something that I think is an important difference between the Moderate-led government and the Green Party's previous government collaborations, and that is precisely the historical investment we are now seeing to counteract mental ill-health.

When we entered the Government Offices, we made clear offensives. We prioritize mental health in primary care, and we also see the connection between school, social services, and healthcare. The solution is not to hide and forget people in the statistics; the solution is early interventions and closer follow-up.

It is exactly what this government is doing, and it is how we will actually address the situation we see within the sickness insurance and can get more people back to work.

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

Malte Tängmark Roos (MP)

Mr. Speaker! The issue is being prepared in the Government Offices, says Caroline Högström. One of these investigations, the most recent one, was presented two years ago. The other investigations have been on the government's desk even longer than that. I may be naive; I am quite new here in the Riksdag. But I do not think it should take two years to read through an investigation report and come to what proposals one wants to implement.

I return to my question: Why does it take so long to process these issues? They have been on your desk for quite some time.

When it comes to mental health, the government is absolutely investing in it, and I think that is one of the few good things the sitting government is doing. We in Miljöpartiet included more money in our budget proposal for psychiatry and for the initiatives on mental health that we want to see. But I am happy to engage in a competition over who can invest the most in countering mental ill-health.

I would still like to have an answer from Caroline Högström: How long should it take to prepare a question in the Government Offices?

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

Caroline Högström (M)

Mr. Speaker! I would never dare to call a member of the Green Party naive, but I can state that when the Green Party was part of the government base for eight years, not particularly much happened in this area. It is only when you are in opposition that you say you want to do things. But when you had the power and the opportunity, we did not see that much. I therefore believe that the Green Party is held responsible when it comes to why it takes time.

One of the factors was that we did not come to a set table. When we took power in 2022, inflation was sky-high. We did not have the reforms in place, and many of the inquiries that have since been presented have not really been such as we can work with directly – they require more work.

I believe rather that this is a result of previous environmental party and Social Democratic policy that we are now trying to clean up.

(Applause)

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

Åsa Eriksson (S)

Mr. Speaker! I would like to begin by moving for the approval of reservation 38.

The sickness insurance must, of course, be a security for everyone who works. When life takes a turn, when the body or the psyche says no, we must be able to trust that society is there. The bourgeois parties chose another path when they reformed the sickness insurance, a path where the sick were made suspicious and pressured, and where the economy many times ultimately forced people back into work before they were ready. We tried to change that step by step when we held government power. We did what we could, but there was no majority in the Riksdag to make the sickness insurance sufficiently good.

Mr. Speaker! We Social Democrats say that it is not the human being that is wrong, but the system. We want the focus shifted from pressuring sick people to helping people back to work capacity. It requires that employers, healthcare, and sometimes even Försäkringskassan and Arbetsförmedlingen take a greater responsibility. It is not reasonable that the person who is sick should bear the entire burden alone.

We Social Democrats have many proposals to make the health insurance more fair, solidary and efficient, but today I want to highlight three parts.

Firstly: The unfair care deduction must be removed. The care deduction hits hardest those workers who need to be at their workplace every day to take care of the elderly, drive the bus, or continue the construction project they are working on. A childcare worker who is sick twice in a month, perhaps because they have been infected by sick children, loses 2,256 kronor in reduced wages today due to the care deduction. That is a lot of money for someone who does not have a particularly high salary.

Mr. Speaker! Half of the LO members state that they have gone to work at least once in the past year despite being ill. This applies to 7 out of 10 retail workers. Sweden is the only country in Scandinavia with double, or actually triple, deductibles in the sickness insurance. No other Nordic country has quarantine deductions. Nevertheless, the Finnish, Danish, and Norwegian workplaces seem to function perfectly well.

Despite this, the SD government wants to keep the system with quarantine deductions. It is short-sighted and unfair. We believe that it is not only right for the individual to remove the unfair quarantine deduction but also socio-economically wise. When the sick can afford to stay home to get well, the spread of infection also decreases, and long-term sick leaves can be prevented.

Secondly: The guarantee payment in the sickness benefit must be raised. Today, it is at such a low level that hardly anyone can live on it for a whole month. It is a mockery of those people who, due to illness or disability, do not have the capacity to work. With a raised guarantee payment, we show that society stands behind these people and that we value their lives and their contribution. It is a matter of dignity but also of equality.

Thirdly, we Social Democrats want to broaden the cooperation within Finsam. It is about giving people with complex needs, who may have been on sick leave for a long time, who have mental ill health or comorbidity, a real chance to find their way back to working life. We just heard Caroline Högström describe the excellent activities in the coordination association in Surahammar. There are very many more around the country.

I wonder why the SD government does not govern the state authorities so that one uses the tool Finsam in an effective way. Today, unfortunately, far too many people fall through the cracks. We read just yesterday in Arbetsvärlden that Arbetsförmedlingen now has a project to get rid of the difficult cases instead of using the tool Finsam, which would have been absolutely excellent for helping the group of people who have reduced work capacity due to illness.

