1. Healthcare and welfare funding

    A move to single-channel funding for social welfare and healthcare services, where everyone has equal access and the private and public sector work together.

  2. The customer has the freedom to choose

    Money follows the customer. Future needs are drivers of development.

  3. Practical trials stimulate action

    Implementation, function and profitability are tested in practice.

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New funding and steering system for social and healthcare services

The problems associated with our healthcare system include inequality and the lack of customer-orientation, co-ordination, incentives and transparency regarding quality and costs. The existing system focuses on the treatment of illnesses and does not support the promotion of health.

According to a study on healthcare in Oulu, carried out in autumn 2013, 10% of the city's population generate 81% of the municipality's social welfare and healthcare costs. The most significant finding of the study was that of the total costs, 38% was generated by Oulu residents using healthcare services only, and 62% by people who use both social and healthcare services. The new, integrated social welfare and healthcare service model is a major step in the right direction for its customers and from a cost perspective.

Healthcare is mainly funded by taxation but, in practice, the funding system includes multiple channels. The funding parties include the public sector: the state (24.4%), local authorities (36.7%), the Social Insurance Institution of Finland (Kela) (14.4%); and the private sector: households (18.6%), employers (2.9%) and relief funds, private insurance providers and organisations (3.1%). A multi-channel funding system breeds inefficiency. The funding system is marked by partial optimisation, as each funding party aims to achieve operating conditions that are optimal from their perspective, and no one bears overall responsibility for the funding system or the quality and results of the produced services.

Sitra employs a customer-oriented approach to tackling these issues. Through our projects, we produce information that supports the reform of the funding of social welfare and healthcare in a manner that is customer-oriented and takes into account future needs.

Our objective is to empower citizens, providing them with the opportunity to influence and choose their healthcare service provider and to make sure that all users of social welfare and healthcare services receive equal access to treatment. Our measures aim to encourage people to take more responsibility for their own well-being and that of friends and family. Our projects create more means and incentives for supporting customer-oriented operating models and the realisation of the “money follows the customer” approach.

The reform of the funding system for social welfare and healthcare services requires wide-ranging and open co-operation, in which Sitra is also participating and contributing.

The comprehensive reform of social welfare and healthcare services in Finland has already been put in motion. The government has outlined that, in the future, five regions will be responsible for the organisation of social welfare and healthcare services. In addition, the Ministry of Social Affairs and Health has appointed a working group to examine options for discontinuing multi-channel funding of social welfare and healthcare.

Five regions for the organisation of social welfare and healthcare services (Press release from the Ministry for Social Affairs and Health, 23 March 2014)

A working group to examine options for clarifying multi-channel funding (Press release from the Ministry for Social Affairs and Health, 27 March 2014)


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