Finnish lawmakers tore into plans by government to raise customer health care costs during a parliamentary debate on Wednesday. MPs have begun discussing a new law proposal which government said would make patient health care costs fairer to everyone across the country.
However, several opposition lawmakers said that the plans would make visits to health care clinics more expensive for society's most vulnerable populations.
The subsidised fees people in Finland pay to go to public health care clinics vary quite a bit across the country's hundreds of municipalities. Now, in new draft legislation, government aims to unify those costs across the board.
The pending bill states that a visit to a health care centre should not cost more than €20.60 and that the cost for a visit to a specialist physician should be a maximum of €41.20.
Minister: Harmonised fees throughout
Centre Party vice chair and Minister of Family Affairs and Social Services Annika Saarikko said the reform would make the health care system more equal for everyone in different parts of Finland.
"For example, it would become much clearer for older people who [often find themselves] in a jungle of fees. Especially when you look at locations, we'll get clear rules on what it will cost and what criteria are used to determine the prices," Saarikko said.
One of the specific aims of government's proposal stipulates that customers' health clinic fees should not rise due to government's long-pending reforms on the social and health care system, colloquially known as 'Sote'.
That reform aims to remove responsibility for healthcare from municipalities, passing it to new regional authorities, and expanding private provision of healthcare services.
"Customer fees will be written into law so that individual regions can't introduce unreasonable fees as a way to solve their financial emergencies," Saarikko said.
Government has also proposed that virtually all health care services for children should be free-of-charge. The bill states that people under the age of 18 would only be charged for health care services in exceptional cases, for example if a patient misses a booked appointment.
Opposition: More expensive health care overall
Opposition MPs roundly criticised the proposal, saying it would make health care services more expensive, particularly for those who require a lot of care.
Left Alliance MP Li Andersson said a change to the current system would most affect people on limited incomes who require a lot of health care services.
"The big problem is covering improvement costs by raising fees for basic health care services. That means people would pay more for each visit, for example when they see a doctor at a health care centre," Andersson said.
The reason there's a risk that the proposed law change could effectively raise consumer health care costs is due to the fact that individual patients currently only pay for a maximum of three visits per year, which amounts to an annual maximum of 61.80 euros. Alternatively, municipalities can also charge a yearly fee of 41.20 euros.
Government's proposal includes a provision that patients would end up paying a maximum of 683 euros per year for health care, including dental services.
Opposition MP from the Swedish People's Party (SPP) Veronica Rehn-Kivi echoed Andersson's sentiments, saying the proposed law would hit those who are at most risk in society.
"In other words if you go to the doctor once a month the sum would be €247.20 per year. That's a huge price increase," Rehn-Kivi said in a press release.
"At the same time government is raising yearly health care fee [ceilings] there are more than 300,000 [unpaid personal] health care bills that go to collection agencies. It is people who are most vulnerable in our society who will have an even more difficult time," Rehn-Kivi said.
Minister: Fees will not rise
However, Minister Saarikko defended the criticism by saying that on the whole, fees would not go up.
"The overall fees that municipalities and the state receive from customers are roughly the same. This is an [overall] total in which individual fees can go up for individual customers, but other fees for others can go down," Saarikko said.
She said the proposed law would give less well-off customers a right to lower health clinic fees.
"It will become clearer for those on low incomes that they have the right to lower health care fees. The [health care] regions will have to inform [low income customers] about their right to discounts," Saarikko said.
Saarikko also defended on Wednesday the controversial proposal to permit smaller private hospitals to carry out the same kind of surgeries which were revoked from smaller public hospitals about a year ago. That decision was strongly criticised by the SPP and politicians from the west-coast city of Vaasa, which was left without an accident and emergency department and provision of certain services.
Saarikko also stood by government's proposal to expand the capability of public hospitals to outsource non-urgent surgeries to private health care providers.
She said the reasoning behind the proposal is to set up common ground rules for private and public health care providers and to secure peoples' access to those services.
"We need the laws so that the national health care guarantee also works when facilities are busy and public hospitals are unable to carry out all of the needed operations," Saarikko said.
When asked why surgeries could not be carried out by the public hospitals which have previously done them, Saarikko said it was a matter of resources.
"Yes, it's a matter of nothaving enough expertise personnel, patient security and the need to cut the costs of health care," Saarikko said.