When authorities join forces in joint efforts, capacity can be built in a secure environment and the individual can receive support to support themselves. Finsam has shown that cooperation works, but today not enough people are reached. We Social Democrats therefore want to see a broadened legislation that allows more groups to receive coordinated support. The government must now urgently ensure that Försäkringskassan and Arbetsförmedlingen are steered so that they already today use the super-potent tool Finsam as it was intended.

Those who pay the price for the government's and the directors-general's nonchalance are the sick and the unemployed, who are forced to continue a life of exclusion. It is shameful.

Mr. Speaker! The Swedish National Audit Office's report on the use of overriding reasons in 180-day sick leave, which is also included in the committee report, is a change to the regulatory framework that the Social Democrats and the Green Party made when we held government power in order not to force sick people away from occupations and workplaces for which they have training and competence.

That report shows something important, namely that Försäkringskassan lacks decision support for how overriding reasons should be interpreted. It creates uncertainty for the case officers but, above all, for the people who need support in a tough life situation. That one is dismissed and thrown into unemployment instead of receiving the rehabilitation, the support, and perhaps the adaptation required to return to the job one can do and the colleagues one knows should obviously be avoided when overriding reasons indicate that there is a way back.

I am proud of the changes to the legislation we made. We Social Democrats oppose a tightening of the assessments. But instead of ensuring that the case officers at Försäkringskassan receive better tools and support to make legally secure and individual assessments, the government chooses to go in another direction. They want to review how the concept is used, and we Social Democrats fear that it is a way to further tighten the assessments. It is the wrong way to go, and therefore we have a specific statement on it.

Mr. Speaker! The sickness insurance must be there when people are unable to work due to illness. It should not be a control machine where people are bounced around, but provide security while work capacity is diminished. We Social Democrats believe that there must be room for individual assessments. Not all illnesses look the same. People are not templates. They are individuals. They have different possibilities for returning to work, and they shall receive support to reach their full work capacity as soon as possible.

We want to task Försäkringskassan with ensuring that employers enter the rehabilitation process earlier, that support is provided faster, that interventions are implemented in a timely manner, and that more people receive support to regain their work capacity instead of getting stuck in passivity and exclusion.

We Social Democrats believe in a sickness insurance that both provides security when one is ill and contributes to people returning to work. It is fair, humane and sustainable. We believe in a society where security goes hand in hand with responsibility, where no one is left behind and where systems are built for the human being – not the other way around.

Sweden should have a health insurance to rely on. But that requires political will. Unfortunately, we have not seen any sign of that from the SD government. We Social Democrats want to build a health insurance that holds up in both headwinds and tailwinds. But for that, a progressive majority here in the Riksdag is clearly required, and I hope that the voters will vote for that in just over a year, because then it will get moving.

(Applause)

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

Ingemar Kihlström (KD)

Mr. Speaker! I would like to begin by moving for the approval of the committee's majority decision. This also entails the rejection of all motions within the area of social security issues.

We know nothing about our own tomorrow. Life can contain situations that mean we need support from healthcare and also financial support. We should all have the opportunity to feel security and that the collective carries and provides support when one, for various reasons, is unable to do what one wishes.

For us Christian Democrats, it is important that the social insurances contribute to economic security regardless of where and when in life you find yourself. At the same time, much more can still be done so that fewer people need to become ill as well as so that more people can return to activity and work after a period of illness. We Christian Democrats advocate for a security system that provides economic security through life's different stages. How the system is structured is of great importance for both people's security as well as people's behavior and motivation to work.

Mr. Speaker! The safety system needs a direction and model that gives every person the motivation to participate in measures that lead back to good health. The goal should also be that every individual returns to work life and activity as soon as possible, naturally based on the ability and capacity the person has or can reach in the long run. Here it is important that society and employers cooperate with good rehabilitation based on each individual case.

To reduce the sickness absence rate in the long term, the preventive work is also central. We Christian Democrats want to emphasize that this preventive work must be seen in a broad perspective. It is not enough to focus on the workplace and the problems that can arise there. The different parts of life must be possible to reconcile.

There must be the possibility of individual choices, not least for families. The basis for this is a policy that broadly contributes to reducing stress and which creates good conditions for improved public health. The possibilities for each individual to put together their life puzzle are influenced by the policies pursued in many different areas.

We believe that policy should, to the greatest extent possible, avoid directing and controlling people's lives. Instead, it should be aimed at continuously creating better conditions for individuals and families to manage their everyday lives. We want to give people power over their everyday lives, and there must be opportunities for freedom of choice. Unfortunately, during the past years, we have seen how the S-led government has moved in the opposite direction and wanted to control the everyday lives of individuals and families with children more.

We want to carry out a clear shift within family policy, where power and influence over one's own everyday life is moved from politics to the individual family. In this way, today's stressed parents and children can get more time with each other while simultaneously making the combination of parenthood and work life easier.

