Four-hour drive for a 15-minute medical appointment as Kela transport costs surge

The number and costs of patient transport reimbursements in Finland have risen sharply since the social and healthcare reform, with some regions seeing a 40 percent increase in expenses, reports Yle Keski-Suomi.

Ritva Kotisaari, 45, from Pihtipudas, must drive four hours round-trip for a 15-minute appointment to replace the battery in her spinal cord stimulator at Jyväskylä’s Nova Hospital. She arranges time off work for the trip, which Kela—Finland’s Social Insurance Institution—partially reimburses. If her chronic pain flares up, she takes a Kela-subsidized taxi or asks her spouse to drive.

Kotisaari admits she has sometimes skipped medical visits due to the long distances. “I think, if the symptoms still bother me in a month, then I’ll go,” she says.

Nationwide, Kela’s reimbursements for medical travel grew by 15.7 percent in real terms between 2023 and 2025—double the rate of trip volume growth. The sharpest cost increases occurred in mid-sized municipalities like Kalajoki, Järvenpää, Loviisa, Nurmijärvi, and Mäntsälä. In Pihtipudas, reimbursements jumped 39 percent to €1.5 million, despite its small population of 3,700.

Päivi Tillman, a Kela researcher, attributes the rise to inflation, higher VAT on taxi fares, and increased ambulance and taxi rates. She also notes that service centralization may force patients to travel farther, particularly for long-distance taxi trips.

While welfare regions save money by consolidating services, the state bears the rising transport costs through Kela. Santeri Seppälä, director of the South Savo welfare region Eloisa, argues that these reimbursements should be integrated into regional funding to enable better cost-benefit decisions.

In 2025, Kela reimbursed 4.6 million medical trips totaling €364 million—less than 1.5 percent of Finland’s €26 billion healthcare budget. Yet for patients like Kotisaari, the financial and logistical burden remains significant.