Tuesday, May 02, 2006

Public Healtcare in Finland: Scrap, or How to Fix It!

There has been quite a bit of debate recently on the state of the public healthcare in Finland. According to laws passed in early 70's the state (and/or municipalities) must provide an adequate level of basic healthcare for all citizens. For two decades it worked marvellously, but since the recession in early 90's the state funding has gradually decreased despite the subsequent accession. For quite some time that was compensated by municipalities and "increased employee efficiency" (i.e., in many cases unpaid, underpaid, or incompetent labor), but recently their back seems to have been broken: nurses are rallying for better salaries and more workforce, and nasty rumors are beginning to circulate about neglected elderly patients left to suffer alone in overcrowded institutions.

So far the supply of doctors has been somewhat sufficient, but as people become older the ratio of nurses to doctors should increase as treatments such as washing, feeding and moving begin to dominate. Nurses are not accustomed to defend their rights by striking, but the young have long ago voted with their feet: nursing has become an unpopular career and in fact there are roughly twice as many nurses in the age group of 40-49 than 30-39. So, as the older age groups retire, the situation will only become worse.

Simultaneously worries are beginning to rise about the state's (i.e., younger generations') ability to pay the pensions the older generations have been promised (by themselves, essentially). If all goes well, then the pensions can indeed be paid, but the economic uncertainties are considerable. Consequently, one way to make it easier for the younger generations is to lift the state's responsibility of public healthcare, at least for the older age groups. This would reduce government spending but the elderly would have to pay their own health care by selling their properties as very few have taken healthcare insurances.

If, on the other hand, we the Finns decide to keep our public basic healthcare system alive, I propose a very simple remedy that will make sure it remains in working condition: enact a law that forbids all private healthcare or any special treatment forever for anyone who has worked sufficiently high in the state or municipalities. This law should at least cover all members of the parliament and anyone else who has made a similar or salary (say, 6000 euros/month or more) while working anywhere in the public sector. Once the politics and higher public servants are made to eat their own dog food the rest will fix itself, trust me on that one!


Blogger Vera said...

There are no decent private health insurance plans available in Finland.

As to the banning private healthcare for the state's top brass: that's what Canada does (for all citizens, not just the public officials), with the obvious result that the rich go to the US for treatment and the not-so-rich die while waiting in lines.

2:24 PM  
Blogger cessu said...

Its hard to say whether the ban would be effective - certainly not for the very richest, but I believe it would nevertheless make normal MP's (and people in similar, after all rather normal positions) think what they decide.

Technically speaking: the society needs more feedback loops than voting every four years. One such feedback loop would be to make the decision-makers live through the consequences of their decisions as the normal citizens will.

2:06 PM  
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