"There is a need in municipalities for the boldness and open-mindedness to test new models for providing health care services," says National Coalition Party secretary Taru Tujunen.

Responses to a Yle survey showed the National Coalition ready to further expand the share of the private sector in health care, on a case-by-case basis.

"The problem in the public sector is inadequacy. Services are not cost efficient and production costs are difficult to calculate," Tujunen argues.

Left Alliance: no subsidies for private companies

Left Alliance party secretary Sirpa Puhakka, for her part, takes the view that privatization has already gone too far. She considers it was a good move by the government when it decided to reduce Social Insurance Institution subsidies for private physicians next year.

"Public funding should be targeted at public services. Of course, entrepreneurs can do business in the health care sector. Those who can pay, can buy, and everyone else is guaranteed public services."

The party secretaries of the Greens and the Finns Party want to see the public sector continuing to carry primary responsibility for health care services.

"The balance is already shifting too much towards private health care services because the queues for public services are too long," notes Panu Laturi of the Green League.

"Health services should be provided as a public service. Private services can be used to balance overflow," says Ossi Sandvik of the Finns Party.

Skimming the cream?

The party secretaries of the Christian Democrats, the Swedish People's Party and the Centre Party are in favour of a middle road that integrates public and private services.

"What is most important is that the chain of health care services functions, and that patients are not shuttled from one counter to the next. We think that services can be functional, produced by the public as well as the private sector," states Swedish People's Party's Johan Johansson.

While the Christian Democrats view private services as increasing the choices available to patients, they also concede that not everyone can exercise that choice.

"Private companies may easily skim the cream off the top and leave substance abuse and psychiatric patients dependent on publicly provided services," warns Christian Democratic Party secretary Asmo Maanselkä.

Big multi-nationals and small charities

Private companies already supply over 30% of all health care services in Finland. Private dental care has surpassed public services.

Some of the biggest private health care providers have been bought by foreign investors.

Nearly all of the party secretaries want to see companies selling health care services in Finland also paying taxes in Finland.

"My attitude is a critical one, if we are talking about an international listed company. But, there are third sector providers, foundations, various kinds of charities and small Finnish health sector companies," points out the Centre Party's Timo Laaninen.

"In widespread use, there are more risks in private services than opportunities. The biggest risk is that profits would not stay in Finland to help sustain the economy," says the Social Democratic Party's Reijo Paananen.

The National Coalition's Taru Tujunen does not consider foreign ownership, as such, a bad thing. She thinks that whether or not to give preference to domestic health care providers should be up to the municipalities themselves.

"The problem is the inability of municipalities to draw up an invitation for bids that would give domestic providers an advantage. The lowest price should not be the sole criterion, nor who owns a company."