On September 18, 2024 at the American Chamber of Commerce’s Health Forum, Niilo Färkkilä, the chairperson of the Pharma Industry Finland board and General Manager Amgen Baltic and Finland, participated in a panel discussion. We asked him what Estonia could learn from the Finnish healthcare system and the significant changes implemented in recent years.
According to him, both Finland and Estonia face similar problems, ranging from an aging population and an increase in chronic diseases to socio-economic inequality, which clearly affects people’s health.
In Estonia, the state budget and the Health Insurance Fund’s budget are not in great shape, and various larger and smaller solutions are being actively sought to address the issues. When we look at Finland, what are the main challenges the Finnish healthcare sector is dealing with?
I think these challenges are very similar to those in Estonia. In fact, all of Europe is facing the same issues, the main concern being that the population is aging, which in turn increases the demand for healthcare services. The number of cancer cases is also rising, and cardiovascular diseases continue to plague people — these are the leading causes of death in both Estonia and Finland. Additionally, the healthcare system’s funding is not enough to cover the growing demand.
Another important issue in Finland is the increase in socio-economic inequality — I also mentioned this during the forum discussion, that people don’t choose whether to invest in their health or not; someone has to do it anyway. If we don’t invest in public health, health inequality will increase, and unfortunately, this is a problem in Finland as well. Furthermore, in both Estonia and Finland, innovative medicines do not reach people quickly enough. This varies greatly across European countries, and Estonia is certainly one of those that does not get medicines fast enough — you’re 28th on the list in terms of getting new medicines to patients, while Finland is 18th. This is an issue that we should pay more attention to.
Have there been any major reforms in Finnish healthcare in recent years that have delivered real results?
I think the answer to the first part of this question is simple: yes, a major healthcare reform has taken place. We used to have over 300 municipalities that managed healthcare themselves — primary care was managed by municipalities, and secondary care was handled by groups of municipalities. This system was abolished and replaced by a new model, where there are 21 government-funded healthcare regions. This project certainly has good goals — for example, the fact that the organizer of primary care and hospital care is the same allows for a better understanding of which areas need more investment, whether the focus should be on prevention, primary care, or hospital treatment. However, it has also brought many challenges in building organizations. Additionally, funding has been insufficient, so challenges remain.
How would you compare the overall well-being and health levels in Estonia and Finland?
I think there are many similarities. The health problems are essentially the same — cardiovascular diseases and cancer are unfortunately the leading causes that claim people’s lives. The outcomes in Estonia are even worse than in Finland. I believe the reason for this is that new medicines and other innovative solutions do not reach the healthcare system quickly enough. On the positive side, Estonia’s highly inspiring startup culture in healthcare and life sciences gives hope for a better future.
Does Finnish healthcare focus more on prevention or treatment?
From the perspective of the pharmaceutical sector, vaccines are the number one preventive method, so Finland has a lot of room for improvement. But as mentioned, chronic diseases account for 75% of healthcare costs. Cardiovascular diseases are the leading cause of death, and this is an area where we have a lot of work to do — how to prevent a person who had their first heart attack from having a second one.
Finland is known as the world’s happiest country — is there data that proves a strong connection between happiness and health?
That’s a good question. I know that according to WHO, countries that invest more in healthcare are generally wealthier. The link between health and happiness has not been fully proven yet, but I really think that in both Estonia and Finland, we should see health more as a strategic factor for economic growth. It’s a core issue of how health impacts happiness.
What do the healthcare systems in Finland (and also Estonia) need most right now?
I think the ability to adapt to new solutions, but also to be more willing to experiment and implement new solutions. I believe this is more a part of Estonian culture, but in the healthcare sector, we often think that we need to build something that works for all citizens at once — this slows things down too much.
Looking at the Finnish healthcare system, what are the latest solutions, and could they benefit Estonia?
It’s definitely worth focusing on overall digitalization and keeping up with innovations in this area. As I’ve mentioned repeatedly, the monitoring and treatment of chronic diseases are the areas where we face significant challenges, but also where we have many opportunities to use digital development tools. The key questions are how to keep patients in treatment and how to support them, how to understand who needs hospital care, and who needs more effective treatment.
In Finland, doctor-patient communication robots are widely used, where one doctor can help six patients simultaneously with simple questions, like prescription renewals. It seems to me that both in Estonia and Finland, one major problem is that doctors don’t want to move to rural areas, which means there can be accessibility issues. So, conversational robots and other similar digital solutions could be a possible solution to this problem.