Terveyskeskus: No one here gets out alive
@ 2:55 pm Looks like the famous Finnish healthcare system is in the news again. Nothing surprising though. According to the National Research and Development Centre for Welfare and Health….
…poor people die more often of diseases that might otherwise have been successfully treated with better care.
Diseases like asthma, diabetes, and pulmonary emphysema are more likely to kill poor people than those better-off financially.
I find it disturbing that poor people don’t get adequate care in Finland. Every modern country should be able to treat all its strata for these common diseases. Only a substandard underlying economic model can be to blame.
To compensate for bad economics, Finland uses an assembly line Terveyskeskus—or health clinic —system which involves near-anonymous physician-patient relationships. Just take a number and wait a few hours for the next available physician. No rapport is developed over time. The patient can only hope that good communication can be achieved during that short visit.
The bottom line is that a high-tax, low-wealth economic model simply can’t sustain good quality care for everyone. Consider that when combined, Ansiovero, VAT and Autovero are roughly the highest in Europe and prevent a sufficient investment base from developing in Finland. It’s no wonder that Finland is among the poorest countries in western Europe. This, despite having otherwise good economic indicators.
Of course, there’s no shame in being poor as a country, but it does cause a high number of people to be dependent on an overburdened, low-budget public healthcare system.
I’m very hopeful that Finland takes steps to change its economic and tax structures to enable wealth accumulation. In my opinion, given Finland’s status as underdog, it should strive to be among the lowest taxed and richest countries in western Europe rather than the highest taxed and poorest.
Ultimately, changes are necessary for the country’s economic wellbeing and also the health of its citizens.
As usual, I’m thinking about Germany and Switzerland. No two-tier healthcare system necessary.
Comment by Kristian — Thu, Mar 29th, 2007 @ 3:01 pm
I am afraid it’s true.
Just yesterday we took our son to the neurology department of the children’s hospital in Helsinki to have a “follow up” visit about his chronic tension headaches.
This “follow up” came two(!) years after his last visit there, and the advice was almost identical: heavy prescription of (get this) Burana and Panadol, along with a week’s trial of muscle relaxants to determine if his headaches are related to the tension in his neck, or if they might be independent of it.
The prescription two years ago? A heavy prescription of (get this) Burana and Panadol, and when we tried to get a follow up appointment they told us we’d have to start all over again at the “regular” doctors to get a referral, despite the fact that he had already been there and his headaches were becoming more frequent and severe than before.
I am fucking fed up with Finnish doctors prescribing Burana for every fucking thing. It’s like they own shares in the company or something.
In the states it might be expensive etc., and far from perfect, but at least there they are so scared of malpractice lawsuits that they cover ALL the bases and do ALL the tests and try to find the RIGHT diagnosis and the RIGHT treatment. Here it seems that the doctor can just say “take a Burana (or 50) and call (another) doctor in the morning.”
Comment by DAVE THE MAVE — Thu, Mar 29th, 2007 @ 3:08 pm
Indeed poor health care is the service that I most blame in this country and one of the few social services whose quality falls behind the Italian counterpart. And luckily enough I am still young and single so I haven’t had many occasions to use public health care for me or (possibly) my children, but the few experiences I had have given me some ideas.
But you can’t have everything from Finland, can you?
Simo
P.S. Autovero is the second thing I hate most.
Comment by Simo — Thu, Mar 29th, 2007 @ 3:15 pm
Unfortunately it is true that the poorer people suffer from these things more in most countries. It is more to do with their lifestyle than the health system. Often the poor can not afford to eat the same kind of good diet as the rich. Statistically (oddly) it is also the poorer in society that are more likely to be smokers. There is no significant difference in healthcare (unless you go private of course) in the health system for most Finns regardless of money; it is much more down to lifestyle. And of course, low taxes does not make for a healthier population. There is an obvious country to point to as an example of this here, USA.
Comment by JG — Thu, Mar 29th, 2007 @ 3:17 pm
On the other hand, the care our prematurely born daughter received at TYKS in Turku was unbelievable and basically free.
Comment by DAVE THE MAVE — Thu, Mar 29th, 2007 @ 3:21 pm
Well, I guess we should make an actual study of countries where the income distribution is more unbalanced than in Finland - that is where there is less progressive taxation and where capital accumulates more freely. In other words, Kristian, why don’t you for example compare Finland and the USA?
There are many serious faults in our system which really is very “cost-effective” in an area where such a thing is often far from being a positive - but you should make it clear that those Swiss and German systems, you so much advertise, are in most ways equally “statist” from a US Republican/Libertarian perspective, they just have a slightly different approach.
Comment by mjr — Thu, Mar 29th, 2007 @ 3:36 pm
On the “net worth” link Kristian likes to use in every post he makes … Wider results have been looked over by Statistics Finland:
http://www.stat.fi/artikkelit/2007/art_2007-02-15_001.html?s=0
Maybe they are just biased :-).
Comment by Zark — Thu, Mar 29th, 2007 @ 4:06 pm
As JG said: Unfortunately it is true that the poorer people suffer from these things more in most countries. It is more to do with their lifestyle than the health system. Often the poor can not afford to eat the same kind of good diet as the rich.
I think this explains quite a lot rather than the lack of healthcare.
Comment by Hank W. — Thu, Mar 29th, 2007 @ 4:12 pm
What is terveyskeskus?
Comment by Dogz — Thu, Mar 29th, 2007 @ 4:20 pm
Terveyskeskus is a building generally always full of people sneezing, coughing, limping, ranting, raving, screaming, pleading, drooling, bleeding, and nearly dying waiting for their Burana tablets.
Comment by DAVE THE MAVE — Thu, Mar 29th, 2007 @ 4:25 pm
“What is terveyskeskus?”
A healthcare center.
Comment by Ã…boy — Thu, Mar 29th, 2007 @ 5:22 pm
mjr: “that is where there is less progressive taxation and where capital accumulates more freely.”
