Elder care is one of the sectors where nonprofit organizations are most active. One exception is the Scandinavian countries, where the nonprofit sector plays a marginal role in this area. In the article, we ask why this is the case. The findings show that in Sweden, nonprofit organizations have found it hard to compete with for-profits and that this inability to compete, in turn, reflects their relative organizational weakness. A main argument in the article is that this weakness must be understood in the context of the historical development of the modern elder care system in Sweden, where social democratic reformers in the 1940s chose to create a universal public system for providing services to the elderly, thereby making the nonprofit sector redundant. Universalism in this interpretation was seen as incompatible with service delivery by private organizations, a view that has come to change in recent years.
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