The Danish healthcare system: universalism for all?

Resumé

This article examines the principle of universalism in the Danish healthcare system, as mandated by the Health Act’s requirement of “easy and equal access.” Drawing on welfare state theory, the authors develop a four-dimensional framework for analyzing universalism in healthcare: financing, access, consumption, and outcomes. Through an empirical assessment of developments in each dimension since 2000, the article shows that while financing and formal access remain largely universal, significant and increasing social and geographical inequalities persist in actual healthcare use and outcomes. These disparities are linked to political priorities, systemic constraints, and the inherent tension between competing policy goals such as quality, choice, and efficiency. The article argues that achieving greater equity in healthcare requires prioritization and targeted redistribution, which is politically challenging due to potential resistance from resourceful groups. The recent 2024 health reform is discussed as a partial response to these structural challenges.