Mr. Speaker! Not all illness can, of course, be avoided through strong preventive work. Healthcare must be able to offer good, accessible care within a reasonable timeframe. Healthcare shall help us feel well and provide care when we become ill. It needs to have a health-promoting and caring mandate. The health-promoting interventions need to receive greater focus. Every person has an individual responsibility, but more societal sectors must contribute so that all people have good mental health and so that preventive measures shall function.

The starting point for the sickness insurance is that it should be secure for those who have reduced capacity to work due to illness. Those who can regain their capacity to work, fully or partially, should naturally receive help and good support to return to work. Anything else would be a great waste of both human and societal resources.

We want the sickness insurance system to ensure people's opportunities, and it is important that the system provides incentives to take advantage of every person's work capacity and offer different paths back to work. The individual's work capacity shall be emphasized, and therefore a possibility for greater flexibility is needed.

Today, the system is quite rigid. We have long argued that the fixed steps in the sickness insurance, which today are 25, 50, 75, or 100 percent, should be changed. We believe that the individual's full capacity and possibility for work effort is not realized in today's system. We continue to advocate and argue for greater flexibility through a personalized percentage between 20 and 100 percent, without fixed steps.

An additional reason for such a system is that it would be more accommodating towards people who, for example, have lost a loved one. Today, many take sick leave due to grief. There is, of course, a possibility for those working in a company with a collective agreement to receive some leave in connection with a death. But after that, the system's bluntness is something that makes it difficult for people who have lost someone to return to normal work capacity at the right pace.

Mr. Speaker! The healthcare queues are still unacceptably long. We have long argued for measures that should address this. For us, what is stated in the Tidö Agreement regarding increased state governance appears as a good step. Shorter healthcare queues provide the opportunity for faster recovery and to return fully and to the best of one's ability to work. It is positive for every human being but also for our society.

Many causes of illness are rooted in mental ill-health. Since taking office, the Government has increased investments in its latest budgets to support the work of meeting mental ill-health. Under a Christian Democratic minister, significant work is now being done to improve this vital care. It is also an important piece of the puzzle to reduce sick leaves and increase public health.

Naturally, focus is also needed on rehabilitation and that measures are implemented to counteract ill health. Reform work is needed to increase the labor supply. Improved rehabilitation and work based on the ability one has provide the conditions to meet the increased sick leaves.

Mr. Speaker! The Christian Democrats are, as stated, giving their support to the committee's proposal. This motion area shows, however, like many other areas, that there is no unified policy within the opposition. The reservations are made largely individually, and one may wonder what the common line is, if, contrary to expectations and my own hope, it becomes a different government after the next election. But that is probably a question that we will not get an answer to in this debate.

The government parties have agreed on a political action program within many areas, including within the social insurance area. We are in the process of launching the policy, and we will return with more proposals.

(Applause)

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

Clara Aranda (SD)

Mr. Speaker! Tonight we are debating the Social Insurance Committee's report on social insurance issues. In the report, the committee also addresses the government's communication regarding the Swedish National Audit Office's report on the Försäkringskassan's use of "considerable reasons" in 180-day sick leave.

Initially, I would like to move for approval of reservation 46 and also read out our position in connection with that specific point.

"The Government should work to increase knowledge about effective rehabilitation measures and review measures to develop rehabilitation measures for those on sick leave who suffer from mental ill-health. In its work, the Government should particularly consider the need for measures to strengthen women's mental health. Mental ill-health is an equality issue. Women are on sick leave at almost twice the rate as men."

The government should also develop the work with knowledge-enhancing measures to increase awareness of early signs of mental ill-health and review structures where early signs of mental ill-health can be handled with rapid measures as part of a systematic proactive work. Knowledge should also be strengthened among the actors involved.

The government should also consider including a suicide prevention focus in the continued work with the sickness insurance, consider the need for a review and analysis of Försäkringskassan's change work with a particular focus on sickness absence for psychiatric diagnoses, consider the possibility of introducing requirements for medical suicide risk assessments in the insurance medical decision support, and consider the need to direct the collective national work on suicide prevention toward the sickness insurance's problem areas. Knowledge of and understanding of the meaning of psychiatric conditions and mental ill-health needs to be further developed.

The government should also work towards needs-based agency communication by tasking the relevant agencies to review their communication with the target group that has stress-related mental ill-health.

Mr. Speaker! Despite the fact that psychiatric diagnoses are the most common cause behind sick leaves, the Sweden Democrats are quite alone in talking about actual measures to handle this, not least in the context concerning sick leaves. Therefore, I am pleased that the Moderates, with Caroline Högström at the forefront, are also highlighting this important area in the chamber tonight. I will continue to specifically address the area in today's debate because the issue clearly needs to be given more attention.