Interestingly, Germany probably has more progressive taxation than Finland. Poor people in Germany pay comparatively less Ansiovero (income tax) and don’t have the high VAT and Autovero (car tax). At the top end, Ansiovero rates look similar to Finland’s. But overall, taxation is much less in Germany. Not surprisingly, consumer prices are also much less.
Insofar as healthcare goes, you’re probably right about it having a statist element. Germany’s healthcare funds are quasi-private, but they do encourage some competition. Switzerland is similar but more privately oriented. Each has strict governmental regulation.
No doubt, each system has some weaknesses and inefficiencies, but each country’s high wealth compensates for them. In Germany’s case, it is despite nearly 1/3 of the country being formerly Communist.
I have an older not-so-wealthy acquaintance who recently had a major medical procedure done in Germany……followed by 6-weeks at a ‘therapeutic Spa resort.’ All covered by the ‘Krankenkasse.’ Good medical care is common for all strata.
mjr: “ In other words, Kristian, why don’t you for example compare Finland and the USA?“
USA pros
+Most advanced equipment that money can buy
+Most advanced research and highest available funding
+Most highly trained physicians (at least 4 years more than here in Europe)
+Best system if your life depends on it
USA cons
-300,000,000 people
-Huge geographic region
-Highly multi-ethnic, so difficult to form consensus
-Former slavery and discrimination, social problems
-For these reasons, healthcare is not evenly distributed and can be financially difficult some people
Although I don’t see the US model per se as being best for Finland, I don’t see why the best aspects of all systems can’t be borrowed. Why can’t people from all over the world fly to private clinics in Finland (instead of US or Switzerland) to have some advanced procedure done? And couldn’t poor people in Finland also benefit from those same advanced medical capabilities?
It takes a pro-investment, high-wealth economy and private funding. There’s simply no other way to raise the level of care in absolute terms for the lower strata.
Comment by Kristian — Thu, Mar 29th, 2007 @ 5:25 pm
“In my opinion, given Finland’s status as underdog, it should strive to be among the lowest taxed and richest countries in western Europe rather than the highest taxed and poorest.”
“It takes a pro-investment, high-wealth economy and private funding. ”
We have the same scratched Kristina of Espoo record going around again.
Comment by pi — Thu, Mar 29th, 2007 @ 5:40 pm
In what country on this planet is the following quote false?
”
…poor people die more often of diseases that might otherwise have been successfully treated with better care.”
Comment by pi — Thu, Mar 29th, 2007 @ 5:46 pm
“the lower strata.”
Hei Kristina what strata do you see yourself?
Comment by Anonymous — Thu, Mar 29th, 2007 @ 5:50 pm
Hmm, I’m sure Kristian that you know that healthcare spending in the USA is very high, certainly much higher than in Finland - despite of that they strangely fail to provide adequate care to all citizens. This is reflected directly in their national health statistics. You seem to think that the reasons for this are, hmm, genetical, historical and geographical among other things. On my part I just suspect that just maybe the absolutely gigantic inequalities of personal wealth and grotesquely monetized political process might have something more to do with than the Civil War. In any case, what you seem to recommend for Finland is to move towards more American type of socical model in order to improve our national health service - despite the empirical observation that the American health care system is obviously both worse AND more expensive than the Finnish one. I guess a good example of theory trumping empirical sense.
Comment by mjr — Thu, Mar 29th, 2007 @ 6:43 pm
mjr: “what you seem to recommend for Finland is to move towards more American type of socical model in order to improve our national health service“
No, I see the Swiss social model as being the better choice. There should be an adequate safety net for everyone.
Since you automatically object to any such ideas, am I to assume that you propose keeping things the same—that is, keep low quality healthcare for poor people here in Finland?
Comment by Kristian — Thu, Mar 29th, 2007 @ 6:58 pm
mjr, why are you so anti everything USA? Why can you never for example say, “well yes I see your point there. That is a strong point of the US economy, maybe we could implement similar thinking regarding that matter here while maintaining a certain amount of security” rather than “Hell no, thats American, that must be crap. There are so many poor there and they hate the rest of the world and they only think about money. Down eith capitalism…..” You, more so than Kristian, sound like a scratched record playing the same old tune. Get up with the times. BTW, I guess you’re happy seeing a good old Finn “Paavo” back in the picture. Might be a change back to the glorius times of 70s and 80s Finland. We might even be able to resurrect the old USSR if we try hard enough.
Comment by Punter — Thu, Mar 29th, 2007 @ 7:18 pm
Kristian-”Although I don’t see the US model per se as being best for Finland, I don’t see why the best aspects of all systems can’t be borrowed. ”
Thanks, good point. I don’t see why we would take the US system for most things as the two countries could be more different. That is not to say however that we can’t learn from different systems and adapt them to suit our economy and conditions. I think there is a lot to gain from various economic models around the world and to simply sit back on our Nordic Model claiming superiority is not only arrogant but also cheating our ever developing and changing society of some basic rights.
Comment by Punter — Thu, Mar 29th, 2007 @ 7:23 pm
Healthcare center? Thanks!
Why was it “terveyskeskus” then? Confusing.
Comment by Dogz — Thu, Mar 29th, 2007 @ 7:59 pm
Coz thats what it reads on the door.
Comment by Hank W. — Thu, Mar 29th, 2007 @ 8:19 pm
@11 Kristian, I think you missed from the cons the litigatious system that forces private practitioners out of business in some areas, as they cannot affored the malpractice insurances.
Comment by Hank W. — Thu, Mar 29th, 2007 @ 8:21 pm
Coz thats what it reads on the door.
Unless of course it says hälsostation
The Swiss system is not the most ideal systems. I think I read in my newspaperr a few weeks ago that the Swiss pay the highest (if not amongst the) health insurance fees in the world.
