Finland’s healthcare choice pilot fails to reduce income gap in private doctor visits

A government pilot scheme aimed at improving equal access to private healthcare has so far primarily benefited high earners and urban residents, according to an analysis by Finland’s Social Insurance Institution (Kela).

The healthcare choice pilot, launched in September, allows pensioners to visit private general practitioners at the same cost as public primary care. However, Kela researchers found that uptake has been uneven, with the highest-income fifth of pensioners using the scheme at nearly three times the rate of the lowest-income fifth (6.5% vs. 2.4%).

Usage also varied sharply by location. In Helsinki, 6% of eligible pensioners used the pilot, compared to 5% in other cities and just 1.9% in rural areas. Total reimbursements for private GP visits under the scheme reached nearly €6.5 million between September and December—three times the amount for the same period in 2024—with nearly a third of costs attributed to the highest-income group and only one-eighth to the lowest.

Kela research professor Jenni Blomgren suggested the disparity may reflect initial uptake by those already familiar with private services, noting that differences “could gradually even out.” The pilot’s stated goals include improving access to care and reducing inequality in private healthcare use.

“So far, the choice pilot does not appear to have narrowed income-based gaps in pensioners’ use of private doctor services at all,” said Kela specialist researcher Heta Moustgaard.