That women are signed off work to a significantly greater extent due to mental ill-health and are signed off work for longer is nothing new. We have known that for a while. It is unfortunately recurring when it comes to issues concerning women's health. Both care and research in the field have long been neglected. The Sweden Democrats have for a long time pushed for the knowledge to increase regarding diseases and conditions that primarily affect women and girls. For us, this is a completely decisive issue regarding fundamental equality.

Mr. Speaker! I am therefore particularly proud that the Sweden Democrats, together with the government, have presented the largest research and innovation bill ever, with a targeted focus on strengthening research on women's health and diseases. It is an initiative that shall focus on diseases and conditions that are unique to or more common among women.

When it comes to mental illness from a sickness insurance perspective, we are in great need of increased knowledge. We need to find out which factors lead to the mental illness, what consequences it has, and which treatment is most effective, not least regarding return to work.

We know that psychiatric diagnoses, for example depression and anxiety, in many cases lead to long-term sick leave. A sick leave in itself is not a treating measure, and an excessively long-lasting sick leave can in turn worsen the mental illness. Therefore, the right interventions early in the sick leave process are absolutely crucial for both the individual and society.

We can also thus state that we need to continue in the same direction that the sitting government, together with the Sverigedemokraterna, has begun, that is, a strengthened focus on research on women's health and diseases that affect women.

We also need to become better at taking in the new research and doing so both faster and more efficiently, not least to ensure that there is a scientific basis behind the measures implemented during long-term sick leaves due to psychiatric diagnoses. We need to ensure measures that make a real difference, that help, treat, and change lives.

Mr. Speaker! I also want to mention the Sweden Democrats' and the government's work with early interventions and care models that can meet different forms of mental ill-health quickly and in a purposeful way based on individual needs. It is absolutely crucial in this context. It is incredibly important that we strengthen primary care's work regarding mental ill-health. This is actually the first targeted initiative ever carried out regarding primary care's work with mental health.

The work to counter and prevent mental ill-health in Sweden continues to be one of the Sweden Democrats' and the government's most important priorities. With a long-term focus and investments that are in proportion to the fact that mental ill-health and suicide are among our time's great health and societal challenges, we will make a difference.

In the revised budget for 2025, there is an increased focus on specialized psychiatric care, which means that an additional 500 million kronor are allocated during 2025 with the aim of increasing the number of care beds within adult psychiatry as well as increasing the number of places for voluntary admission to a ward. This shows once again that we, together with the government, take this issue very seriously.

Mr. Speaker! I could stand here and speak for a very long time about our many and groundbreaking initiatives in the area of mental health, though I realize that I need to limit myself somewhat as the hour is late. In summary, we can all observe that the conditions to reduce the number of long-term sick leaves as a result of psychiatric diagnoses are increasing with the multifaceted measures that I have accounted for in my speech, and we will continue this work.

Mr. Speaker! I initially mentioned the government's communication regarding the National Audit Office's report on Försäkringskassan's use of overriding reasons in 180-day sick leave. I also want to state that the Sweden Democrats support the analysis in the government's communication, as we see that there is a need for Försäkringskassan to take measures to increase the uniformity and accuracy in the use of the provision on overriding reasons, based on what appears from the National Audit Office's observations and its recommendations to the agency.

For us, it is important to ensure what we mean by the mandate as well: that we get a uniform and accurate application by having Försäkringskassan rectify existing deficiencies in its guidelines on how the rule change shall be applied. With that said, the Sverigedemokraterna will closely follow Försäkringskassans work to ensure that the mandate does not lead to an excessively strict assessment. In our view, that is not the purpose of the mandate.

(Applause)

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

Patrik Karlson (L)

Mr. Speaker! The sickness insurance shall provide financial security in the event of illness and actively support the path back to working life. During this parliamentary term, the government has, among other things, taken initiatives to lower the thresholds for returning to work for those who have been on sick leave.

An important example is the proposal regarding work trials with maintained sickness allowance. This means that the person who is entitled to full sickness allowance in agreement with their employer shall be able to trial working for a short period without losing their compensation. The work trial can take place for up to 14 days at a time, but at most twice per year. Through this reform, those on sick leave are given a new opportunity to test their work capacity on a small scale, without the worry of being left without income.

For the individual, this can mean faster rehabilitation and increased self-esteem, and for the employer and society, it means that valuable competence is utilized. I believe that is how most of us want the sickness insurance to function – as a trampoline back into the working community, not quicksand that one gets stuck in.

We have also received and are continuing to work with broader foundations to promote a longer and more sustainable working life. In the autumn, the study A more sustainable and longer working life was presented. It describes measures that can make it possible for more people to have the energy and desire to work longer into old age, something that we see a need for today given that we have a skills shortage in the labor market. This is clearly important for the economy of the society but also for the individual's self-determination. Through a better work environment, skills development in working life and flexibility in the pension system, we lay a foundation so that those who can and want to work longer are able to do so.