Comment by JG — Thu, Mar 29th, 2007 @ 8:35 pm
From my opinion of working within the Finnish healthcare system I would attribute poor people dying more a result of their lifestyle, rather than the level of care. The listed diseases of asthma, diabetes, and pulmonary emphysema are all exacerbated by poor lifestyle choices such as smoking, excessive drinking and unhealthy eating. Unsuprisingly, poor people are usually less educated(less intelligent) and do these things. Thus, their deaths should be attributed to their own stupidity, rather than blaming the system.
This being said, the highest level of care does not even begin to compare with that of the U.S. Almost all of the innovation in medicine or medical technology that we hear about or study has an American orgin. American doctors and nurses also have much better education and knowledge than here in Finland.
And don’t get me started about the wage levels here……..
Comment by Unit — Thu, Mar 29th, 2007 @ 8:55 pm
+ USA pro’s
Front of the line
I actually know my doctor, and he knows me
I get 3rd, and 4th Doctor options/visits for the same problem’
and the best one of all
I get to pick MY medical solution.
No forced feeding of a single solution by a Government on me. No withholding of a solution, because we need your money for more urgent medical needs, i.e. not your needs.
By the way what Slavery problem are you bringing up? Are you talking about the current “Slavery” problem we have with Saudi couples living here with their servants?
Comment by winter “Against stupidity, the gods themselves are helpless.†— Thu, Mar 29th, 2007 @ 9:02 pm
Well, Punter, I’m really arguing against modern libertarian cum conservative economic ideas, that are so destructive in practice and co childishly inane intellectually - and in the Western world they happen to be strongest in the USA. This site is, sadly, dedicated to promoting such ideals, so it is always handy to point out that in the society that is much more tuned to this ideology many things are observably worse than in the Nordic countries for example. A prime example is the health care system which manages to be both wasteful AND non-universal in the USA. As for the Swiss “model”, Kristian, I don’t know, Switzerland really seems to be quite a unique case, wouldn’t you say. But what I would really like to know more about are your ideas about the racial composition of the USA - they seem to be quite “colourful”, and no pun intended.
Comment by mjr — Thu, Mar 29th, 2007 @ 9:15 pm
“Unsuprisingly, poor people are usually less educated(less intelligent) and do these things. Thus, their deaths should be attributed to their own stupidity, rather than blaming the system.” - Unit(wit)
Poor people are not less intelligent, dumbass.
Comment by DAVE THE MAVE — Thu, Mar 29th, 2007 @ 9:19 pm
Note though Dave that this person does work in the healthcare system and therefore poor, backing up his/her point
Comment by Punter — Thu, Mar 29th, 2007 @ 10:11 pm
No, I think too many of you that wish for the welfare state to remain simply compare every anti nordic statement as meaning pro US. I think Phil and many contributors to this site (winter excluded) see the pitfalls of the US system but also the positives that are there and simply wish for a discussion on incorporating some of them.Rather than getting a lively and open intelligent discussion, many and particularly you always seem to shoot down any idea with your typical anti US views. It would seem that you have somehow been hurt by the US and see it as the enemy. Certainly looking at the position and success of the US on a global level, be it right or wrong in your mind, you can’t refuse their global leadership position and the positives they offer in many cases. Now, admitted they have faults too, certainly, with the benefit of hindsight and our supposed intellectual superiority we could take their positives and those of others and mould it to our own advantage to develop a truely unique solution.
Comment by Punter — Thu, Mar 29th, 2007 @ 10:19 pm
No, Punter, the point is that the US society certainly is far closer to libertarian economic ideals than the Nordic societies. It is true of course that we have nowhere a purely libertarian society in actual, prosaic existence - though many believe because such a thing couldn’t logically survive longer than, say, 60 seconds. So it’s easy to defend something completely imaginary but much harder to argue why a society that is so much closer to one’s ideals is in many areas so much behind countries that are far further removed from libertarian cum modern conservative ideals. Btw, I don’t see myself being anti-American at all, see below what I think of that great nation:
http://stockholmslender.blogspot.com/2006/02/liars-in-public-places.html
Comment by mjr — Thu, Mar 29th, 2007 @ 11:18 pm
our everlasting intellectual superiority can be found at the nearest local pub.
the most annoying thing about the Finns in general (my self included)
is the new feel of self righteusness which we didn’t use to have
at all. nowadays, when the world has suddendly shrunked to the
size of tennis ball, we are constantly finding our selves
explaining our doings more and more to the outside world.
seeking that common ground which has been the basis of
Finnis culture after the world wars.
AKA: we are so small but then again so big.
this leaves us in very difficult position in the world
which we are trying to cope with.. mainly by
covering our arses all the time. we just can’t afford
to be otherwise since we are a people “which is dying away”.
all this economical advantage seeking and free economy praising
will ultimately brake our society. the wellfare system and
health care used to work like a charm.. nowadays
it doesn’t because of the globalisation.
we cant do anything about it. we would like to take
care of our own. but the prize is beginning to
tear us apart. US is another deal all together.
since the whole society bases on the one common thing
what all desire. not the similarity of people or culture.
Comment by bonkers — Thu, Mar 29th, 2007 @ 11:23 pm
bonkers: “the wellfare system and
health care used to work like a charm..”
Interesting evaluation. My mother knew the healthcare system from the 1950’s through the 1980’s. We moved around a lot when I was young. She always waited to have any medical procedures done outside of Finland and didn’t even like having routine check-ups here.
And then there were the relatives we ‘evacuated.’ That was before you could pay for private services. But, we also evacuated one less than two-years-ago; that’s because the procedure wasn’t available here—not even here in Europe.
Comment by Kristian — Fri, Mar 30th, 2007 @ 12:28 am
#26
No no you misunderstood the twat, it’s because God wants them to be poor, right unit?
