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Thursday's papers: Health care costs change, elder care nurse quota, train track plans questioned

Lower health costs, a better nurse-patient ratio and a faster Helsinki-Tampere rail link are among Thursday's topics.

Asukas ja hoitaja hoivakodissa.
The 0.7-nurse ratio bill is in the works. Image: Emmi Korhonen / Lehtikuva

Finland is set to instate new service charges for public health services, which the government said is intended to expand the availability of cost-free health services and lower existing costs to patients. The draft bill was sent in to Parliament on Wednesday for a comment round that ends on 1 April.

Tabloid Ilta-Sanomat wrote that some 980,000 people in Finland could see their annual health care payments fall by an average of 44 euros in the beginning of 2021, while many costs will remain the same.

About 33,000 people's care costs are actually expected to rise somewhat, mostly among over 80-year-olds. However, the very elderly will also see the highest cuts to their service charges, with some 15 percent expecting savings of over 100 euros per year.

The new bill would also greatly benefit families with children over other single- or several-person households. Nearly half of two-adult families would see health care charge cuts between 10 and 100 euros each year, whereas less than 20 percent of singles would see any health cost savings.

hoitaja työssään
Trips to the nurse may become free. Image: Laura Hyyti / Yle

The bill is also meant to improve the financial standing of those customers who use public health services regularly in all age groups, IS wrote. The annual maximum for an individual's health care costs in Finland – the limit after which health services are free or compensated – is currently 683 euros, according to the Ministry of Social Affairs and Health. The government hopes to include more services under that maximum charge, such as dental health, psychotherapy and temporary home care.

Research chief Jussi Tervola from the Finnish Institute for Health and Welfare (THL) said the bill proposal published on Wednesday is mostly successful.

"The reform will improve accessibility by removing the surcharge for visiting a nurse's office," Tervola said. "New costs will also be added to the law that will make payments more equitable from one municipality to another."

Tervola did criticise the bill for still making patients monitor the health care fee cap themselves.

Give and take in elder care

In related health news, Parliament on Wednesday also addressed a proposal to include a minimum nursing care ratio of 0.7 nurses per patient in all of Finland' 24-hour care facilities by law. The current non-binding recommendation is 0.5 nurses, Iltalehti wrote.

The bill has faced criticism for being insufficient in ensuring elder care. Opposition MPs from the conservative National Coalition Party and the populist Finns Party said that affixing a legal minimum to round-the-clock care would risk the quality of other services such as home nursing and support for informal family care.

Minister of Family Affairs and Social Services Krista Kiuru said in Iltalehti that the concerns are legitimate.

"Particularly in terms of home care, the challenge is that such services are conducted in many varied ways across the country, and the needs of those receiving home care are always different," Kiuru said. "Improved working conditions will likely draw an inordinate amount of professionals to 24-hour care, unless the conditions of home care are also addressed."

Kiuru said that the nurse ratio bill is only the first step in a series of improvements planned for Finland's health care system. The 0.7-nurse minimum would come into effect in August 2020 with a transition period ending on 1 April 2023. This would cost the government some 276 million euros, with an additional 45 million for service development into 2023 – still about one billion euros short, according to professor of social politics Teppo Kröger from the University of Jyväskylä, who was interviewd by IL last October.

Study: Repairs better than new Helsinki-Tampere rail line

Market research organisation Taloustutkimus reported on Wednesday that the benefits of a proposed new direct one-hour rail line between Helsinki and Tampere are far overshadowed by the advantages of repairing the existing main line between the two cities.

Nearly two-thirds of commuters travel to work in towns along the Helsinki-Tampere track, while a non-stop line from city to city would improve the trips of just 36 percent of commuters, wrote daily Helsingin Sanomat.

Commuting to the three large cities of Helsinki, Vantaa and Tampere from smaller towns such as Järvenpää, Hyvinkää, Riihimäki, Janakkala, Hämeenlinna and Akaa is seven times more common than commuting between the three big ones.

"People need to use trains, but the main line is just blocked," said Taloustutkimus researcher Pasi Holm in HS. "Currently neither the quality nor the capacity of the line is up to the standards of long distance, cargo and commuter traffic."

Problems also combine and escalate when the tracks are not updated, leading to about 30 million euros' worth of productivity losses, Holm estimated.

Finally, the cost difference between a direct line and an overhaul of the current line is considerable: the new line would cost 2.6 billion euros, whereas repairing the tracks that benefit the most commuters would come to 1.1 billion euros.

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