Mr. Speaker! A concrete problem that has existed is the rule that a self-employed person over 55 years of age is not allowed to switch to a shorter waiting period in the sickness insurance. This has for a long time been perceived as unfair and hindered the security of older entrepreneurs. Pleasantly enough, this waiting period rule is to be abolished. It is reasonable that older self-employed persons are given the same opportunity as others to adapt their security. For the entrepreneur, it is about daring to continue running their life's work without worry of being left without compensation in the event of illness in their later years.

Self-employed individuals and students are two groups that have historically sometimes been caught in the gaps of our safety nets. We have long pushed for everyone to have a reasonable protection, regardless of whether one is employed, self-employed, or studying. A dynamic economy and lifelong learning require that people dare to take risks, both in their companies and in themselves, without fear of being completely left out of the safety nets if something unforeseen were to happen. It is quite clear that we need to keep up with societal developments and modernize our rules so that they suit both today's labor market and our educational patterns.

Mr. Speaker! Every krona in our welfare systems is intended to help – the sick, the unemployed, the person with a disability, the student or the pensioner. When benefit fraud is committed or incorrect payments occur from the systems, both the taxpayers and those in need are betrayed. It also undermines public trust when headlines about welfare fraud appear time and again.

That is why this government has made the fight against benefit fraud and cheating one of our priority issues. We can already see a number of completed and planned measures to tackle the problems. I am pleased that we are taking action on this, because I continue to want a broad and generous welfare system. It requires that we are tough on those who exploit it improperly.

An example of legislation in the area that is already in place is the law on the duty to provide information to counter incorrect payments. That law means that authorities have simply been given an increased obligation to share information to detect fraud and errors. Previously, secrecy and silos could prevent, for example, Skatteverket and Försäkringskassan from easily exchanging data – now we have changed that.

Another part is the payment security within the social insurance which became law on March 1, 2025. This means that Försäkringskassan can now, just like Skatteverket, in cases of tax fraud, be given the opportunity via a court to freeze assets of the person who is liable for repayment as a result of fraud, if there is a significant risk that the person will otherwise flee from their payment responsibility. In that case, Kronofogden simply steps in and takes the property into claim until the debt is paid or collected.

Through our collective work against incorrect payments, we increase the legitimacy of the security systems. Everyone who in one way or another is dependent on a benefit – sickness benefit, pension, student grants or other – should feel that the system is solid and reliable. Taxpayers shall know that their money is used correctly. And those who follow the rules, the vast majority, shall be spared the mistrust that spreads when fraud is uncovered. We all win from this, because that is how we maintain the will to finance our security systems even moving forward.

With this said, I move for approval of the committee's proposal.

(Applause)

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

Tony Haddou (V)

Mr. Speaker! One should be able to feel secure that the safety nets are there if one becomes ill. Unfortunately, that is not always the case. We have heard countless stories about people who, despite being assessed by doctors as too ill to work, lose their sickness benefit from Försäkringskassan with reference to the fact that they can take work that is normally available on the labor market.

The situation improved, however, in 2021 when the Left Party's mandates were needed in negotiations with the Social Democrats. At that time, we pushed through improvements in the sickness insurance which mean that more people receive sick leave after day 180. This, however, seemed to disturb the government and the Sweden Democrats slightly, and they appointed an inquiry to evaluate the new rules in the sickness insurance. The conclusion of the inquiry was that the new rules, which now allow more people to actually have the opportunity to get well and return to their jobs, should be abolished.

The government might get a small pat on the back for not implementing the commission's proposals. But what was also done when the commission was appointed was that another commission, which was to look at further improvements in the sickness insurance, was laid down.

This says something about the government and the ambitions it has or does not have, because there is much that needs to be improved in the health insurance.

The main goal of the sickness insurance must be that people should become healthy, regain their capacity to work and return to work or be able to seek new work – not that the sickness absence rates should be as low as possible. The numbers-based policy in the sickness insurance has been allowed to be governing for all too long. It must also be a goal that one shall receive financial security during the time.

Mr. Speaker! I will also say a few words about the quarantine deduction. The quarantine deduction represents a significant economic burden for those who work in traditional blue-collar jobs, especially for those who are extra vulnerable to infection or work in an industry where one needs to avoid infecting others, for example in preschool and healthcare.

Sweden is unique in the Nordic region in having a double deductible in the sickness insurance – we have a waiting period deduction while simultaneously not providing one hundred percent compensation during the subsequent days. No other Nordic countries have that system.

The government parties warn of "Monday sickness" if the quarantine deduction is removed. It is strange that this illness only seems to occur in Sweden. One thousand kronor less in wages for becoming ill for a month is a cost that many LO workers cannot afford to take. Therefore, many go to work despite being sick, with the risk of infecting others and simultaneously straining their own health. It is time for Sweden, like other Nordic countries, to scrap the quarantine deduction.

With this, I move for approval of reservation 39.

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

Anders W Jonsson (C)

Mr. Speaker! The social security system, which we are debating at this late hour, is an immensely important part of the Swedish security system. This applies not least to the sick leave system.

