Swedish occupational injury insurance: A laudable programme in need of reform

The Swedish occupational insurance system attributes an occupational cause to any injury or illness in the absence of overwhelming contrary evidence. Illnesses compensable under other sections of Sweden's welfare system are thereby shifted to the occupational programme. Examples are provided involving cases based upon ambient smoke and fumes in the workplace. The results greatly inflate the system's costs, discourage scientific evaluations of the causes of illnesses and injuries, and hinder programmes for the prevention of occupational maladies. A laudable effort to promote employee welfare thus has the actual consequence of reducing the system's overall benefits. The arrangement has provoked demands for reform, which warrant careful study to reduce the system's administrative burdens and potential for arbitrariness. Several possible approaches to reform are discussed