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Saving is not easy, nor is reforming. However, it is clear that something must be done to ensure that public funds are sufficient to promote and provide care for everyone’s health. Governments have long found it challenging to heed calculations and guidelines made in official preparations.

When I studied medical law in the early 2000s, these questions were already in discussion. We extensively considered prioritization, equitable distribution of costs, the location of hospitals, and the justifications for treatment decisions. It was interesting and important to study and discuss these matters together with medical students.

Personally, I believe that quick access to knowledgeable and skilled primary healthcare is crucial. There, the causes of illness should be quickly investigated, and the need for further treatment assessed. This prevents untreated issues or illnesses from worsening and becoming more serious. As a result, an individual’s well-being deteriorates, and the costs of care rise for society. In emergency situations, prompt treatment is also essential, as time is often a decisive factor for the outcome in many health crises.

Based on my own and my close ones’ experiences, I can say that specialized healthcare is generally excellent and competent. Controls work, and even serious illnesses and injuries are treated very well and with professionalism.

The questions of how many skilled professionals we will have in the future and where they can work are critical.

I have pondered this matter a lot for various reasons. I believe that, based on my experiences, the most important thing is to receive the best possible care, even if it is not just a short distance away. The fact that a skilled team performs surgery on you is more important than receiving service right nearby.

However, rehabilitation and aftercare should be accessible so that your support network can assist and be present in those moments.

Only sufficiently large and nationally centralized units can continue to provide top expertise through professional teams when we need specialized healthcare. Hopefully, this will happen as rarely as possible when primary healthcare is functioning effectively.

The issue is timely and requires the ability to make significant political decisions that go beyond just those related to specialized healthcare.

In our medical profession, we are the only profession that has truly excellent opportunities to work multiple jobs simultaneously. They can work in the public sector and then shift to perform the same tasks in the private sector. Generally, public employers can do nothing but agree to these arrangements. There is a desire to also work in public duties as private practitioners, which raises questions about whether it is appropriate for work done under public responsibility and how equality among other public officials is realized in this context.

Then there are Kela reimbursements and the income transfer to private operators through them. This did not produce the desired results, as was known, but it was still attempted once again with half a billion.

We are at a crucial and important juncture because the population is aging, morbidity is likely increasing, and costs are rising for various reasons.

It is necessary to base politics on research and evidence. We must improve the situation in primary healthcare and ensure effective specialized healthcare.

This week, a claim also arose that the constitution complicates treatment decisions. Thus, amendments to the constitution are proposed to resolve the issue. This interpretation and the ongoing criticism of the constitution greatly perplex me.

This matter does not require opening or amending the constitution.

Legislation on Prioritization

In Finland, the basis for prioritization is the Constitution (731/1999), which states:

“The public authority must secure, as provided by law, adequate social and healthcare services for everyone and promote the health of the population.”

Thus, the constitution does NOT create a subjective right for patients to receive all possible healthcare.

What is considered adequate is open to interpretation and has not been defined very precisely in legislation. This has specifically been left to individual medical consideration in Finland.

The issue is complex in many ways, but it can be addressed under the current legislation.

The law on the status and rights of patients (785/1992) states:

“Every person permanently residing in Finland has the right, without discrimination, to receive healthcare and medical treatment according to their health condition, within the resources available at any given time in the healthcare system.”

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