If one is affected by reduced capacity to work due to illness or injury, one should have a security that means one does not consequently face major economic problems. For many years now, we in Sweden have had major problems with the sickness insurance system. So it still is. Not least now, we can see how the costs for the sickness insurance system have increased sharply. They increased by 14 billion to 90 billion during 2024. It is the largest increase in many years. Half of the cost stems from mental ill-health.

That the system varies so significantly over the years without there being differences regarding which diseases, injuries, or accidents occur in the country is a sign that the system is not functioning. Just look at this with mental ill-health! In Norrbotten, only 41 percent of sick leaves are due to mental ill-health, while in Dalarna, which is actually a similar county, it is 54 percent.

Now during the winter, we received figures showing that repeated sick leaves are twice as common for people under 30 years of age as for people over 30 years of age. One might otherwise imagine the opposite, i.e., that there is more short-term absence the older one gets, but that is not the case. One in six under 30 was on sick leave six times per year.

The difference becomes obvious when one compares two important security systems, namely the pension system and the health insurance system. The pension system has for decades been characterized by our attempts to maintain political peace. It has not been quick shifts, but rather stable solutions. The health insurance system, on the other hand, has been open to political battles and quick shifts in different directions. This is concerning for the state finances. It is concerning for the companies, which have to bear the consequences of a very rapidly varying sick leave frequency. But it is most serious for the individuals, who feel anxiety about which rules actually apply if they are affected by illness or injury.

We must see that sick leave is a medical measure that not only has positive effects but also a number of side effects. There is, Mr. Speaker, plenty of research showing that long-term sick leave is associated with deteriorated health. For example, sick leave is associated with an eight times higher risk of suicide.

Just as in the rest of healthcare, where measures are carefully weighed when prescribing medication – what benefits does the medication have for the patient, what disadvantages does it have, and will the side effects outweigh the positive parts of the treatment? – one must also think in terms of sick leave. It is often argued in the debate that denied sick leave would be very serious for the individual. So it can certainly be in some cases.

But the Swedish National Audit Office conducted a very good review a few years ago where they looked at just over 5,000 people on sick leave. Some of them had been granted continued sick leave, but others had not. Both groups were completely comparable. The review showed that a denial of sickness benefit also yields positive effects in the form of increased chances of returning to work and a reduced risk of leaving the labor market with early retirement. The most interesting thing was that no difference could be seen when comparing the state of health in both groups.

We have received significantly increased costs. When the Minister for Health Insurance was asked what this could be due to, she said: I have no idea. But one explanation is actually the changes that were made during the previous term. The Center Party voted for them.

The most important change was that after 180 days of sick leave, one would not have strict requirements to start looking for another job, but if there was a possibility of returning to the previous job, one could continue to be on sick leave. This was a change with the best of intentions – it was intended to lead to more people returning to the work they had had previously. But an investigation that came out just over a year ago showed that was not the case. The investigation showed that the sick leaves have become longer and that the return to previous employers has not increased. The investigation's conclusion to the government was: Do it again! Do it right! Back up!

What we have to debate today is the National Audit Office's report, which essentially reached the same conclusion: Sick leaves have become longer, the return to the own employers has decreased, and there have been no effects when it comes to financial support or the individual's health.

The remarkable thing, Mr. Speaker, is that the government is doing nothing about this. The investigation has been put in a drawer. On the basis of the National Audit Office's report, some various assignments are given, but one does not seriously consider the changes that were made during the previous term with such negative consequences.

Mr. Speaker! In the debate, the care deduction is often brought up and it is argued that it would be a necessary reform to remove it. But if the care deduction is removed, it will lead to more people being on sick leave, not fewer. When a sick leave for the individual becomes cheaper, it will also lead to more people being put on sick leave. This will, Mr. Speaker, lead to more individuals being affected.

It also leads to the companies having to bear the costs. Svenskt Näringsliv has calculated that it amounts to 14 billion annually. I do not foresee the Center Party contributing to more people being on sick leave through a removed quarantine deduction. Instead, one should look objectively at another proposal, namely to have a smaller quarantine deduction at the beginning of a sick leave period and a second quarantine deduction later.

I want to comment on what happened during last year and which is still relevant, namely that the current government removed the high-cost protection for companies and employers. The high-cost protection meant that one could be compensated if one were to incur too high costs for sick leaves. It was an old system. It was introduced in 2010 and was changed somewhat in 2015.

There were two purposes. One and the most important purpose was to ensure that people with disabilities would find it easier to get work. Above all, small businesses that employ people with disabilities should not constantly have to think: Can this lead to high sick leave costs? The second purpose was, of course, to support not least the small businesses, which are those that are absolutely best at employing people who are far away from the labor market.

This was abolished with a club strike here in the chamber, and now we see the consequence. Another burden has been placed on the Swedish small businesses. Furthermore, people with disabilities will be moved even further away from the labor market.

