Does Finland’s freedom of choice for specialist hospitals work?

Since 2014, every Finn has the right to chose the best specialised hospital if his general practitioner believes that the patient needs surgery or special treatment for things like heart defects, bone implants, cancer treatment, etc., at a cost of just around €30 to €40 for each visit.

Under the present system, university hospitals have specialised units and companies doing just this type of work. Under this system groups of neighbouring municipalities have set up joint healthcare federations that run the hospitals and healthcare centres for their residents - writes finnishnews.

It is useful to give an illustration of how this works – this is based on a real case from a patient known to this correspondent.

The patient, let’s call her Anna, is 75 years old and was complaining of a dull pain in her chest and breathlessness when exercising. She lives near Tampere and decided to go to her local healthcare centre to see what was wrong.

The municipalities in and around Tampere had decided to outsource their healthcare centre activity to a Swedish owned healthcare company called Attendo. The same municipal federation also had a big university training hospital in Tampere called TAYS. Patients cannot go there directly but have to have a referral for treatment from their local doctor at the public healthcare centre or from a private healthcare company doctor.

The public healthcare doctor at Attendo could not find any reason to send her to a specialist and gave her some advice to eat less and do more exercise as well as cut out beer and wine.

Anna was happy to find that there was nothing serious and thought that she would feel better by cutting down on less healthy food, but 3 months later she still felt tired and breathless and the dull pain in her chest had not gone away.

She then turned to an old doctor friend at Mehiläinen, a private healthcare operator, that cost three times as much to visit (€90) as the public healthcare centre.

She was told immediately to visit the TAYS Heart Hospital, a private hospital in Helsinki that is 100% owned by TAYS, the University Hospital in Tampere! She was given a referral to see a specialist and within a few days she was on the operating table and given the balloon treatment to remove a clogged up narrowing of one of her arteries connected to the heart. It was a near miss, because she could have had heart failure soon. The cost to here was three days in Helsinki in the hospital for a total cost of €100.

If she had paid privately for the same treatment in the same hospital it would have cost well over €3000!

The question here is that how can ordinary folk know what is the best place to go?

What treatment can you possibly know how to choose or get chosen for you because it seems to this correspondent that this story illustrates that medical treatment is a bit like the lottery. Anna could have easily ended up dead, or paying €3000 for something that saved her life for a mere €100…

When our politicians talk about freedom of choice for healthcare you need to have a very strong basic healthcare service that is really reliable.

Attendo obviously only wanted patients to pop in the door and get paid for increasing volume of patients. If one patients happens to die because of carelessness then so what, there are still another million out there…

Read other news on the city site of Helsinki.

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