The academic essay as a text form
It takes time and effort to develop reasoned arguments about the future based on research. Accordingly, a suitable form is needed, one that can accommodate reasoning, reflections and questions with a scientific basis. The academic essay was therefore chosen as the text form.
‘Essay’ means attempt. It is a way of exploring reasoning, reflecting and analysing ideas through writing, using a slightly more personal approach than, for example, a scientific article. Here, writing can be seen as a method of investigation, a way of exploring, engaging and associating, rather than simply transferring information. The essay form can be likened to ‘a learned conversation’ (Wallsten & Moberg, 2018, p. 65), in which science is presented hand in hand with critical discussion. It is an approach to reasoning in which the outcome does not have to be obvious from the outset, and which may lead to more questions than were present at the beginning of the process. In short, it is a form that is well suited to developing new questions and arguments about the future, based on science.
The researchers have used their previous and ongoing research as a platform for their writing. Based on this, they have developed arguments and questions concerning future Nordic resilience in welfare.
In other words, this publication is a collection of essays, through which researchers representing a wide range of focuses and perspectives share well-founded reflections and arguments and pose questions that encourage both reflection and action.
Four essays
The four texts in this publication have a certain inherent order. They constitute individual examples of arguments, questions and reflections that are relevant to healthcare within the welfare system, as viewed from a gender and resilience perspective. The researchers represent a wide range of disciplines, and the texts therefore also address different empirical contexts within healthcare, as well as different knowledge perspectives. The texts consider and reflect on challenges, both at the system level and at the point where staff meet users. Taken as a whole, the texts cover the entire spectrum between these extremes, as well as the conditions and circumstances that frame it. They move between macro-level structures and policy frameworks, meso-level organisational structures, leadership, communication and collaboration within healthcare, and micro-level individual actions and scope for action. All four texts use gender and resilience perspectives in their analyses of Nordic healthcare but approach the subject from different angles, at partially different levels and with different approaches. In-depth reasoning is presented alongside exploratory questioning. Sometimes priorities and approaches are clearly advocated, while other times we are left with more questions than answers. All the essays ask the reader to pause and reflect; tomorrow’s trials are still shrouded in mystery, but there is knowledge and experience to draw on.
The first essay is written by John Lapidus, a researcher in economic history at the University of Gothenburg. We are presented with a critical analysis of the rapid growth of private health insurance. The text addresses macro-level challenges and focuses on the development and consequences of the two-tier system that is being created. Lapidus offers an in-depth discussion of the complexity of the so-called hidden welfare state and its implications for the resilience of the welfare state as a whole. He discusses how this development challenges legislation on medical care in the Nordic countries, which is based on the principle of healthcare according to need and on equal terms, and how this leads to reduced resilience. The second essay is written by Ann Liljas and Bo Burström, researchers in global public health at Karolinska Institutet. They begin by discussing the shortcomings in the preparedness of Sweden’s healthcare and social care systems for older adults, which became apparent during the COVID-19 pandemic. With a view to learning lessons for the future, Liljas and Burström draw attention to the need for both sustainable organisation and sustainable staffing in this area of healthcare and social care systems, taking demographic developments into account. Taking Sweden as a starting point, they discuss the link between working conditions and staff turnover and the ability to maintain high-quality healthcare. The text addresses both the macro and meso levels and highlights a number of examples from which lessons can be learned. Questions are raised about how collaboration, exchange of experience and learning can increase resilience, and the spotlight is turned on how financial and human resources need to be prioritised. The third essay is written by Paula Mulinari, a researcher in social work at Malmö University. We encounter reflections, fears and hopes from women working in healthcare. Mulinari’s text is based on individual stories, in which experiences of the prevailing conditions in the sector form a platform for discussing temporal inequality and crisis at the societal level. From a resilience perspective, Mulinari argues that women employed in the healthcare and social care sector are already in a crisis situation, with constant work-related stress, high sick leave rates and greater responsibility for unpaid care work in the home. The text raises questions about whether the sector is in a state of permanent crisis that workers are paying the price for, how welfare is organised and how time and greater temporal justice can be crucial to strengthening resilience.