Voluntary insurance for the compensation of patients for damage sustained in health care was introduced in Sweden 20 years ago and similar systems exist in Finland, Denmark and Norway. This type of insurance is, or is in the process of becoming, statutory. The basic principle is that the apportioning of blame to any individual(s) is not a prerequisite for compensation to be paid out for injury sustained by a patient. Owing to hospital proprietors and care givers having taken out patient insurance policies with approved insurance companies, it has been possible for damages to be compensated in accordance with current insurance norms and the frequency of lawsuits arising from injury sustained in health care has been minimised. This type of insurance is universally accepted, and has often enabled unfortunate confrontations between doctors and patients to be avoided.

The 12th Nordic social medical congresses was held June 16-18 1993 in Kuopio Finland focusing on the topic of public health around the Baltic Sea and the great differences between the northern and southeastern Baltic countries. Among 340 participants there were some from Russia Estonia Lithuania Latvia Poland the US China and Tanzania. Special sessions dealt with HIV infection life style and health environmental hygiene and health health education nutrition policy dental care quality assurance health economics and suicide behavior. In 120 presentations Nordic sociomedical research results and demonstrated including preventive dental care and disease prevention within the Karelia project. The former Soviet states struggle with major health and disease care problems. While cancer incidence is on the decline in western Europe it is on the increase in easter Europe. The same is true of the incidence cardiovascular diseases and diabetes. In some Baltic countries and Russia air water and soil pollution is so severe that mortality and morbidity figures are double those of Finland. Suicides are higher than in the West. A 1992 Estonian study fund that 2% of all Estonian men aged 20-39 who were sent to Chernobyl to clean up were exposed to radiation and they will be followed up in cooperation with Finlands Cancer Registry. At the conference Lettish researchers were urged to follow up about 6500 Lettish people and Lithuanian researchers to follow up 7000 Lithuanians who were also involved in the clean-up. In the Baltic countries and Russia HIV infection started earlier than in the North and at the conference 21 cases were reported in Latvia 14 in Lithuania 29 in Estonia and less than 100 in the St. Petersburg area. An increasing number of girls from the East have entered the sex industry. In Poland intravenous drug use has risen in the last two years and sex education has been absent.

For the first time since the war started in former Yugoslavia physicians from the medical associations in Bosnia-Herzegovina, Croatia, Macedonia, Montenegro, Serbia and Slovenia met in Oslo, Norway, to establish a dialogue between medical professionals on issues related to humanitarian assistance, health and medical issues. The three days meeting was initiated by the Norwegian Medical Association's Committee on Human Rights and financed by the Norwegian Ministry of Foreign Affairs. The meeting was held in cooperation with the World Health Organization and the medical associations of all the Nordic countries. The meeting in Oslo started in tension but ended with a joint statement (page 303) from all eleven participating delegations to continue dialogue on issues related to humanitarian assistance to the people of former Yugoslavia and to find ways of moving forward in health and medical issues.