Observation (CEACR) - adoptée 1992, publiée 79ème session CIT (1992)

Article 17 of the Convention. In its previous comments, the Committee noted the comments transmitted by the Central Organisation of Finnish Trade Unions (SAK) to the effect that, because the communities did not have enough capacity to provide basic municipal health care, insured persons had been forced to resort to private health services; some 30 per cent of the costs incurred were refunded. The Committee consequently pointed out that, under Article 17 of the Convention, the rules concerning sharing by the beneficiary or his breadwinner in the cost of medical care should be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection.

In its reply, the Government states that medical care is the responsibility of the municipalities, particularly in the case of emergency treatment. It states that, if a patient also resorts for any reason to the care of a private physician, such care is reimbursed at 60 per cent of the rate approved by the Ministry of Social Affairs and Health, on the basis of the sickness insurance scheme. The same applies to examinations and treatment given at private hospitals or in special categories of municipal establishments.

The Committee has noted this information with interest. It would be grateful if the Government would indicate whether and, if so, for what reasons and under what conditions (for example owing to a possible inadequacy of the medical or hospital infrastructure at municipal level) insured persons may find it necessary in practice to resort to the services of private physicians or to undergo treatment in private hospital establishments. In this connection it asks the Government to supply statistics on the number of insured persons resorting to private medicine (whether for out-patient or in-patient care) in proportion to the total demand for care. Furthermore the Committee would also like the Government to indicate whether and how far the rates of reimbursement applied to consultations with private physicians and hospital care by the sickness insurance scheme correspond to the actual fees of physicians or hospitals.