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June 22, 1994, Vol 271, No. 24 >
ARTICLE | June 22, 1994

Finland's Health Care System: Title and subTitle BreakUniversal Access to Health Care in a Capitalistic Democracy FREE

Terhi Hermanson, MD, MS; Seppo Aro, MD, MS; Charles L. Bennett, MD, PhD
[+] Author Affiliations

Edited by Annette Flanagin, RN, MA, Associate Senior Editor.

Reprint requests (in the United States) to Durham Veterans Affairs Medical Center, Health Services Research and Development (152), 508 Fulton St, Durham, NC 27705 (Dr Bennett). All other requests to National Board of Medicolegal Affairs, PO Box 265, Helsinki, Finland 00531 (Dr Hermanson).


JAMA. 1994;271(24):1957-1962. doi:10.1001/jama.1994.03510480081040
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References

In Europe, several countries with national health services have started experimenting with planned markets.1 Finland has a national health care system funded through general taxation, with good access to care and a large emphasis on primary care and preventive services. In 1993, Finnish health care financing was reorganized with the purpose of increasing efficiency and performance.

Background  Since her independence in 1917, Finland has been a republic, combining a parliamentary system with a strong presidency. It is a country of 5 million inhabitants but is sparsely populated. The Finnish population is culturally and racially homogeneous. In contrast to Sweden and Denmark, there is very little immigration into Finland. Finland's economy was formerly dominated by agriculture; however, in the past few decades it has been primarily transformed into services (60% of the population) and industry (30% of the population).2 Finland governs by a capitalistic democracy, but its people have