Comment by Anonymous — Fri, Mar 30th, 2007 @ 12:56 am
Oh, Kristian, I didn’t realize you were an Ehrnrooth, or was it Wasastjerna? Now I begin to get an idea why you seem to be so divorced from the Finnish, hmm, should I say reality, well, everyday life…
Comment by mjr — Fri, Mar 30th, 2007 @ 12:59 am
mjr: “ As for the Swiss “modelâ€Â, Kristian, I don’t know, Switzerland really seems to be quite a unique case, wouldn’t you say.”
Yes, that’s why eastern European countries are adopting elements of the Swiss system—the economic model in particular. It wouldn’t hurt Finland to move in that direction too.
There are inefficiencies in the healthcare system though, and they are recognized. But things can’t change overnight because, well, change means someone wins and another loses. Switzerland is a complicated place in that way. Sort of inflexible.
Nevertheless, there are no major shortages and most people trust the system—-and so do my (Finnish) family members that live there. It’s an easy choice for them. Most are on the ‘basic’ plan. No frills.
mjr: “But what I would really like to know more about are your ideas about the racial composition of the USA”
Why don’t you visit the US? Maybe you could even live on the edge of a ghetto like I did (though only for a short time) and realize that that’s where the African slaves settled after they were freed. They still live there after 150-years. There’s very deep segregation compared to anything we have here in Europe.
For that matter, consider the area where winter lives. He’s under the Mason-Dixon Line, which separated the North and South during the Civil War. It was also the demarcation line between slave and non-slave states. People from the South still dislike those from the North because of the war.
Then you can consider many waves of immigrants that settled—and initially segregated themselves—over the last century. Each city still has separate Polish, Italian and Irish sections….and then later parts include Puerto Rican, Mexican, Chinese, etc.
New York’s Chinatown has nearly the population of Helsinki.
All these segregations and waves of immigration contributed to America’s ‘fend for yourself’ motto. The whole economic system was built around it. The trend now is toward closer integration, so my guess is that the social safety nets will be rebuilt. They’re already making improvements by making healthcare universal. But it won’t happen overnight.
Comment by Kristian — Fri, Mar 30th, 2007 @ 1:18 am
“Now I begin to get an idea why you seem to be so divorced from the Finnish, hmm, should I say reality, well, everyday life…”
Probably true. Moving around a lot has forced me to see things from more of an international perspective. You can read all about something, but it’s not the same as experiencing it.
Sometimes I get the feeling that your interpretation of “reality”, concerning other places, is from reading articles that suit your particular views. Sort of like a social scientist sitting in a library. I suggest you broaden your experience base. You’ll miss-out on a lot of things if you don’t. The world is changing whether you like it or not.
Comment by Kristian — Fri, Mar 30th, 2007 @ 1:37 am
“People from the South still dislike those from the North because of the war.”
The war we had with Germany? With who? I don’t remember any war here in Southern Maryland in my Fathers, or my generation.
Anyone who thinks that slavery is a factor, well except those who want free money for it, is living a dream. Ever hear of the former slave we now call Oprah? She is a little on the rich side. Has a TV show as well.
Comment by winter “Against stupidity, the gods themselves are helpless.†— Fri, Mar 30th, 2007 @ 3:21 am
“I don’t remember any war here” - winturd
This is your main problem in understanding the issue. Only after the Civil War did blacks in the US get the right to vote, then only 40+ years ago did they get the right to walk on the same side of the street and (maybe) the same shops.
To this day blacks are marginalized by their history of poverty brought upon them due to this segregation. You can’t just keep a populace mostly uneducated and poor and then all of a sudden say “OK! Time to go to Harvard and Macy’s.”
They have a lot of hurt to heal. This is why a large population of blacks are in prison, addicted to drugs and hopeless. You can’t just all of a sudden expect people to be cured of indoctrinated poverty.
Why do you think African Americans have their own dialect which employs bad grammar, made up words and phrases?
It’s because the US NEVER TOOK CARE OF THEM… until very recently. And up to this generation, it has been too little too late.
Kind of like when the man giving out brains, and you thought they said “trains,” and said that you didn’t want any, winter.
Comment by RAVE THE DAVE — Fri, Mar 30th, 2007 @ 8:07 am
Speaking of Ms. Winfrey, if you’re in New York, be sure to catch The Color Purple. Dat shure is good.
Oprah calls it The Color Green.
Comment by Freeridin' Franklin — Fri, Mar 30th, 2007 @ 8:25 am
Kind of like when the man giving out brains, and you thought they said “trains,†and said that you didn’t want any, winter.
No tranes for mee i wanna hUMMER.
Comment by Freeridin' Franklin — Fri, Mar 30th, 2007 @ 8:31 am
“No tranes for mee i wanna hUMMER.” - Freeridin’ Franklin doing a believable winturd impression
Comment by DAVE THE MAVE — Fri, Mar 30th, 2007 @ 9:34 am
Well, Kristian you seem to filter data very narrowly and rely quite exceedingly on anecdotal data. I too have sense experience, have lived abroad and worked in very international contexts, but in a planet of 6 billion people and with a species with 200 000 years of history you really can’t just rely on your personal experiences - or prejudices, or ideology. I’m hyper pragmatic when it comes to party politics and practical social and economical solutions: I better be as I don’t have a Grand Theory informing beforehand what empirical observations to discard and what fictive positions to take for real - instead of that I just rely on particular local contexts and constellations, and rational empirical observations. Somehow, just somehow, I see this approach as being more sensible than letting my ideology dictate the limits of my observations.
Comment by mjr — Fri, Mar 30th, 2007 @ 9:42 am
@26
Sorry for the offense. I will now refer to the poor as “people who otherwise be in MENSA but could not afford to take the test”
As a generalisation: Higher intelligence=Better ability to get into University= Higher Paying Job.
