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Home NATIONALPolitical "give-and-take" changes outlook for Finland's healthcare system
Mon, 09 Nov, 2015 12:00:30 AM
News Analysis
FTimes-Xinhua Report, Nov 9

The three parties in the coalition government Friday reached agreement on a healthcare reform plan that would allow patients to choose whether to use a public health center, or go to a private service provider or to a "third sector" operator without extra cost.

     The Friday night deal actually restored the internal cohesion of the ruling coalition somewhat to the surprise of the public in the Nordic nation.

    Kansallinen Kokoomus (National Coalition Party), had long been pushing for participation by private health operators, and now their role was endorsed by the other two ruling parties - the Suomen Keskusta (Centre Party) and Perussuomalaiset (Finns Party).

     The Opposition Social Democrats said the Centre had "sold away" public healthcare in return for securing continued centrist power bases across the country.

     Currently the country's 180 municipalities have been responsible for arranging healthcare services. Plans to reform the system in order to save billions of euros will see new regions taking the role instead of the municipalities, but the number of regions was a question that seemed to almost split the coalition late Friday.

     Centre Party leader and Prime Minister Juha Sipilä insisted on creating 18 health districts, but the National Coalition Party could agree on no more than 12, fearing that the Centre Party -- with its large rural backing -- could become an overwhelming regional power.

     The situation was described by Finnish analysts as polarization between "Finland of cities" and "Finland of regions". Even though a regional city would largely vote the Conservative Party, the surrounding rural areas dominated by the Centre would outvote the cities in a regional administration.

     The final outcome was a compromise arrangement that there will be 18 autonomous healthcare regions, but only 15 of them have the resources, and the remaining three will have to jointly organize services with others. Meanwhile, the current public-financed system will open doors to private operators.

     The overnight deal received instant strong criticism from the opposition on Saturday. The Social Democratic Party's parliamentary group chairman Antti Lindtman said the Centre Party seemed to have "sold away public health care".

     He said it was political horse-trading that the Conservatives were able to get through "privatization of health services", and that in return, the Centre Party's future power in regional administrations was accepted.

     Lindtman said the third aspect of the deal was that the populist Finns Party averted the risk of new elections. Based on late polls, the Finns Party could have done poorly in any new parliamentary election for the present.

     Conservative Party chairman Alexander Stubb dismissed on Saturday the view that the reform plan would mean "privatization". PM Sipilä also said the healthcare system would be a public one with private industry participation. In the new system, the regional administrations would still define who the eligible service-providers are.

     Tuomas Poysti, the senior civil servant in charge of preparing the health and social services reform, told national broadcaster Yle on Saturday that the idea is not to copy the Swedish system of "money-attached-to-the patient", but to create a Finnish alternative.

     News analyst Jaana Savolainen of the newspaper Helsingin Sanomat described the decisions as a major ideological victory for the Conservatives. Social welfare and healthcare services take a major step towards a market economy, she said.

     Unlike much of the continental Europe, private healthcare in Finland is mainly run by large companies mostly owned by international investors. The "private doctors' offices" with a few doctors and modest support services have mostly been bought out by investors.

     Critics of the upcoming reform plan have said that private companies would be unbeatable adversaries in an open competition in urban areas, but would not take care of sparsely populated regions.

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