The cost of being sick in Finland
I have health care on the brain. What with the mid-term elections and health care registration for the coming year, I’ve been thinking a lot about our health care coverage. We also happen to be in pretty bad shape at our house right now, with a recent root canal, current kidney stone, and a couple of cases of bronchitis plus a few colds spread out among us. It seems like a good time to take a look at how healthcare is set up in the Nordic countries.
Anu Partanen, in her book The Nordic Theory of Everything, covers a lot of information on the Finnish health care system, so I’ll be looking at their program specifically. And if you are interested in the details, I highly recommend her book.
The Finnish system takes most of its funding (about 90%) from taxes. If you pay your taxes, you can consider them inclusive of your health insurance premiums. But, just like in the States, there are costs associated with healthcare in addition to these payments. All of these costs assume you are a tax-paying citizen of Finland. For those who are visiting from the States, your bills would be much higher.
Similar to our copay system, fees are charged for specific services. These fees are capped by the government, but each municipality is allowed to determine what they will charge, so the fees can vary based on location. I will be using the fee schedule for Helsinki.
One interesting facet of this system that I wasn’t aware of before is that children under the age of 18 do not pay many of these fees. They are only required to pay up to seven days of hospital fees, and any outpatient clinic fees. Doctor visits and dentist visits require no payment.
For adults, the fees are as follows:
- Health Clinic (this includes any doctor at the local clinic, including emergency services during business hours): Free in Helsinki
- Outpatient Clinic: €32,70
- Hospital Daily Fee: €38,80
- Yearly Maximum Payment Limit: €683
Fees seem to be similar to the American model of copays required when we visit the doctor. The maximum payment limit is similar to the standard maximum out of pocket amount.
My current individual max is more than twice this number. And I have to pay it for each person in my family until we hit the family max, which is about eight times that number. According to the Helsinki data sheet, I would only have to pay this amount for my husband and myself, as my children would be almost free under their plan.
So the most I would end up paying, if we maxed out our 7 days per child in the hospital/ER and didn’t need outpatient services for any of them, would be roughly one third of what I pay out of pocket each year, including our copays. This doesn’t count what we spend at the dentist, which is also included in the Finnish figure.
It is worthwhile to note that the fee charged to ride in an ambulance is €9,25. That is a big drop from the $500-$1000 or more charged for a short ambulance ride here in the states. Prescriptions are supposed to be paid in full, but the government will reimburse you. And as Anu mentions in her book, the government is able to negotiate very good pricing for every drug they approve for use.
Anu also makes the point that the type of care received in each country is unique; there isn’t a perfect comparison. America likes to focus on the individual. Americans have endless options available and they pay for those options. Finland has basic, tried and true services that work for a large portion of the population. That is definitely something to keep in mind.
One last benefit of the Finnish model: Your insurance doesn’t change every time you switch employers. Health care is provided by the government, so it stays the same regardless of who you work for. As long as you pay your taxes, you have insurance.
Truthfully, I have no problem with my health care. I know I will be fine if anything serious should happen. But it would be nice to know that my family is covered in the event of serious illness, no matter where I work or what I earn.
What did I learn from this?
There is a certain feeling of trust and security that comes with knowing you can go to the doctor no matter what you do for a living and no matter how little you earn.