Proposed health fee hikes could put services out of reach

Plans to raise social and healthcare fees in Finland have drawn criticism, with the Deputy Parliamentary Ombudsman warning that the changes could put services beyond the reach of people who need them, Yle reports.

The government plans to increase the maximum fees for health centre visits, outpatient clinic appointments and dental care. The changes were agreed during last spring’s spending framework talks and are intended to take effect gradually from the beginning of next year. The consultation period on the proposals ends next week.

The fee for a visit to a health centre doctor would rise by 20 per cent to 36.20 euros. Outpatient clinic and dental care fees would increase by 10 per cent. In 2023, the maximum fee for a health centre doctor’s visit was 20.90 euros.

The proposals would also introduce new fees for special examinations, surgery and procedures. Fees would additionally be charged in connection with deceased people. Estates would have to pay for determining the medical cause of death and for storing the deceased.

Chancellor of Justice Janne Salminen said the government should assess more closely the combined effects of the new and earlier fee changes, particularly on people with long-term illnesses and those who need extensive services.

“Further preparation should assess more precisely the extent to which the effects of the changes fall on the same people and how significant the overall increase in the fee burden could become for them,” Salminen’s statement said.

Deputy Parliamentary Ombudsman Susanna Lindroos-Hovinheimo said the proposed fees could put services beyond the reach of those who need them and endanger access to adequate healthcare. She said the cumulative effects of the changes must not become unreasonable, particularly for people and families in the most vulnerable positions.

The Finnish Medical Association said research on fee increases shows consistently that they reduce the use of primary and preventive healthcare services in particular, while increasing delays in treatment.

The association also criticised the proposed special examination fee, which could be charged for procedures such as magnetic resonance imaging. It said patients could refuse medically critical examinations for financial reasons, even though such imaging is used to diagnose and monitor serious and life-threatening illnesses and patients generally cannot influence whether they need it.

Takuusäätiö, a Finnish debt advice organisation, said fees related to deceased people could be problematic for estates with little or no money. It called for clear grounds for waiving the fees when an estate cannot cover essential funeral and estate administration costs. It also said no storage fee should be charged for periods when a delay is caused by circumstances beyond the relatives’ control.

The fee increases and new charges are part of the government’s savings programme, which aims to improve the sustainability of public finances. Maximum social and healthcare fees are set by decree, while wellbeing services counties ultimately decide whether to collect them.