There are other things that we from Centerpartiet want to highlight. It concerns this issue of qualifying for parts of the social security system. We think it is important that further consideration is given to it. It is about additional measures to facilitate things for small business owners. As some previous speakers have mentioned, it is about lowering the threshold for returning to work after sick leave – based on more flexibility regarding which levels it concerns.

Last but not least, it is about strengthening the coordination associations' ability to work. In that regard, Mr. Speaker, it is remarkable that the government is not doing more. There is a broad political consensus here. We clearly see what positive effects it has, but the government is strikingly inactive.

I would like, Mr. Speaker, to move for the adoption of reservation 1.

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

Malte Tängmark Roos (MP)

Mr. Speaker! In the previous debate on economic family policy, I spoke about the security that the Swedish welfare system exists to create and about how we as members of Parliament have a responsibility to mend the tears in the welfare system that we know exist today.

I want to continue this debate in the same spirit, because just as the child allowance and the parental insurance exist to create security for families with children, the sickness insurance exists to create security for everyone when they become ill – to ensure that no one has to live in poverty and exclusion because of their illness or their disability.

When one wants to but cannot work due to illness, one shall have the right to compensation to cover one's livelihood and to support and help to return to health, work, studies or other occupation.

For a long time, however, it has not always worked that way. Too many people are declared unfit for work prematurely or are completely denied sickness benefit, sickness compensation, or activity compensation. Sick and exhausted people are forced to seek jobs they cannot get or complete. In the end, many are forced to go to the social services with their hat in hand to ask for social assistance – with high requirements and low compensations.

According to figures from the National Board of Health and Welfare, 14 percent of all those who received social assistance in 2022 were people who were on sick leave with a medical certificate but who did not receive sickness benefit, sickness compensation, or activity compensation from the Social Insurance Agency. An additional 3 percent were people who received such a low sickness compensation or activity compensation that they needed social assistance to achieve a reasonable standard of living. In over 25 municipalities in Sweden, the proportion of those on sick leave among those receiving financial assistance amounts to over a quarter. In some municipalities, it is as many as 40 percent.

The municipalities bear the costs of the state's failure, and people are forced into poverty and insecurity. The system has broken down.

Mr. Speaker! This problem can be solved. The Green Party wants to introduce a joint insurance for illness and unemployment – a seamless and comprehensive security system under a single authority, which is clear and covers everyone. In the Green Party's Sweden, it simply should not be possible to be left without insurance, to be bounced between authorities that do not want to take responsibility, or to receive such a low compensation that social assistance is the only way out.

As a step towards this job security, we want to repair the current system. People who are ill must receive a compensation that it is possible to live on. The support must be individually adapted. The focus must lie on rehabilitation and recovery for those affected, not on rushing people back to work.

The care deduction must be abolished. We want to replace the strict time limits that exist in the insurance today with continuous assessments so that the individual receives the right interventions when it comes to rehabilitation and support. The rules for volunteering with maintained compensation and for trying out work and study without risking the loss of one's compensation must become more flexible. And more people must be included in the system from the very beginning.

Students need to be given the opportunity to be signed off on sick leave part-time, just like regular wage earners. Today, students who become ill are forced for a bit longer to choose between continuing to study full-time and risking burning themselves out, being signed off on sick leave full-time and then retaining their student grants but falling far behind in their studies, or dropping out of their studies entirely, which thousands of students choose to do every year.

There is a completed investigation report on the government's desk – the investigation was commissioned by a previous, red-green government – with proposals to enable part-time sick leave for students. It would strengthen students' health and economic situation and reduce the dropouts from the programs by more than 2,000 students every year. The government has so far shown no interest in implementing the investigation's proposals. It is time that they do so now.

Mr. Speaker! It is not only the students' position in the social security systems that needs to be strengthened. It also concerns cultural workers, athletes, gig workers, temporary employees, entrepreneurs, and freelancers. These are groups that contribute enormously to Swedish society, to culture, and to the economy, but who, in an incredibly rigid social security system, are not allowed to enjoy the same security as we others.

Even here, there are today completed investigation proposals on the government's table – the investigations were commissioned by a red-green government. They are proposals on how these groups' position can be strengthened. This involves, for example, calculating the income basis for sickness allowance (SGI) on historical incomes instead of on assumed future incomes. This would mean that the mentioned groups could receive an SGI that corresponds to what they actually paid into the sickness insurance systems. But if it is more favorable, there shall continue to be the possibility to have one's SGI calculated on expected incomes. There are also proposals that state artistic scholarships should be included in the SGI, which would give artists a better and more secure financial situation in the event of illness and unemployment.

It has been two years since the investigation A safety system for everyone was presented. But every time the government parties are asked when a bill will be submitted, they answer that the matter is being prepared in the Government Offices. Then one wonders: Why is it being delayed?