And: Lower intelligence= Less educational opportunities= A lower paying job
Comment by Unit — Fri, Mar 30th, 2007 @ 10:08 am
DAVE: “it’s because the US NEVER TOOK CARE OF THEM… until very recently. ”
It’s probably not even a matter of taking care of them. For the most part, everyone takes care of themselves in American society. But, in the case of Blacks, they were outright denied opportunities (education, financial capital, etc.)
Perhaps Franklin experienced some of these slave-descendants in NY? Most are very amicable people, but some are very loud and hostile.
Comment by Kristian — Fri, Mar 30th, 2007 @ 11:02 am
“but some are very loud and hostile.”
And that’s why winter doesn’t like to pay for them with his tax money.
Comment by Kristian — Fri, Mar 30th, 2007 @ 11:21 am
I’m not so sure the swiss model is the way to go, its just seems overly expensive to me, and of course will rank highly if people throw money at it. A health consumer report:
http://www.healthpowerhouse.com/media/RaportEHCI2006en.pdf
…ranks Switzerland 5/26, Finland 9/26, Germany 3/26, and France 1/26. Now maybe we could look at the German, or French models to try and learn, but why do you insist on the Swiss model? “Good but expensive.” is what the report has to say. As the Finland their comments are “…really good outcomes. If Finland improves the waiting list situation, they can be a top contender”
Looking at the figures from the World Health Organization (www.who.int), they show the Switzerland spend 11.5% of their total GDP on health care, compared to Finland’s 7.4%, Germany’s pay 11.1%, and the French pay 10.1%.
General government expenditure on health as percentage of total expenditure on health for, Switzerland:58.5%, Finland:76.5%, Germany:78.2%, and France:76.3%.
Private expenditure on health as percentage of total expenditure on health is Switzerland:41.5%, Finland:23.5%, Germany:21.8%, France:23.7%.
Social security expenditure on health as percentage of general government expenditure on health is Switzerland:69.3%, Finland:21.5%, Germany: 87.4%, France:96.7%.
The Swiss just seem to be paying more for something other countries provide cheaper, and better. I don’t disagree that there needs to be improvements in the Finnish system, but im no expert in the health care scene so can only look at the stat’s and personal views (which have been excellent so far). I’m quite impressed at the level of health care with such underfunding. And if I didn’t, I would just move back to that zero tax haven I lived for 13 years, back to that perfect private care…but then I remember passing all those people begging on the streets, and realizing which ones die off when they don’t show up to beg for food….now those were depressing starts to the day…
Comment by ebi — Fri, Mar 30th, 2007 @ 11:45 am
ebi: “why do you insist on the Swiss model?“
Throughout this page, I’m referring mainly to the Swiss economic model, not the healthcare model. Please read post #34.
My point has been that you can’t have good healthcare within a high-tax, low-wealth context.
Comment by Kristian — Fri, Mar 30th, 2007 @ 12:25 pm
#46
By paying high private insurance payments, US style.
Comment by Anonymous — Fri, Mar 30th, 2007 @ 1:08 pm
“blacks are marginalized by their history of poverty”
is just a left wing, I am so sorry, talking point. My neighbor who is black, would tell you he had done just fine, with out, your so called racist help.
If blacks to day, have less education than whites, its because they support inner city schools that are union run thug teaching universities.
In other words, they made their own choices. Not even impacted by some system that went away 40 years ago.
Comment by winter “Against stupidity, the gods themselves are helpless.†— Fri, Mar 30th, 2007 @ 1:23 pm
winter, you are a cunt.
Comment by DAVE THE MAVE — Fri, Mar 30th, 2007 @ 2:13 pm
Hey winter, during the summer when it’s around 100F, you need to invite him over to your house for some chilled watermelon. I know they like that
Comment by Kristian — Fri, Mar 30th, 2007 @ 2:23 pm
winter:
is just a left wing, I am so sorry, talking point. My neighbor who is black, would tell you he had done just fine, with out, your so called racist help.
Right-wingers in general and libtardians in particular, on the other hand, are masters in the art of induction from anecdotes to eternal truths.
You are right in that education is the key in lifting the underprivileged from their current position. The welfare of the students, instead of the teachers, should be the primary concern.
Kristian:
Perhaps Franklin experienced some of these slave-descendants in NY? Most are very amicable people, but some are very loud and hostile.
People in general were quite friendly and the friendliest ones we met in Harlem. Some people gave me the famous New York attitude, but nothing I couldn’t survive. We encountered quite a few loud people, but alas, zero hostility.
I’m certainly looking forward to my next visit in that town.
Comment by Freeridin' Franklin — Sat, Mar 31st, 2007 @ 2:19 am
“My mother knew the healthcare system from the 1950’s through the 1980’s…”
Heh, to be honest, I can’t blame your mom. At that time there were many of those wartime doctors and midwives around and they could be quite rough at times.
If you had pain somewhere, you got yelled at for coming to complain about all kinds of little pains. If it turned out to be serious, you got yelled at for not showing up earlier. And if YOU yelled, while giving birth to a child, the midwive could ask, whether you yelled also, when the child was put in there.
When I had my little operation few months ago, there was this young nurse asking how I was doing and whether I was nervous. She asked also if I have been in anesthesia before. ‘Once in the 70’s’, I replied. “In the 70’s!!!!?!?, no wonder you are a bit nervous.”
She sounded, like I had had my skull drilled once in the 14th. century.
Comment by Antti rn — Sat, Mar 31st, 2007 @ 2:10 pm
OMFG! I think I have to kill myself now! Winter actually made some sense there.
Quite a few people in the USA feel that the racial quotas and the proposed slavery reparations are completely useless and, indeed, harmful to the black community. According to them, these ‘entitlements’ actually enforce the feeling of inferiority and dependence.
http://www.cir-usa.org/articles/156.html
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/05/15/DDG5HIR5VC1.DTL
Comment by Fat Bastard — Sat, Mar 31st, 2007 @ 2:31 pm
“Quite a few people in the USA feel that the racial quotas and the proposed slavery reparations are completely useless and, indeed, harmful to the black community.” - Fat Bastard
Then again, there are quite a few people in the USA who believe that images of Jesus in pieces of French Toast and pictures of his mom on tunnel walls in Chicago are signs of the resurrection.
