The increased Kela compensations in citizens’ wallets are hardly visible because the health service companies have raised their prices. This is against the goals of the Orpo government.
According to Iltalehti’s report, the increases made to Kela reimbursements at the beginning of the year have not reduced the amount the customer has to pay much, because the health companies have raised their prices.
Petteri Orpon By raising the Kela compensations, the (kok) government has aimed for more people to apply for a private doctor’s office with a more affordable customer fee, and this would ease the situation of queues for treatment on the public side.
The government increased Kela compensation from eight euros to 30 euros at the turn of the year. The draft presentation that went through the opinion round in the spring would further increase Kela reimbursements: for example, the reimbursement for general practitioner visits would rise to 50 euros.
The government has outlined that it will spend 500 million euros on Kela compensation increases during the government period, of which the state’s share is 355 million euros.
If the companies had not raised their prices from a year ago, the amount customers would have to pay would have decreased by 22 euros due to the increase in the Kela compensation.
In reality, the impact on citizens’ wallets has been considerably smaller.
Pihlajalinna has raised its service fees. Mikko Törmänen
Service fees have increased
Based on Pihlajalinna’s price list, in the lowest prices for visits to a general practitioner and a specialist, the customer’s remaining share fell to only nine euros instead of 22 euros.
At Terveystalo, the amount left to be paid by the customer in the lowest prices for doctor’s visits fell by almost 19 euros, but only three euros in the highest prices.
Based on Mehiläinen’s price list, at the lowest prices the Kela compensation seems to be in full, i.e. 22 euros less to be paid. However, this is not the whole picture, as it only applies to the company’s lowest prices.
In addition, health companies have increased their service fees across the board. Kela compensations do not apply to service fees.
For example, Terveystalo’s service fee has risen from 29.7 euros to 34.9 euros. In the case of Terveystalo’s lowest prices, the increase in the prices of the most affordable reception visits and service fees eats up the reduction brought by the 30-euro Kela compensation to around 13 euros.
Kela’s statistics reveal
The price lists of the three largest health service companies Terveystalo, Mehiläinen and Pihlajalinna are difficult for consumers to understand.
For example, from the beginning of 2024, Mehiläinen began to announce only the starting prices for visits on its website, whereas before the website could find the minimum and maximum price for a doctor’s appointment of a certain length.
The exceptionally low price of an individual doctor can make the price list look cheaper than it really is. Therefore, it is not possible to conclude from the changes made to the price lists alone how much the services paid by users have actually increased.
However, statistics from Kela and the EU show that the rise in prices has been even stronger than it appears from Iltalehti’s Price Comparison of health companies.
According to Kela, the average price of a private non-specialized doctor’s visit in 2023 in the whole country was 84 euros, while in 2024 the average was 97 euros according to EU statistics.
The increase has therefore accumulated over 15 percent in a year.
The national average of the median prices for a general medicine specialist’s appointment in 2023 was 93 euros, and 105 euros this year. That means an increase of almost 13 percent.
There are small differences between the years in the statistics, and the figures for 2024 apply to January–June. However, according to Kela, the magnitude of the price increase is correct.
“Significant pricing power”
In the board’s draft presentation regarding the increase in Kela compensation, it is stated that the private sector has significant pricing power due to, among other things, the concentration of the market.
In the draft, one of the risks is that service providers raise the fees they charge for services as demand increases.
– In this case, the compensation increases would benefit the service providers, not the users of private services. The beneficiaries could be both self-employed doctors and medical centers, the draft presentation states.
Kela is also interested in the effects of raising Kela compensations. It has begun to investigate the effects of the change on the prices of private service providers.
Mehiläinen increased the Kanta payment by 80 cents. Tiina Somerpuro
The evaluation has not yet been completed, but the head of Kela’s research unit, the research professor Hennamari Mikkolan according to the results, it can already be said that prices have risen faster than the consumer price index. The consumer price index is considered a general measure of inflation, i.e. it tracks the price development of goods and services.
Increases in Kela compensation have had only minor effects on people’s behavior.
According to Kela, the number of private doctor visits increased by only about two percent between January and June, while the state’s Kela compensation expenses tripled to 47 million euros.
Kela estimates that the increase in Kela reimbursements for general practitioner visits to 50 euros will not cause a large number of people to switch from the public sector to clients of private doctors.
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The health giants disagree
Iltalehti asked three companies producing private medical services, Mehiläi, Terveystalo and Pihlajalinna, for interviews about the effect of the increase in Kela compensations on the companies’ prices and results. The companies deny that the Kela compensations affected the prices.
Pihlajalinna:
An interview about Pihlajalinna was not given due to scheduling reasons. The company’s director of communications and responsibility Tuula Lehto communicates that the lifting of the Kela compensation has had no effect on the pricing of the services.
– The increase in Kela compensations has had no effect on the pricing of our services. The increase in compensation has been moderately reflected in the demand for our services. However, only about 15 percent of Pihlajalinna’s customers are private customers, Lehto writes.
He writes that, on average, the level of price increases follows the general level of inflation. In recent years, the costs have been increased by salary inflation, “system investments due to tightening of regulation” and the increase in costs of materials and premises.
Health House:
Terveystalo also did not give an interview citing scheduling reasons. Director of the company’s healthcare services Sari Heinonen says by email that the increase in Kela compensations has not affected the company’s pricing.
– Our prices are affected by usual factors, such as investments, general cost level and labor costs. A large part of the turnover of healthcare services comes from business and insurance customers, and thus the change in compensation for private customers has not had a significant impact on the company’s results or prospects, Heinonen writes.
According to Heinonen, the increase in compensation supports consumers’ purchasing power and improves the chances of quickly seeking treatment. He hopes for predictability and sustainability in decisions related to Kela compensation.
Bee:
Mehiläinen’s business manager Johanna Asklöf says in an interview with Iltalehti that the increase in Kela compensation has had no effect on the company’s pricing.
– Kela compensations are not the basis of pricing. Various changes in cost levels and ensuring service production possibilities are the ones that affect our pricing decisions, Asklöf lists.
Asklöf also points out that the changes made to the level of Kela compensation have not been reflected in the customers’ behavior.
– Mehiläinen is a large producer of social and health services, and we have not seen a big change in relation to the latest changes in Kela compensations. It is possible that some individuals have found it easier to use private health care.
“A more stable operating environment”
The increase in Kela compensations has been taken into account in the annual reports and bulletins of large companies that provide medical services.
In its 2024 half-year report, Terveystalo stated that the measures of the government program “support the growth of demand for private service production and bring new opportunities for the implementation of publicly funded and privately produced services”.
In addition, the company considered it a risk that the compensation system would be changed.
– Changes in the reimbursement system for healthcare services may adversely affect Terveystalo’s business, financial position and operating result, Terveystalo’s semi-annual report states.
In Terveystalo’s half-year report, it is considered a risk that the Kela reimbursement system would be changed. Tiina Somerpuro
The board program was also considered a positive thing in Pihlajalinna, where the company’s operating environment was estimated to be “more stable” thanks to the new board program.
– The government program of the new Finnish government is positive from Pihlajalinna’s point of view. The government program takes a strong stance on the treatment queues that have reached a critical level – almost 170,000 customers are waiting for access to non-urgent specialized medical care, the 2023 half-yearly report states.
The government is currently preparing changes to its Kela compensation model based on the critical feedback it has received. With the changes, the government aims to make its actions more effective.
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