I may be naive, but I really do not think it should have to take two years for the government parties and the Sweden Democrats to read an investigation report and come up with which proposals they want to implement. It is high time that the investigations on the safety systems are converted into government bills with the aim of strengthening the job security of cultural workers and others.

Mr. Speaker! Even those who are unemployed can get cancer. In legislation, groups are often handled separately. But in reality, a person can be hit with a number of different challenges simultaneously. Today, the sickness benefit-generating income is zeroed out if one, as an unemployed person, receives a sanction from Arbetsförmedlingen. At the moment, the sanction is primarily that the a-kassan is withdrawn for five days. But the long-term consequences are all the more drastic.

When an unemployed person becomes certified as sick without having entered employment after such a sanction, that person is denied sickness allowance. A person with cancer can therefore be left without sickness allowance and without the possibility of being available on the labor market. In their illness, the person may simultaneously need to apply for social assistance to survive.

It is not unreasonable to have sanctions if one neglects their job search, but it is unreasonable that mistakes should be able to affect a severely ill person several years later. Miljöpartiet therefore considers that SGI must be protected in the event of sanctions from Arbetsförmedlingen and that the government should immediately return with a proposal on this.

Madam Speaker! All people have the right to live their lives in security. We can give them that security. By repairing the cracks in our social insurances, we can ensure that people who become ill in Sweden receive the help they need, whether it concerns a couple of days for a wage earner with a fever or the rest of their lives for an entrepreneur with chronic fatigue syndrome. If the Tidö parties are not willing to do it this mandate period, Miljöpartiet is ready to do it in a government position next mandate period.

I move for approval of reservation 25 and reservation 36.

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

Jessica Rodén (S)

Madam Speaker! A society that holds together is a society where we protect the most vulnerable and where the safety systems actually provide security. It is a society where solidarity is not just a beautiful word but a promise – from all of us, to one another.

But this social contract is being torn apart. Inflation has hit Swedish households hard. Fewer and fewer families with children manage to make ends meet. Single parents are forced to choose between fueling the car to get to work and putting fruit on the table. At the same time, unemployment is sky-high, no housing is being built, and social problems are growing. The government's policy is completely out of step with people's reality.

I want to particularly highlight the need to reform the occupational injury insurance. It was introduced to protect those who are injured in their work – not as a subsidy but as an insurance. It is a right and a recognition from society: If you wear yourself out, society will be there for you if you need it.

Today, however, the insurance does not work. The responsible minister has said here in the chamber that more analyses are required, but what Sweden's unemployed need is action. The Government and Sverigedemokraterna talk about more people entering the workforce but ignore that their own policy leads to more layoffs and increased unemployment. At the same time, they fail those who already have a job to go to.

Today's system is convoluted and cumbersome. It is not uncommon for individuals with documented work-related injuries to be denied compensation because the connection between the injury and the work is considered insufficiently clarified. It is unreasonable.

This particularly affects women. Women's work environment problems – such as wear and tear, strain injuries, and mental ill-health – are often harder to measure than a broken leg. But that does not make them any less real. Women in healthcare, care, and school wear themselves out at work but have difficulty getting their injuries approved as work-related injuries. The system is built for another time, for another type of work, and for another body.

We Social Democrats want to see a modernization of the occupational injury insurance. It is far too difficult to access the insurance. The insurance is not equal. Women-dominated occupations rarely have their work-related injuries recognized, because the assessments are adapted to a different type of body and a different type of work environment.

The exceptions that have been successively built into the system must also be removed. We need a guarantee that actually applies to everyone who works – not a patchwork of rules that protects some more than others.

Madam Speaker! The mental and cognitive burden in working life has increased, and this must also be reflected in the regulatory framework. No one should be left without protection just because working life has changed. We Social Democrats want to see a work injury insurance that meets today's working life and that recognizes that injuries can look different and that all bodies are worth protecting. The security shall apply to all occupations, all genders, and the entire labor market.

The investigation's proposal gives us a unique opportunity to rectify the injustices and deficiencies that have long plagued the system. To include mental ill-health, stress-related exhaustion, and diseases such as long-covid as work-related injuries is a matter of fundamental justice and a recognition of what today's work environment actually looks like.

We must modernize the insurance in step with a changing working life. Gig jobs, remote work and new forms of employment require a protection that does not only apply to traditional workplaces. The safety net shall apply to everyone, regardless of how or where one works.

It is simultaneously important that the occupational injury insurance is connected to the whole of our view on the sickness insurance. My colleague previously raised the need to remove the waiting period deduction, increase the guarantee compensation, and broaden the cooperation within Finsam. These are important steps. Together, it is about creating a security system that is fair, equal, and understandable.

Secure social security is a foundation for the entire labor market to function. The security should not be underestimated. It is a prerequisite for both freedom and responsibility. A strong society invests in people's security so that everyone can contribute according to their ability.

(Applause)

The deliberation was hereby concluded.

(A decision was to be taken on 15 May.)

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