Comment by RAVE THE DAVE — Sat, Mar 31st, 2007 @ 2:34 pm
Kristian:
“I find it disturbing that poor people don’t get adequate care in Finland. Every modern country should be able to treat all its strata for these common diseases. Only a substandard underlying economic model can be to blame.”
This is simply too much, even from you. You seem to be able to use any piece of information, to support your misguided view of the world. Get a fuckin’ life.
I’m a diabetic, so I think I can comment on the diabetes issue, with at least some credibility. And diabetes was one (out of three) diseases you used for this sorry attack on finnish health-care.
Diabetics receive FREE (and that is free from the point view of the sufferer - just to keep winter, and similar thrash off my back) medication. In what sense is that “economic model” “substandard” from the point of view of the poor, Kristian? Diabetics also get FREE (same disclaimers as previously) syringes, sticks to their blood sugar measurement devices, …
Now, diabetes is - at least the type 1 I suffer from - an incurable chronic disease. The “adequate care” is a daily thing, that is the responsibility of the individual patient. You can’t have one MD for each sufferer telling them what to do, in everyday life. You - as a patient/parent - have to take responsibility. Given your FREE “medicine” it’s possible (or let’s say, that’s ALL you need) to live well, maybe seeing your doctor once a year (although 4 times a year is what is offered in Finland normally, plus of course a possibility to contact a specially schooled nurse almost instantly).
The way you decipher the information at hand (concerning diabetes) is laughable. It simply ISN’T so that financial means affect the quality of treatment when it comes to diabetes. The latest knowledge is available for the common patient, in terms of e.g. HUS in Helsinki (the private sector - forget it). Hell, the current ARKKIATRI Risto Pelkonen (a great doctor btw.) used to be my “personal” doctor - and this was simply thanks to the public health care you spit upon more or less constantly. And it had nothing to do with my “strata” or such. I was just one patient among others.
Did you have a few too many of those wonderful cheap german supermarket beers you keep importing, while analysing the info you got? You should be sober when you draw conclusions from statistical data. Things aren’t always the way YOU want them to be, even though they might give false IMPLICATIONS if treated carelessly.
So, wealth can be a factor in “treatment” of diseases. But it can be a SECONDARY factor, in terms of access to information etc.
Comment by Thomas — Sat, Mar 31st, 2007 @ 3:48 pm
“during the summer when it’s around 100F, you need to invite him over to your house for some chilled watermelon. ”
Huh, in Southern Maryland it is Blue Crabs and Oysters in the summer. By the way he has the big gun collection, the National Guard would like to have. Bambi is dinner.
Summer fun: Take a medium size watermelon, cut a opening, the size of a small cup. Pore in a full bottle of Rum, or (If you can get it) moonshine. Let it sit for several hours, and keep on rotating the watermellon to get the Rum distributed.
Then cut the watermellon up, and party with the dunkin Sailors.
Comment by winter “Against stupidity, the gods themselves are helpless.†— Sat, Mar 31st, 2007 @ 5:26 pm
@Thomas
If you lived in USA this might happen to you
http://www.helpconnie.blogspot.com/
USA with their all poerful healthcare according to winter is just going to let her to be ended up in the ER
Comment by Anonymous — Sat, Mar 31st, 2007 @ 5:33 pm
#58:
“If you lived in USA this might happen to you”
I’m not sure this couldn’t happen in Finland as well. The point is - that Finland fully supports diabetics that respond to ordinary treatment. This seems to be some VERY special case, that I do not know of (and believe me, I have some experience, being a diabetic, having 2 sons who are, and having a brother - and his son as well - who is diabetic).
But - nevertheless - in most cases dibetes is treatable, and Finland provides the best of cares, cheaply (from the pow of ALL patients, not only rich ones). Unlike what the “unreparable record” keeps on, and on, and on, … claiming
Comment by Thomas — Sat, Mar 31st, 2007 @ 6:27 pm
Kristian:
“As usual, I’m thinking”
As usual, you aren’t THINKING. That’s the main problem with your postings.
Comment by Thomas — Sat, Mar 31st, 2007 @ 7:40 pm
Kristian thinking? Its like I got my spelling right. He first has to switch off the BBC, then he will see the world is not ending by morning.
Comment by winter “Against stupidity, the gods themselves are helpless.†— Sun, Apr 1st, 2007 @ 2:16 am
47 million americans are lacking health insurance. Each year 20 000 people die because they could get treatment.
http://www.hs.fi/ulkomaat/artikkeli/Miljoonat+amerikkalaiset+ovat+vailla+sairausvakuutusta/1135226265271
Comment by somone — Sun, Apr 1st, 2007 @ 9:18 am
Correction: couldn´t
Comment by somone — Sun, Apr 1st, 2007 @ 10:12 am
Kristian wrote (in post 12):
“Most highly trained physicians (at least 4 years more than here in Europe)”
As usual, you’re wrong. The US pre-med training isn’t medical training. It’s an undergraduate degree from a college, consisting of basic subjects such as biology, chemistry, physics and mathematics. In other words, it’s the Finnish lukio.
The actual medical school in the US is only four years so it’s actually shorter than in Finland where it’s six years.
Comment by Ã…boy — Sun, Apr 1st, 2007 @ 11:16 am
“Each year 20 000 people die because they could get treatment.”
Please try again. Treatment is given if you walk or are taken into a Hospital. Just see for yourself, visit any emergency center.
Its really that simple.
Comment by winter “Against stupidity, the gods themselves are helpless.†— Sun, Apr 1st, 2007 @ 1:30 pm
#64 And as usual Ã…boy, your opinions are rooted in your own biases.
