Calculation or Care? A Feminist Argument Against the Prevailing Epistemic Authority of Health Economics in Swedish Care Governance

This position paper examines the growing dominance of health economics in Swedish healthcare governance and argues that its elevated epistemic authority produces significant risks for the sustainability and ethical integrity of care systems. Drawing on feminist theories of care and critical political economy, the paper interrogates the assumption that care can be adequately represented, valued, or prioritized through economic models. Three core critiques are developed. First, the commodification of care imposes rationalizing logics onto practices that are intrinsically relational, affective, and resistant to market measurement. Second, prevailing economic theories of value—rooted in neoclassical assumptions—fail to recognize the substantial social, reproductive, and moral value generated by care work, while enabling exploitative labour conditions and rent-seeking behavior in medical industries. Third, the integration of financial incentives into governance structures crowds out ethical commitments embedded in Swedish health legislation, creating moral distress for care workers and policy contradictions that undermine equitable care provision. While acknowledging the role of economic expertise, the paper ultimately argues for more pluralistic forms of knowledge in healthcare decision‑making.