Healthcare Privatisation Through Neoliberal Newspeak: The Case of Sweden and Beyond By J.Lapidus, London: Routledge, 2026. 182 pp. $190 (hb); $42.99 (ebk). ISBN: 978‐1‐032‐81415‐5

In the early 1900s, healthcare in Sweden was fragmented and largely privatised. It was primarily designed for wage earners affiliated with labour unions. After World War II, it took several decades to establish a cohesive and universal healthcare system. Through political reforms and legislation, healthcare became affordable, and physicians became public employees with regulated working conditions and standardised education. In this book, economic historian John Lapidus examines how later Swedish healthcare moved along a trajectory from a progressive and universal healthcare system towards a divided and polarised one seen today. This trajectory, he writes, is nourished by a neoliberal newspeak which becomes evident in how the problems with healthcare are described and addressed in public debate. Over the course of the book, Lapidus shows how Sweden's universal healthcare system has become (re)fragmented and increasingly reliant on private solutions. From a sociological perspective, the book offers valuable insights into how the gradual transformation of the healthcare system is facilitated by a range of diverse institutions. Although operating independently and from different vantage points, these institutions collectively contribute to the system's ongoing development. Even more relevant is how various types of solutions, most notably healthcare insurance, create a system that discriminates between different categories of patients. Lapidus borrows the concept of newspeak from George Orwell's dystopian novel ‘1984’. Newspeak is the invented language that the totalitarian party seeks to replace ordinary language with. The language aims to reduce the vocabulary available for expressing dissent and align linguistic possibilities with the ideological needs of the regime. Without the words and grammar to articulate oppositional ideas, it becomes impossible even to cognitively conceive thoughts that criticise the Party. The first chapter introduces the context, examining how private funding and for-profit provision have divided the Swedish healthcare system. Public funding primarily serves disadvantaged groups, whereas private capital is steered towards the more privileged strata of society. This development is similar to the implementation of Third Way politics in the United Kingdom, when social democratic institutions began operating according to a conservative rationale. The last chapter summarises future developments and ‘what is to be done?’. The five chapters in between are about key institutions, such as private providers, insurance companies, unions, politicians and civil society. Each chapter shows that privatisation undermines the universalist principles of the progressive welfare model, which is central to the Swedish healthcare system. This shift appears to be an irreversible process, where the issues caused by privatisation are paradoxically addressed through further privatisation. Sweden, though a relatively small country in northern Europe, has emerged as a frontrunner in the transformation of its entire welfare system. Each chapter concludes with an international outlook, and the trajectory described by Lapidus aligns with developments observed across many US–European nations. Sweden serves as a case study of how gradual changes in the managerial aspects of governance can, over time, transform an egalitarian welfare system into one that is increasingly divided and polarised. Using newspeak as a central concept serves Lapidus's purposes, and it is a bold approach. However, a broader discussion could strengthen his arguments, particularly by exploring how this concept relates to similar notions, such as the Frankfurt School's critique, most notably Herbert Marcuse's idea of the one-dimensional man. In addition, using newspeak can be misleading, since in ‘1984’ the language was deliberately engineered by a centralised and identifiable actor, the Party. In Lapidus's book, the debate is shaped by a fragmented constellation of actors who collectively exercise a form of (one-dimensional) decentralised totalitarian power. A methodological consideration is that Lapidus himself is deeply immersed in the debate he analyses. In fact, he is one of the public intellectuals actively shaping this discourse by criticising it. He writes on page one, ‘I myself have played a not insignificant role by publishing over a hundred articles in Sweden's largest newspapers over the past 10 years’. He could explicitly address the fact that he becomes part of the analytical object. An extended appendix reflecting on his position would strengthen the arguments. Lapidus takes a stand. The book is written in an agitative style, which is a welcome contrast to other studies on healthcare governance. As a synthesis of the debate on privatisation, the book offers a valuable contribution. Lapidus is analysing a fundamental transition in Swedish healthcare while it is unfolding before our very eyes. International scholars can gain important insights into how this process is sustained through a depoliticised newspeak that researchers, providers, think tanks and policy professionals collectively use and how this leads to a polarised provision of healthcare services. The author takes full responsibility for this article. The author has nothing to report.