“The US pre-med training isn’t medical training. It’s an undergraduate degree from a college”
True.
“In other words, it’s the Finnish lukio.”
False.
“The actual medical school in the US is only four years so it’s actually shorter than in Finland where it’s six years.”
Whereas American medical school, per se, is only 4-years, it is followed by a residency requirement of 2- to 6-years and a licensing examination administered by the state. Hence, between 6- and 10-years total beyond the Bachelors degree—10- to 14-years overall.
The Finnish program—as with most in Europe—does everything within 6-years, including the equivalent of US residency. It is condensed to fit within limitations of the low-Wealth economic model.
Comment by Kristian — Sun, Apr 1st, 2007 @ 1:32 pm
Kristian:
The Finnish programâ€â€as with most in Europeâ€â€does everything within 6-years, including the equivalent of US residency.
Clueless as usual. Let’s just say that the Lic.Med. degree isn’t “everything”. It’s a licence to practice medicine on the most basic level. It’s a vocational degree for medical professionals. Everything beyond that takes years of more training.
Comment by Freeridin' Franklin — Sun, Apr 1st, 2007 @ 3:15 pm
@67 “Let’s just say that the Lic.Med. degree isn’t “everythingâ€Â. It’s a licence to practice medicine on the most basic level.“
Yes, obviously. Did I indicate otherwise?
6-years in Finland/Europe
10-years in USA
For basic level practice.
Comment by Kristian — Sun, Apr 1st, 2007 @ 3:17 pm
Kristian:
“6-years in Finland/Europe
10-years in USA”
What are you driving at? Is there some kind of OPTIMAL time you need to study/practise in order to become a good enough doctor? Why not extend it to 40 years, so that fully trained doctors could retire at end of practise.
Your implications concerning the “low-Wealth economic model” are simply astonishing. Ever heard of life-long education? That SURELY HAS to be on the agenda of ANY FUCKIN’ doctor on this fuckin’ planet. Or do you think doctors treating AIDS in the US in the 80s said, well, when I was in medical school, these symptoms were not invented, therefore they don’t exist. Given the way you look upon reality, I’m sure that’s the way you would choose/recommend.
It doesn’t matter whether your education is 6 or 10 years. What matters is, is it adequate. Adequate to provide the tools for the life-long educational experience. I don’t see why 6 years is not enough. Where’s your evidence to the contrary.
Comment by Thomas — Sun, Apr 1st, 2007 @ 4:07 pm
From Wikipedia:
“Peruskoulutuksen jälkeen lääkari anoo Terveydenhuollon oikeusturvakeskukselta (TEO) laillistamista eli oikeutta harjoittaa ammattia laillistettuna lääkärinä toisen johdon ja valvonnan alaisena. Jotta lääkäri voisi harjoittaa ammattiaan itsenäisesti, hänen tulee EU-säännösten mukaan suorittaa peruskoulutuksen lisäksi kolmivuotinen perusterveydenhuollon lisäkoulutus (ns. eurovaihe). Lisäkoulutukseen kuuluu käytännön lääkärinä työskentelyä sairaalassa ja terveyskeskuksessa sekä pieni määrä terveydenhuollon hallinnon koulutusta.”
( http://fi.wikipedia.org/wiki/L%C3%A4%C3%A4k%C3%A4ri )
So it turns out that Finnish doctors need three additional years and supervised practice before they can be independent professionals. That’s a total of nine years of education when added to the basic medical training. And that’s just for a “yleislääkäri” (general practitioner).
Comment by Ã…boy — Sun, Apr 1st, 2007 @ 4:55 pm
ie. specializing requires at least 5-6 additional years of studying.
Comment by Ã…boy — Sun, Apr 1st, 2007 @ 4:57 pm
Finnish doctors can and DO practise in the field when they have been in Medical school for 3 years only, In healthcenters and päivystys.
This would be impossible in the states. The same goes for nurses as well. Does this affect the quality of care? Me thinks so.
Comment by Unit — Sun, Apr 1st, 2007 @ 7:02 pm
Thomas @ 69
I would feel much better knowing that I have a fully qualified doctor looking after me than a 22 year old kid 3 years out of lukio.
And Ã…boy, lukio is not the same as 4 years bachelors at University. Quit drinking the Cool Aide.
Comment by Unit — Sun, Apr 1st, 2007 @ 7:05 pm
#73
Neither is it the equilevant to the US high school
Comment by Anonymous — Sun, Apr 1st, 2007 @ 7:18 pm
#74
That was never contested. Lukio is more advanced than High School. I havn’t heard arguments to the contrary.
Comment by Unit — Sun, Apr 1st, 2007 @ 7:57 pm
Unit:
“I would feel much better knowing that I have a fully qualified doctor looking after me than a 22 year old kid 3 years out of lukio.”
So now you - unlike the surprisingly quiet Kristian
- might tell us the OPTIMAL time it takes to school a doctor. If the only criteria is that they shouldn’t be 22 year olds (which isn’t really possible in Finland), then how do you suggest they ought to be qualified, so that you would feel better?
I find it somewhat strange, that MD’s require a certain AGE to be qualified? Shouldn’t ability be the formost criteria?
Comment by Thomas — Sun, Apr 1st, 2007 @ 9:58 pm
Unit: “Lukio is more advanced than High School.”
Perhaps that’s true for the average case. I’d say there’s about a year of overlap; last year of Finnish Lukio corresponds with first year of US University.
But I think medical students are above average in any country. Above average US students are already taking University courses during their 11th and 12th years of High School, so they are comparable with top Finnish Lukio students.
Unit: “I would feel much better knowing that I have a fully qualified doctor looking after me than a 22 year old kid 3 years out of lukio.”
That’s exactly how I felt on two recent occasions. In one case, it was a dentist though. The other was a very young ‘physician’ who rolled his eyes at my request for a blood pressure test, when I was experiencing shortness of breath. Youthful incompetence is scary when considering healthcare. In my opinion, maturity counts. The bachelors helps ensure it.
