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From my experience, free Healthcare has extremely long wait lines, and bad quality of service, unless it is an urgent matter. I would guess if the mental illnes

From my experience, free Healthcare has extremely long wait lines, and bad quality of service, unless it is an urgent matter. I would guess if the mental illness is not severe, not an urget matter, it will not be treated well.

silvestrov 3y ago
This feels like a political statement and not from knowledge of Finland. Finland: "The time within which you must get access to non-urgent care and treatment is laid down in law." source, which has list of waiting times: https://www.hel.fi/en/health-and-social-services/data-and-the-rights-of-the-client/waiting-times-and-customer-satisfaction https://www.hel.fi/en/health-and-social-services/data-and-th...
- FredPret 3y ago
  You can’t legislate a waiting time! Laws act on people, not reality. What if it takes the doctors longer to work on the people in front of you? What if more urgent cases arrive and goes to the front of the line?
  - tapland 3y ago
    Yeah, for urgent care that can happen wether it's free or not.
  - SgtBastard 3y ago
    I’d suggest reading the link the person you’re replying to posted.
  - vidarh 3y ago
    You can legislate it because it puts the government in breach of law if they don't provide sufficient funding to ensure sufficient excess capacity to meet the criteria. Governments legislate standards of care all the time.
  - d0gbread 3y ago
    Imagine this take on something like an enterprise SLA, that helps me reason about how at an individual level it feels nonsensical but at the parent level there are a bunch of upstream levers available to meet those SLAs.
- usr1106 3y ago
  And the law is frequently violated. Nowadays more than 50% of Finnish newborns are covered by voluntary private health insurance, although all of them are covered already by public health care. I think that tells very much how much people still trust in the public health system.
  - beefield 3y ago
    ...or it tells how easy it is to sell insurance to the parents of newborns
    - usr1106 3y ago
      Partly. But if you have queued for Finnish healthcare you know that the problem is real.
- veeti 3y ago
  There are practically no consequences for breaking these laws. It is a fact that these time requirements are not met by public healthcare in areas like Helsinki [1] [2]. [1] https://www.laakarilehti.fi/terveydenhuolto/hoitotakuu-pitaa-enaa-harvoin/ https://www.laakarilehti.fi/terveydenhuolto/hoitotakuu-pitaa... [2] https://www.iltalehti.fi/politiikka/a/f3392e98-c524-4c22-a534-51a16e4cfaf9 https://www.iltalehti.fi/politiikka/a/f3392e98-c524-4c22-a53...
tapland 3y ago
Your experience isn't from Scandinavia I take it?
SgtBastard 3y ago
Free, universal health care works extremely well in Australia, New Zealand and the Nordics (as noted).
- usr1106 3y ago
  Not in Finland I can tell you from living there after having lived in several other countries. A significant part is private, paid "voluntarily". Why would anybody pay voluntarily to avoid "extremely good" service they are entitled too?
  - coldtea 3y ago
    For the same reason some people wont be caught dead in a 3 star hotel, and would rather only stay on 5 star hotels. Meanwhile, for millions who would otherwise stretch to afford the latter or skip it altogether, it works extremely well, as it does anytime you just want a bed for the night (the 95% of basic medical treatments), and not jakuzi and 3 restaurant choices.
    - usr1106 3y ago
      You don't get "extremely good" (as the GP wrote) service at a 3 star hotel. Less than 1% of the population uses 5 star hotels. In Finland over 50% of the population use private health care (either directly or via their work contract). Edit: As a commenter pointed out it's 50% that use private health care, too. Very few people would exclusively use private health care.
      - coldtea 3y ago
        If you can afford it (or your employer pays for it), you get to use whatever. It helps cut some queue times, and gives you more choice and convenience. Doesn't mean the free one can't still be "extremely good". I might pay for IntelliJ, even though a free IDE or even editor like Emacs is still extremely good. And 40% of the population is still a huge number of people, who would otherwise had trouble affording private health care or get the shitty low tier and/or hella expensive private care afforded by the poorer in the US. It's also not exactly like "50% of the population use private health care". It's more like "50% of the population ALSO use private health care", in addition to the provided free health care.
vidarh 3y ago
When you remove lack of funds as a reason to stay out of the queues, you do indeed tend to end up with demand more accurately reflecting need, and sometimes that leads to queues. When you also have private care available, as you do in almost every country with universal healthcare, the proportion who opts to go private is a good reflection of whether people consider the public care sufficient. I don't know about Finland, but e.g. in the UK only about 10% opts for private insurance - most of it as incidental employment perks in higher paying jobs rather than an explicit choice -, despite private insurance here being far cheaper than the US (in part because the NHS offsets some of their costs by renting out excess capacity, and insurers mostly offer "top up" services - e.g. faster access to specialists etc). The low level of private healthcare spend in countries with universal healthcare - especially in those, like the UK, where taxpayers pay less in tax per capita for public healthcare than in the US (NHS costs less per capita across the whole population, not just users, than Medicare and Medicaid) - to me is a fairly strong indication that most people don't consider them to provide bad quality of service or too long waits.
- alibarber 3y ago
  I am British but live in Finland. The Finnish health service is a lot more complex. I'm not really able to make a distinction on better or worse because thankfully my exposure to both has been pretty minimal, although, I'll end with an anecodote that illustrates that it's not easy to compare. The private sector in Finland is, compartively, huge. Like, imagine a normal shopping centre and two of the bigger units are private, nationwide doctors surgeries. This is pretty much any larger shopping centre in a reasonably sized town here. The reason is that employers are mandated to provide some kind of health insurance to employees. It is this health insurance that is then responsible for giving you a sick note or ensuring that workplace injuries are taken care of - not the public service. The legal minimum is pretty low, so you can't go to them like a GP in the UK and be guaranteed that they'll do anything if it's not covered by the contract with your employer. Now, employers are free to top this up, so 'yeah the pay's comparable but the healthcare is much better' is a common point of disussion in social groups. In my personal case, which is not that special, it's great! I can book an appointment for basically _now_ (Sunday afternoon) online and go get whatever I want looked at. If I was dependent on the public system, lol no - just like home pretty much. Anyway, I guess what I'm saying is that it's very much a two tier system, and I think it was long ago realised that a way for working people to 'skip the queue' was becoming needed, as if these people became ill and stopped working then they wouldn't be paying for the public system (through taxes).
nonethewiser 3y ago
In my experience its a lot faster to get into a specialist too in the US than the UK for example. A matter of weeks compared to years. When it takes years you effectively cant get treatment for some acute issues which last for a few months at a time and then go dormant for a while, such as some serious sinus problems.
coldtea 3y ago
That's the experience of people who live in places with shitty free healthcare options and can afford top tier healtcare on demand. Difference to the experience of millions who'd rather skip treatments for even basic stuff like dentals than bear the costs...
kalleboo 3y ago
Japan has universal health care and it has the opposite problem - it's great for anything that is not urgent (more MRI units per capita than anywhere else) but there are horror stories about people stuck in ambulances riding around looking for emergency care.

