Some issues on provision and access to dental services in Norway

Abstract

The organisation and financing of the Norwegian oral health care differ compared to general health care. The public responsibility for general health care includes the whole population, and the scope is universal coverage involving public finance, and historically public provision as well. Concerning oral health care, there seems to be less emphasis on providing the same level of service to all citizens. The limited public responsibility for providing oral health care leaves Norwegian dentistry dominated by private providers, and most adults faced with paying all costs themselves when they seek dental services. These aspects have potential distributional consequences, which are only explored to some extent in the research literature. On a general level, the research problems focused in this thesis concern different issues on provision and access to dental services in Norway. The present thesis is a collection of four separate papers. The introduction outlines theoretical and empirical aspects concerning the financing, government, need for, and the regulations of Norwegian oral health care, reflecting the different aspects of the four papers. The introduction also includes general methodological issues that are relevant for the empirical analyses. My scientific approach draws from multi disciplinary perspectives and theoretical frameworks. My basic perspective, however, is health economics, although I also focus on perspectives from sociology, political science, and critical theory. The thesis documents large geographical differences in dental attendance and self rated oral health among Norwegian adults. It also inquires as to health policy reasoning to explain why free pricing and free establishment rights for private dentists remain characteristic features of Norwegian dentistry.