_
Also, whereas I’m convinced that the depth of learning in the vocational sense is the same in Finland vs. USA, the US bachelors degree adds an extra theoretical/breadth component that is very significant. Even in the worst case, it ensures that a doctor is capable of communicating with- and interpreting a patient at the highest level possible.
In the Finnish/European system, a patient can only hope that the doctor possesses those abilities innately—because he surely didn’t acquire them in his narrowly focused schooling.
In Finland and much of Europe, education is condensed to fit within limitations of the low-Wealth economic model.
Comment by Kristian — Sun, Apr 1st, 2007 @ 10:50 pm
So now that the comparative “shortness” of Finnish medical training has been refuted (basic training nine years) the argument turns into “Oh yeah? Well.. but.. but Finnish doctors don’t have any peoples skills”.
Come on.
Comment by Ã…boy — Sun, Apr 1st, 2007 @ 11:49 pm
Kristian:
“The other was a physician who rolled his eyes at taking my blood pressure when I was experiencing shortness of breath. ”
You didn’t happen to import one of those blood pressure measurement devices (which are surely less expensive in consumer haven Germany - if not free ;-)) while you imported german supermarket beer? Then you could tell the espooian physician your pressure, and avoid the rolling eyes.
But - since you are a supporter of the private economy/wealth - I’m sure you let the espoonian (or some other) tax payer, pay for your blood pressure measurents.
Comment by Thomas — Sun, Apr 1st, 2007 @ 11:57 pm
Ã…boy—working under supervision is not medical training in the theoretical sense. I’m surprised to hear from you that less education is somehow better in this case. After all, you’re the one who so adamantly charges “Polytechnic is not REAL University!”
Comment by Kristian — Mon, Apr 2nd, 2007 @ 12:05 am
“Whereas American medical school, per se, is only 4-years, it is followed by a residency requirement of 2- to 6-years”
Care to tell us how’s this is any different from studying and practicing under the supervision of a personal instructor while working?
“working under supervision is not medical training in the theoretical sense”
So practicing under expert tutelage what you’ve studied before in theory isn’t training? Wow. You’re not making a lot of sense. Oh and about that jab, you do realize that medical schools train the would-be-doctors both academically and vocationally? Even though medicine is an academic science the training in medical school leads to a vocation.
Comment by Ã…boy — Mon, Apr 2nd, 2007 @ 12:32 am
“you do realize that medical schools train the would-be-doctors both academically and vocationally?”
Exactly. It’s the same in the US. However, in the US there is that extra academic component—4-years worth—that doesn’t exist here in Finland/Europe.
“ So practicing under expert tutelage what you’ve studied before in theory isn’t training? Wow. You’re not making a lot of sense.”
And I don’t think you’re comprehending very well.
Comment by Kristian — Mon, Apr 2nd, 2007 @ 12:47 am
“in the US there is that extra academic componentâ€â€4-years worth”
I’m sorry, what extra component? What’s so superiorly academic about a residency when compared to the Finnish/European training period of three years?
Comment by Ã…boy — Mon, Apr 2nd, 2007 @ 8:27 am
Ã…boy,
You completely ignore my point on how UNGRADUATED doctors are working within the healthcare system. They are not under any supervision in this capacity either.
This doesn’t worry you at all? It pops up in Iltalehti from time to time. The last time was following a childs death. Oh well, Not your child so why give a rip.
Comment by unit — Mon, Apr 2nd, 2007 @ 8:57 am
I don’t know the details of the case you’re referring to but up till now a medical student has been allowed to work in some instances if they’ve studied three years. There has been some controversy and now they’re changing that to four years. I think that’s good. If American med students are working with actual patients after only four years then why couldn’t Finnish med students do the same?
Comment by Ã…boy — Mon, Apr 2nd, 2007 @ 9:24 am
It’s a different thing if the students are working in a learning capacity such as in their residency.
Doing keikka shifts as a sijainen in a päivystys or healthcentre is a different story. Working as an independant professional when you are not is scary, especially when dealing with important issues such as life and death.
Comment by unit — Mon, Apr 2nd, 2007 @ 9:42 am
I have to say that these comments in this blog are just miss leading. I hope no one aint taking these for a hard facts. Finland does have all around one of the best healt care systems, but USA does have the best care what you can get with money can buy(and pretty decent system for poor, but far away from the best). When I’m reading this I got image of countrie where poor aint got any threatment at all and if you even have some cash your are getting doctor who dont know what he/she is doing…..c’mon.
http://archives.cnn.com/2000/HEALTH/06/20/healthsystems.list/index.html Finns ranked as 31
US ranked as 37
http://www.cnn.com/SPECIALS/2006/mothers.moments/interactive/popup.mothers.charts/frameset.exclude.html
Getting that white jacket in Finland takes this: 6 years now you are able to give treatment but you cant yet work as a independent doctor that takes 3-4 years more. Most do go on after that(what is a big prob here atm because we would need more those basic doctor) to specialize for some field that takes 5 or 6 years depending in what field you have chosen.
Comment by doc — Mon, Apr 2nd, 2007 @ 12:03 pm
But Doc… Its not PC, if someone doesn’t complain that the baby death rate in USA is not higher than say Cuba. Well if you use those scewed numbers each country publishes to cover up a really bad system.
The real only number that counts is the “feet” number. Where do folks go, using their “feet” to get there, and get quality medical care.
Its not Finland.
Comment by winter “Against stupidity, the gods themselves are helpless.†— Mon, Apr 2nd, 2007 @ 1:04 pm
riiight…
a bunch of bullcrap is what this is.
healthcare in Finland is top class compared to any other land.
AND
Of course you get better treatment if you can afford a private doctor, it’s like that in every singel country in the world.
Comment by kalevi sorsa — Thu, Apr 12th, 2007 @ 4:48 pm