ARGENT SNAIL

Finnish Medical System Part 2

This is a slightly updated version of an essay I wrote a couple of years ago.

Then, June 2006 I became seriously ill and had to go into the hospital, and was left with a long-lasting physical problem – I have been assured by American doctors that the same thing would have happened if I had gotten sick in the USA. I quickly learned more than I ever thought I would about how the Finnish system works.

Before I go into that, here is some background information. The fees I mention are what people pay for medical care, assuming they can afford to pay. Medical care is considered a right, not a privilege, so if people cannot afford to pay, it is free. So, all fees I mention are the most someone will pay out of pocket.

Prescriptions: When you get a prescription filled you pay roughly half the cost of the medicine, the government pays the other half. However, once you have spent roughly 700 euros on prescriptions in a single calendar year, your out of pocket costs go to 1.50 euros per prescription each time you fill your prescription. This is for most prescriptions However, for some diseases the most common healing/maintenance drugs are free (100% paid by the government) or mostly free (72% paid by the government). Examples of these include drugs for: diabetes, various cancers, epilepsy. As in the USA, new and experimental medicines may not be covered,though they are reviewed on a regular basis and their status can and does change.

Doctor visits and hospital stays: Doctors visits are 22 euros a visit if you see the doctor. If you are getting routine treatment that a nurse does, such as allergy shots, wound cleaning (which I receive weekly), or something like that, if you go to the health center it is free. Also, if your combined doctor and/or hospital expenses go over roughly 500 euros in a calendar year, your doctor's visits are free and the hospital stay goes down from 26 euros a day to 22 euros a day for the rest of the calendar year.

Medical tests: Medical tests are free provided they are requested by a doctor. I have had assorted blood work, cat scans, x-rays, EKG's and other tests I can't remember off the top of my head, and my husband has had hearing tests and allergy tests, and we have paid nothing for any of these tests.

I was in the hospital for 12 days and the bill for the entire time - doctors, nurses, tests, the stay itself, etc. came to 312 euros. Since it is covered by the government, it took no time at all to check in or out – I gave them my Finnish social security number and that was it. About a month later I got my bill,and when I called to see if I could arrange to pay it over 3 months it was arranged quickly and easily.

Once I got home, I still needed treatment. For over 2 months special visiting nurses came to my house at least once a day to take care of me. They provided all medical supplies except for some of my prescription drugs. They provided the special bandages I needed and the over the counter aids. The cost for a visit (including the supplies) was seven euros – and if the nurses have to come more than once during the same day, it is capped at 10 euros a day. I received this treatment everyday, including weekends and holidays. The cost never went over the 10 euro cap, no matter what the day or what time they came, including the time they had to come at 2AM.

After the two month period I was transferred over to the visiting nurses from my health center, which was more expensive, 22 euros for a home visit, but still very reasonable. I normally only needed them two times a week, but they were available if I needed them every day of the week, and holidays. Again, the cost did not change, no matter what day they came.


When they realized I would need the home nurses long term, they then looked at our income, and reduced our charged to 55 euros a month. This covers one visit a week. Every other visit is short, 1 hour, and is only one nurse. The alternate week visit is a two hour visit of two nurses. In other words I am paying 55 euros a month for 6 hours a month of nursing care. When the doctor comes to me, he is also covered under that monthly bill.

I have had to have transfusions at home several times. The special nurses to do that were covered under the 55 euro set fee. There is no charge or limit on the blood.

I need special bandages, some of which are very expensive. Every type my health center keeps in stock after I was ill for three months they gave me, for free, along with gauze pads to clean my wounds, gauze to hold the bandages in place, special tape to tape everything onto my legs, pads for my bed so when my legs leak fluid I don't make a mess, etc. All of this is given to me at no charge. I also need another kind of special bandage, which is a weird type of foam dressing which is not stocked by my health center. I have to pay for it myself, but the Finnish government gives me an allowance each month to help pay for it – and that covers about 75% of their cost. I am one of many people who receive assorted medical allowances to help pay for their medical problems. One of my friends has a daughter who is a celiac – she cannot digest gluten. Her daughter receives a grant each month to help pay for her more expensive special gluten-free foods.

My health center has also loaned or, in some places, has given me, medical equipment, at no cost to us. They gave me a special mattress for my bed which helps reduce the possibility of bed sores. They have lent me a cane to aid in my walking. They lent me a wheelchair and a stool for the shower (when I couldn't stand up long enough to get really clean). They have lent me a standard hospital bed. The City of Helsinki did some remodeling of our home to make it easier for me to get around. This included installing grab bars and wheelchair ramps. This was done at no charge to us.

I am also covered under the Finnish dental system, where the government pays roughly 50% of my customary and reasonable dental bills – cleanings, fillings, root canals, etc. I had to have emergency dental work where one of my teeth more or less fell apart. I went to a private dentist instead of going to the public one, mostly because I did not think of calling the public one, and the private dentist was able to save the tooth with a giant filling and some other work. The work was quick and virtually painless and my out of pocket cost, which was a lot higher than it would have been if I had gone to the public dentist, was just under 80 euros!

We do not qualify for this, since my husband is in fine physical shape, but if I lived alone, or we both had medical issues, it is possible, through the health system, to get someone to come to our home on a regular basis to clean it, in addition to the nurses. Finland also has a program for shut-ins similar to meals-on-wheels. We would not pay for this help, the government system would.

If this was the USA we would probably be bankrupt by now, even with very good health insurance. Even the best health insurance would not pay for my special bandages since they are not prescription, when you add up the cost of the ones I pay for and the free ones, are over 600 euros a month.

For the record, my 82 year old father-in-law, has had no problems getting medical help under the Finnish system. He has had cataract operations, was hospitalized after he had two strokes, and other assorted medical problems. The government system treats him the same as anyone else, despite his age. There are no “death panels” or people being denied treatment of any sort because of their age or state of health.

Now, as with all systems there are some drawbacks. The main one here is that we do pay more in taxes than you do in the USA. And, that is a drawback – none of us like paying taxes, and everybody, no matter their tax bracket, feels that they pay too much. However, I figure I can only wear one dress at a time, I can only drive one car at a time. There is a lot of peace of mind in knowing that we don't have to worry about health insurance, medical costs, or nursing homes when we get too old to live at home alone.

There are many social benefits in Finland that I will probably never take advantage of, such as free college education (college is competitive to get into, but if you get into it, tuition is free, housing and food is subsidized and students can get a student allowance for up to 55 months – most Finnish college students graduate with a masters because of the subsidized education) or the extensive paid leave you get when you have a baby. My higher taxes go to pay for this and other social benefits, but it also helps ensure that life here has a lot less crime of all sorts, lower infant mortality, less everyday violence, etc. Even though I have never paid any Finnish income taxes (though, of course, my husband has), when I got sick it turned out I was eligible first for a year of sick leave money, and then two years of unemployment money. Because I had not paid into the system I only receive the minimum, but that is still slightly more than 400 euros a month, and that makes a real difference to our budget.

Do I think the Finnish system is perfect – of course not Every system could be improved. But, having been sick, and even hospitalized several times in the USA, I can state that if I had to be sick, not that I want to be, I would much rather be sick here, under socialized medicine, than back in the USA, even with the best medical insurance.