• Spending overview
• Policy overview
• Diseases overview

Spending overview

Healthcare spending amounted to an estimated 8.3% of Finland's GDP in 2009 and is expected to rise over the next five years, driven by increasing pharmaceutical costs and the growing cost of caring for an ageing population. In 2009, however, Finland's GDP fell dramatically, pushing up the proportion of national income devoted to healthcare. According to the OECD, public expenditure accounted for 74.6% of total healthcare spending in 2007, less than in other Nordic countries, but about the same (if slightly less) than France and Germany. As in other industrialised countries, the ageing of the population and the availability of more expensive treatments and technologies will exert upward pressure on the costs of the health system in future.

The health system is funded mainly through municipal and state taxes and payroll contributions to the National Health Insurance (NHI). Coverage provided by the statutory health system is comprehensive. Patient charges are levied for services such as visits by family doctors and in-patient care, which may vary from one municipality to another up to a nationally set maximum. The government introduced several measures in the 1990s to contain healthcare costs, which seem to have been successful in promoting the cost-effectiveness of the system.

Further reforms were introduced from the beginning of 2006, dividing health insurance financing into two parts: medical care insurance and earned income insurance.

User charges have increased in recent years and have been extended to new areas. These charges are high in comparison with those in other European countries, despite the annual ceiling applied to out-of-pocket expenses paid by individuals. Moreover, a report commissioned by the Finnish government, published in 2008, pointed to over-prescribing and a lack of transparency in pricing.

Policy overview

Despite large out-of-pocket payments and a limited choice available to patients in terms of general practitioners (GPs) and hospitals, public satisfaction with the healthcare system is high. The system is highly decentralised. The basic operating framework is laid down by law, but responsibility for organising health services lies with the country's municipalities. Municipalities provide primary healthcare, sometimes jointly with neighbouring areas, and can buy in services from other municipalities or from the private sector. Each municipality belongs to one of the country's hospital districts, which own almost all hospitals and provide specialist medical care. Finland reduced its number of hospital beds sharply during the 1990s. Nearly all beds are in municipal hospitals, with the remainder in private hospitals and in state hospitals. Finns make few visits to doctors compared with most other EU nationals—an annual average of 4.2 visits in 2007. This low level may be a response to the introduction of user charges, but is probably also the result of the prominent role played by nurses within the primary healthcare system.

Private healthcare supplements public care, especially in large municipalities. Patients are partly reimbursed by the state for private healthcare charges. Only a small proportion of doctors earn a living solely as private practitioners, although around one-third of them work in both the private and public sectors. Most private care is out-patient care, such as specialist doctor consultations, physiotherapy and dentistry.

Diseases overview

The general standard of health among the Finnish population will remain high over the forecast period. Life expectancy will continue to rise, while the infant mortality rate is one of the lowest in the world. Average life expectancy was an estimated 78.8 years in 2008, although a wide discrepancy exists between men (75.3 years) and women (82.5 years). Male life expectancy is adversely affected by cardiovascular disease and the frequent incidence of both alcoholism and accidents. Finland also has one of the highest rates of type 1 diabetes in the world, and there has been an increase in the proportion of overweight children and adults. Outbreaks of the MRSA (methicillin-resistant staphylococcus aureus) superbug since 2003 have shaken public confidence in the system, although it is better controlled in Finland than in many other EU countries.

In response to a number of cases of influenza A (H1N1) in 2009, the government has purchased a pre-pandemic vaccine to cover the whole of its 5.3m population. It assumes two doses: one pre-pandemic, the other during a pandemic.