Private operators in Sweden fear that the introduction of patient choice in specialist areas has, and will, lead to massive falls in prices and profitability. The new contracts do not allow price competition, but, where new patient choice tariffs have already been introduced for things like knee surgery they are typically at levels which are around 30% lower than existing levels. Similar price pressure accompanied the introduction of patient choice in homecare.  One source said: “Counties are increasingly sharing data on prices and using McKinsey to even compare prices in Sweden to other countries. We could see counties trying to persuade German operators to set up here.”