Overview

From 2023, Finland’s restructured health system will deliver health and social services via 22 Well-being Service Counties, which are governed by democratically elected councils and financed from the state budget. Municipalities retain responsibility for public health functions. In 2020, Finland’s health expenditure per capita was above the EU average and represented 9.6% of GDP. Out-of-pocket spending is just over 16% of total health expenditure and is largely due to household payments for pharmaceuticals, long-term care, dental care and outpatient care.

After two decades in the making, the major structural reform has centralized responsibility for the organisation of health and social services from municipal to regional level, and health system financing has moved to the national level. A primary and longstanding aim of the reform is to reduce socioeconomic and geographic inequalities; ensure the quality of health, social and rescue services; improve access to care, particularly primary care; and to control costs. As implementation only began in 2023, some adjustments to the system are expected to be made in future. Other changes that have taken place over the past decade have largely been incremental and mainly focused on modifying existing features of the health system. In particular, a series of measures were taken to reduce the share of public spending on health: some of these translated into reduced levels of reimbursement for medicines, and increased user fees.