REFERENCES

1 +
Saltman R, von Otter C. Planned Markets and Public Competition: Strategic Reform in Northern European Health Systems . Buckingham, England: Open University Press; 1992;.
2 +
Health for All Policy in Finland: WHO Health Policy Review . Copenhagen, Denmark: WHO Regional Office for Europe; 1991;.
3 +
Statistical Yearbook of Finland . Helsinki, Finland: Statistics Finland; 1993;;88.
4 +
Terveyttä kaikille vuoteen 2000: udistettu yhteistyöohjelma. Sosiaali: Terveysministeriön Julkaisuja. 1993. No. 2.
5 +
Economic Surveys of Finland, 1988/89 . Paris, France: OECD Publications; 1991;.
6 +
Health Statistics in the Nordic Countries 1991 . Copenhagen, Denmark: Nordisk Medicinal Statistisk Komite; 1993;. No. 40.
7 +
Berg M-A, Helakorpi S, Puska P. Suomalaisen aikuisväestön terveysk ayttäytyminen. Kansanterveyslaitoksen Julkaisuja B. 1993; No. 10.
8 +
Kontula O.  The prevalence of drug use with reference to problem use in Finland. Int J Addict . In press.
9 +
Teperi J, Keskimäki I, Aro S. Socioeconomic status and declining abortion rate in Finland. In: Abstracts of the American Public Health Association, 121st Annual Meeting; October 24-28, 1993; San Francisco, Calif.
10 +
Koonin LM, Smith JC, Ramick M, Lawson HW.  Abortion surveillance—United States. MMWR CDC Surveill Summ . 1992;;41:1-33.
11 +
Rimpelä AH, Rimpelä MK, Kosunen E.  Use of oral contraceptives by adolescents and its consequences in Finland 1981-91. BMJ . 1992;;305:1053-1057.
12 +
Health Services 1987 . Helsinki, Finland: National Board of Health in Finland; 1989;.
13 +
Paunio M, Virtanen M, Peltola H, et al.  Increase of vaccination coverage by mass media and individual approach: intensified measles, mumps, and rubella prevention program in Finland. Am J Epidemiol . 1991;;133:1152-1160.
14 +
Valkonen T, Martelin T, Rimpelä A. Socioeconomic Mortality Differences in Finland 1971-85 . Helsinki, Finland: Central Statistical Office of Finland; 1991;. Study 176.
15 +
Läärä E, Day NE, Hakama M.  Trends in mortality from cervical cancer in the Nordic countries: association with organised screening programmes. Lancet . 1987;; 1:1247-1249.
16 +
Poistoprojektin loppuraportti. Helsinki, Finland: STAKES; 1994. Aiheita, No. 45.
17 +
Lönnqvist J.  National suicide prevention project in Finland: a research phase of the project. Psychiatr Fenn . 1988;;19:125-132.
18 +
 Update: acquired immunodeficiency syndrome—United States, 1992. MMWR Morb Mortal Wkly Rep . 1993;;42:547-557.
19 +
Löytönen M.  The spatial diffusion of human immunodeficiency virus type 1 in Finland, 1982-1997. Ann Assoc Am Geogr . 1991;;81:127-151.
20 +
Tavoitteena laatupalvelut kohtuukustnnuksin: yhteenveto palvelurakenneselvityksistä: sosiaali—ja terveysministeriö. Työryhmämuistio. 1993; No. 7.
21 +
Heikkilä J.  Ohitusleikkaukset—suomalainen iäisyysongelma? Suom Lääkäril . 1992;;47:1412.
22 +
Saltman RB.  Recent health policy initiatives in Nordic countries. Health Care Financing Rev . 1992;;13:157-166.
23 +
Physicians in Finland . Helsinki, Finland: Finnish Medical Association; 1993;.
24 +
Aro S, Noro A, Byckling T, Häkkinen U, Salinto M, Kerppilä S. Aikuisväestön terveyspalvelujen käyttö ja terveydentila 1992 . Jyväskylä, Finland: STAKES; 1993;. Report No. 120.
25 +
Salmela R.  Regional inequalities in health and health care in Finland and Norway. Health Policy . 1993;;24:83-94.
26 +
Vohlonen I, Pekurinen M, Saltman RB.  Re-organizing primary medical care in Finland: the personal doctor program. Health Policy . 1989;:13:65-79.
27 +
Aro S, Liukko M, eds. Väestövastuisen perusterveydenhuollon kokeilut 1989-1993. Mikä muuttui? Helsinki, Finland: STAKES; 1993;. Report No. 102.
28 +
Lääkäreiden työaikatietoja. Kunnallinen tyomarkkinalaitos . Helsinki, Finland: Finnish Medical Association; 1992;.
29 +
Jäättelä A, Kujala S, Niinimäki T.  Yksityisvastaanottotoiminnan kehittyminen Suomessa 1980—luvulla. Suom Lääkäril . 1990;;45:1668-1672.
30 +
Riska E.  The professional status of doctors in the Nordic countries. Milbank Q . 1988;;66( (suppl 2) ):133-147.
31 +
Hermanson T. Lääkäri terveydenhuollon hallinnossa. Lääkintöhallituksen Tutkimuksia. 1989; No. 49.
32 +
Hermanson T. Professionalismin ilmeneminen terveydenhuollon johtosääntökiistassa. Kansanterveystieteen Julkaisuja . Helsinki, Finland: University of Helsinki; 1986;.
33 +
Kokkonen P.  No-fault liability and patient insurance: the Finnish Patient Injury Law of 1986. Int Digest Health Legislation . 1989;;40:241-246.
34 +
The Patient Insurance Association, Helsinki, Finland, press release, April 3, 1994.
35 +
Health-data . Paris, France: Organization of Economic Cooperation and Development; 1993;. Organization of Economic Cooperation and Development Social Policy Study No. 7.
36 +
Statistical Abstract of the United States 1993: The National Data Book . Washington, DC: US Dept of Commerce, Economics and Statistics Administration, Bureau of the Census; 1993;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Saltman R, von Otter C. Planned Markets and Public Competition: Strategic Reform in Northern European Health Systems . Buckingham, England: Open University Press; 1992;.
