Service choices in healthcare in Finland
Service choices in healthcare refer to publicly-funded healthcare services. The service choices are applied in public healthcare, in private healthcare entitling to reimbursement under the health insurance scheme and in situations where a patient seeks treatment in another EU or EEA country or in Switzerland.
As a general rule, service choices in healthcare comprise medically and dentally justified
- disease prevention
- examinations to detect an illness
- treatment
- rehabilitation.
The aim is to use only examination, treatment and rehabilitation methods that are effective, reasonable in terms of cost and safe in the Finnish healthcare system. For this reason, the service choices exclude procedures that
- involve an unreasonably high risk for the patient’s life or health
or
- whose effect is limited or whose costs are unreasonably high in view of the health benefits to be gained and the therapeutic value.
Why are the service choices defined?
The background to legislation on the service choices lies in the EU Directive on patients’ rights in cross-border healthcare, whose provisions came into effect in Finland at the beginning of 2014. Under the Directive, a person from Finland seeking treatment abroad is entitled to reimbursement only for examinations or treatment included in the service choices in healthcare in Finland. The service choices need to be defined in order to know what treatment can be reimbursed.
If the treatment provided abroad is not part of the service choices in Finland, reimbursement cannot be received for it abroad. An exception to this are rare diseases, for which prior authorisation can be granted in some cases. Correspondingly, the country of residence of a person coming to Finland for treatment does not reimburse the costs of treatment that is available in Finland but not part of the service choices in the country of residence.
Range of services determined by the Council for Choices in Health Care
The service choices in healthcare are defined by the Council for Choices in Health Care (COHERE Finland), established under the Ministry of Social Affairs and Health. Its tasks are to
- issue recommendations regarding what health and medical care procedures, examinations and treatment and rehabilitation methods should be included in or excluded from the service choices
- monitor and evaluate the service choices in healthcare
- issue opinions at the request of Kela and other authorities on the application of the service choices and on the principles to be used in defining them
- participate in public debate and cooperation with regard to the service choices
- monitor international development and participate in international cooperation
- deal with other matters designated to it by the Ministry of Social Affairs and Health.
The criteria for including or excluding services can be viewed on the website of the Council for Choices in Health Care.