silvestrov 3y ago

This feels like a political statement and not from knowledge of Finland. Finland: "The time within which you must get access to non-urgent care and treatment is laid down in law." source, which has list of waiting times: https://www.hel.fi/en/health-and-social-services/data-and-the-rights-of-the-client/waiting-times-and-customer-satisfaction https://www.hel.fi/en/health-and-social-services/data-and-th...

FredPret 3y ago
You can’t legislate a waiting time! Laws act on people, not reality. What if it takes the doctors longer to work on the people in front of you? What if more urgent cases arrive and goes to the front of the line?
- tapland 3y ago
  Yeah, for urgent care that can happen wether it's free or not.
- SgtBastard 3y ago
  I’d suggest reading the link the person you’re replying to posted.
- vidarh 3y ago
  You can legislate it because it puts the government in breach of law if they don't provide sufficient funding to ensure sufficient excess capacity to meet the criteria. Governments legislate standards of care all the time.
- d0gbread 3y ago
  Imagine this take on something like an enterprise SLA, that helps me reason about how at an individual level it feels nonsensical but at the parent level there are a bunch of upstream levers available to meet those SLAs.
usr1106 3y ago
And the law is frequently violated. Nowadays more than 50% of Finnish newborns are covered by voluntary private health insurance, although all of them are covered already by public health care. I think that tells very much how much people still trust in the public health system.
- beefield 3y ago
  ...or it tells how easy it is to sell insurance to the parents of newborns
  - usr1106 3y ago
    Partly. But if you have queued for Finnish healthcare you know that the problem is real.
veeti 3y ago
There are practically no consequences for breaking these laws. It is a fact that these time requirements are not met by public healthcare in areas like Helsinki [1] [2]. [1] https://www.laakarilehti.fi/terveydenhuolto/hoitotakuu-pitaa-enaa-harvoin/ https://www.laakarilehti.fi/terveydenhuolto/hoitotakuu-pitaa... [2] https://www.iltalehti.fi/politiikka/a/f3392e98-c524-4c22-a534-51a16e4cfaf9 https://www.iltalehti.fi/politiikka/a/f3392e98-c524-4c22-a53...

tapland 3y ago

Your experience isn't from Scandinavia I take it?

