Five Twitter-like myths about Finland’s SOTE healthcare reform

It is better to be rather pessimistic than wildly optimistic when big reforms are being pushed through Parliament like an express train.

We do not have one big reform, but 2 very big reforms that are connected, medically speaking, at the hip. The healthcare reform and the creation of the Counties will mean that all social and healthcare matters will be decided by central government through the Counties. Almost all healthcare matters will be taken out of the hands of the municipalities. The risks associated with these reforms are not small, they are huge.

The fact that the present government can only maintain the smallest majority in Parliament to pass these huge reforms with the votes of a phoney political party with less than 2% support of all voters, is nothing but scandalous and foolish. The 2 big parties, the Conservative and the Centre Party are involved in scurrilous behaviour and are devaluing the spirit of our cherished democracy.

… and here are the 5 myths that they are selling us:

The reform will reduce healthcare costs by €3 billion over the next 10 years

This figure has been introduced some 2 years ago when the people heading the project with absolutely nothing more than a vague idea of what was being proposed and with an estimate of €1 billion for IT costs. This number has continued to be used even though the whole reform has seen many different versions and is now more complex than ever before. The second major objection to this figure is that the government has recently confirmed to FinnishNews that there is now no estimate for IT costs, which according to the experience of other countries will cost substantially more than the first estimate. The government can expect that the costs of the new Counties and the healthcare reform will not result in any cost savings, but, most probably, increased costs.

The private sector will produce huge cost saving through productivity improvements

The private sector is more concerned with the extra profits it can earn from increased efficiencies in managing healthcare services and billing the government for the maximum costs. It is probable that the present proposals will increase unnecessary laboratory testing, drug prescriptions and doctor/patient meetings to maximise the income of private healthcare companies as has been seen in the US, Australia and Singapore. So productivity may increase but cost savings will enrich the companies not the public sector or taxpayers/patients. The biggest private healthcare companies are already enjoying aggressive tax savings by having off-shore owners or creative loans from a group holding company abroad, and by paying doctors and nurses a little more that are destroying the very fabric of public healthcare.

Care of the elderly will improve

In a recent press statement (HS 27.3.2018) , the leading civil servant in the Ministry of Finances has said that more money should be allocated for home-care of the elderly, while care homes should be cut back in number. This is the opposite of what is needed, terribly expensive, and dangerously wishful thinking, as an increasing share of the population is getting older with many more experiencing dementia and debilitating physical weakness. This growing group of taxpayers cannot stay at home without intermittent 24/7 assistance, and that is expensive and impractical. Just think of having a nurse on call 24/7 for every elderly patient living in their own apartment spread all over the city! The best solution and most cost effective is to build many small apartments designed for such patients with caseworkers and nurses in the same building.

Consumers are being hassled by private insurance companies who are suggesting that the SOTE healthcare reforms will weaken public healthcare availability and that private care will be more effective

Private healthcare insurance is a goldmine for the companies, and they would not be in the business if it did not work so well. The activity is seldom transparent or well-regulated. It operates in an asymmetrical manner as seen, for example, in the US and in Australia where healthcare insurance has the following characteristics – high costs, a lack of transparency, complex contracts, excessive cover for patients, the ability to make one-sided announcements that covered ailments will be reduced in number, and announcements that the customers will be responsible for a larger share of costs of medical procedures. Both of these countries actively use private healthcare insurance as a common method of cover, as opposed to the taxed -base system common in all the Nordic countries. The idea that private insurance will offer a full service cost effective solution is like believing in fairy tales, except if you are are rich enough not to care.

Freedom of choice is an important characteristic of the healthcare reform

Just imagine having a heart attack or going in to hospital after a stroke – you will not want to wait around and demand that you see this or that doctor – you just want to be treated professionally as quickly as possible. Most other serious surgery and elective procedures will be performed by most doctors well and giving ordinary people the choice of 3 or 10 doctors is about as useful as a parachute in a submarine.

It would be nice to have the same doctor some of the time but that is not always possible because they too are busy and need holidays. But freedom of choice cannot be promised to everybody all of the time – but it is misleading to use it to push for the privatisation of public by saying that only the private sector can offer such a service and it is also a misleading promise that you always get your favourite doctor when you get flu or a stroke…

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