2 +
Health for All Policy in Finland: WHO Health Policy Review . Copenhagen, Denmark: WHO Regional Office for Europe; 1991;.
3 +
Statistical Yearbook of Finland . Helsinki, Finland: Statistics Finland; 1993;;88.
4 +
Terveyttä kaikille vuoteen 2000: udistettu yhteistyöohjelma. Sosiaali: Terveysministeriön Julkaisuja. 1993. No. 2.
5 +
Economic Surveys of Finland, 1988/89 . Paris, France: OECD Publications; 1991;.
6 +
Health Statistics in the Nordic Countries 1991 . Copenhagen, Denmark: Nordisk Medicinal Statistisk Komite; 1993;. No. 40.
7 +
Berg M-A, Helakorpi S, Puska P. Suomalaisen aikuisväestön terveysk ayttäytyminen. Kansanterveyslaitoksen Julkaisuja B. 1993; No. 10.
8 +
Kontula O.  The prevalence of drug use with reference to problem use in Finland. Int J Addict . In press.
9 +
Teperi J, Keskimäki I, Aro S. Socioeconomic status and declining abortion rate in Finland. In: Abstracts of the American Public Health Association, 121st Annual Meeting; October 24-28, 1993; San Francisco, Calif.
10 +
Koonin LM, Smith JC, Ramick M, Lawson HW.  Abortion surveillance—United States. MMWR CDC Surveill Summ . 1992;;41:1-33.
11 +
Rimpelä AH, Rimpelä MK, Kosunen E.  Use of oral contraceptives by adolescents and its consequences in Finland 1981-91. BMJ . 1992;;305:1053-1057.
12 +
Health Services 1987 . Helsinki, Finland: National Board of Health in Finland; 1989;.
13 +
Paunio M, Virtanen M, Peltola H, et al.  Increase of vaccination coverage by mass media and individual approach: intensified measles, mumps, and rubella prevention program in Finland. Am J Epidemiol . 1991;;133:1152-1160.
14 +
Valkonen T, Martelin T, Rimpelä A. Socioeconomic Mortality Differences in Finland 1971-85 . Helsinki, Finland: Central Statistical Office of Finland; 1991;. Study 176.
15 +
Läärä E, Day NE, Hakama M.  Trends in mortality from cervical cancer in the Nordic countries: association with organised screening programmes. Lancet . 1987;; 1:1247-1249.
16 +
Poistoprojektin loppuraportti. Helsinki, Finland: STAKES; 1994. Aiheita, No. 45.
17 +
Lönnqvist J.  National suicide prevention project in Finland: a research phase of the project. Psychiatr Fenn . 1988;;19:125-132.
18 +
 Update: acquired immunodeficiency syndrome—United States, 1992. MMWR Morb Mortal Wkly Rep . 1993;;42:547-557.
19 +
Löytönen M.  The spatial diffusion of human immunodeficiency virus type 1 in Finland, 1982-1997. Ann Assoc Am Geogr . 1991;;81:127-151.
20 +
Tavoitteena laatupalvelut kohtuukustnnuksin: yhteenveto palvelurakenneselvityksistä: sosiaali—ja terveysministeriö. Työryhmämuistio. 1993; No. 7.
21 +
Heikkilä J.  Ohitusleikkaukset—suomalainen iäisyysongelma? Suom Lääkäril . 1992;;47:1412.
22 +
Saltman RB.  Recent health policy initiatives in Nordic countries. Health Care Financing Rev . 1992;;13:157-166.
23 +
Physicians in Finland . Helsinki, Finland: Finnish Medical Association; 1993;.
24 +
Aro S, Noro A, Byckling T, Häkkinen U, Salinto M, Kerppilä S. Aikuisväestön terveyspalvelujen käyttö ja terveydentila 1992 . Jyväskylä, Finland: STAKES; 1993;. Report No. 120.
25 +
Salmela R.  Regional inequalities in health and health care in Finland and Norway. Health Policy . 1993;;24:83-94.
26 +
Vohlonen I, Pekurinen M, Saltman RB.  Re-organizing primary medical care in Finland: the personal doctor program. Health Policy . 1989;:13:65-79.
27 +
Aro S, Liukko M, eds. Väestövastuisen perusterveydenhuollon kokeilut 1989-1993. Mikä muuttui? Helsinki, Finland: STAKES; 1993;. Report No. 102.
28 +
Lääkäreiden työaikatietoja. Kunnallinen tyomarkkinalaitos . Helsinki, Finland: Finnish Medical Association; 1992;.
29 +
Jäättelä A, Kujala S, Niinimäki T.  Yksityisvastaanottotoiminnan kehittyminen Suomessa 1980—luvulla. Suom Lääkäril . 1990;;45:1668-1672.
30 +
Riska E.  The professional status of doctors in the Nordic countries. Milbank Q . 1988;;66( (suppl 2) ):133-147.
31 +
Hermanson T. Lääkäri terveydenhuollon hallinnossa. Lääkintöhallituksen Tutkimuksia. 1989; No. 49.
32 +
Hermanson T. Professionalismin ilmeneminen terveydenhuollon johtosääntökiistassa. Kansanterveystieteen Julkaisuja . Helsinki, Finland: University of Helsinki; 1986;.
33 +
Kokkonen P.  No-fault liability and patient insurance: the Finnish Patient Injury Law of 1986. Int Digest Health Legislation . 1989;;40:241-246.
34 +
The Patient Insurance Association, Helsinki, Finland, press release, April 3, 1994.
35 +
Health-data . Paris, France: Organization of Economic Cooperation and Development; 1993;. Organization of Economic Cooperation and Development Social Policy Study No. 7.
36 +
Statistical Abstract of the United States 1993: The National Data Book . Washington, DC: US Dept of Commerce, Economics and Statistics Administration, Bureau of the Census; 1993;.

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