SgtBastard 3y ago

Free, universal health care works extremely well in Australia, New Zealand and the Nordics (as noted).

usr1106 3y ago
Not in Finland I can tell you from living there after having lived in several other countries. A significant part is private, paid "voluntarily". Why would anybody pay voluntarily to avoid "extremely good" service they are entitled too?
- coldtea 3y ago
  For the same reason some people wont be caught dead in a 3 star hotel, and would rather only stay on 5 star hotels. Meanwhile, for millions who would otherwise stretch to afford the latter or skip it altogether, it works extremely well, as it does anytime you just want a bed for the night (the 95% of basic medical treatments), and not jakuzi and 3 restaurant choices.
  - usr1106 3y ago
    You don't get "extremely good" (as the GP wrote) service at a 3 star hotel. Less than 1% of the population uses 5 star hotels. In Finland over 50% of the population use private health care (either directly or via their work contract). Edit: As a commenter pointed out it's 50% that use private health care, too. Very few people would exclusively use private health care.
    - coldtea 3y ago
      If you can afford it (or your employer pays for it), you get to use whatever. It helps cut some queue times, and gives you more choice and convenience. Doesn't mean the free one can't still be "extremely good". I might pay for IntelliJ, even though a free IDE or even editor like Emacs is still extremely good. And 40% of the population is still a huge number of people, who would otherwise had trouble affording private health care or get the shitty low tier and/or hella expensive private care afforded by the poorer in the US. It's also not exactly like "50% of the population use private health care". It's more like "50% of the population ALSO use private health care", in addition to the provided free health care.

vidarh 3y ago

When you remove lack of funds as a reason to stay out of the queues, you do indeed tend to end up with demand more accurately reflecting need, and sometimes that leads to queues. When you also have private care available, as you do in almost every country with universal healthcare, the proportion who opts to go private is a good reflection of whether people consider the public care sufficient. I don't know about Finland, but e.g. in the UK only about 10% opts for private insurance - most of it as incidental employment perks in higher paying jobs rather than an explicit choice -, despite private insurance here being far cheaper than the US (in part because the NHS offsets some of their costs by renting out excess capacity, and insurers mostly offer "top up" services - e.g. faster access to specialists etc). The low level of private healthcare spend in countries with universal healthcare - especially in those, like the UK, where taxpayers pay less in tax per capita for public healthcare than in the US (NHS costs less per capita across the whole population, not just users, than Medicare and Medicaid) - to me is a fairly strong indication that most people don't consider them to provide bad quality of service or too long waits.

alibarber 3y ago
I am British but live in Finland. The Finnish health service is a lot more complex. I'm not really able to make a distinction on better or worse because thankfully my exposure to both has been pretty minimal, although, I'll end with an anecodote that illustrates that it's not easy to compare. The private sector in Finland is, compartively, huge. Like, imagine a normal shopping centre and two of the bigger units are private, nationwide doctors surgeries. This is pretty much any larger shopping centre in a reasonably sized town here. The reason is that employers are mandated to provide some kind of health insurance to employees. It is this health insurance that is then responsible for giving you a sick note or ensuring that workplace injuries are taken care of - not the public service. The legal minimum is pretty low, so you can't go to them like a GP in the UK and be guaranteed that they'll do anything if it's not covered by the contract with your employer. Now, employers are free to top this up, so 'yeah the pay's comparable but the healthcare is much better' is a common point of disussion in social groups. In my personal case, which is not that special, it's great! I can book an appointment for basically _now_ (Sunday afternoon) online and go get whatever I want looked at. If I was dependent on the public system, lol no - just like home pretty much. Anyway, I guess what I'm saying is that it's very much a two tier system, and I think it was long ago realised that a way for working people to 'skip the queue' was becoming needed, as if these people became ill and stopped working then they wouldn't be paying for the public system (through taxes).

nonethewiser 3y ago

In my experience its a lot faster to get into a specialist too in the US than the UK for example. A matter of weeks compared to years. When it takes years you effectively cant get treatment for some acute issues which last for a few months at a time and then go dormant for a while, such as some serious sinus problems.

coldtea 3y ago

That's the experience of people who live in places with shitty free healthcare options and can afford top tier healtcare on demand. Difference to the experience of millions who'd rather skip treatments for even basic stuff like dentals than bear the costs...

kalleboo 3y ago

Japan has universal health care and it has the opposite problem - it's great for anything that is not urgent (more MRI units per capita than anywhere else) but there are horror stories about people stuck in ambulances riding around looking for emergency care.