HELSINKI， April 8 (Xinhua) -- The Finnish center-right government plans to throw the country's public health care system into cold water by allowing almost open competition with commercial health providers.


　　In the latest phase of years of planning， the government this week announced plans to convert public health care units into publicly-owned companies. Such a change would make it possible to compare cost and efficiency of publicly-owned and private operators.


　　From 2019， regional health authorities would license the public， private and third sector operators including civic organizations to offer primary care services. Patients could then choose the service provider they choose -- but would have to stay with their choice for some time at least.


　　Based on the patient's decision， public money for his or her care would go either to a publicly-owned company or to a commercial operator.


　　Critics of the reform fear the companies would not have the competitive edge required to survive against commercial operators. In recent years， international capital has been pouring into Finnish private health care， and some private companies have already welcomed the change that would open public funds for them.


　　Critics also say the commercial operators probably would not go to sparely populated areas anyway， but would simply leave them for the public companies and instead harvest the lucrative city health care markets， creating disparity.


　　In the cabinet， the Conservatives， one of the three ruling parties in the government， have been aggressively promoting the idea that the patients have the "right to choose." But some believe the underlying political agenda is to give private health care companies wider business opportunities in Finland.


　　The Conservatives got the concept accepted in a cabinet compromise last November. In return， they had to accept the Centre Party's idea of regionalization.


　　A third ruling party， the Finns Party， had the most difficulty accepting the would-be system. Health minister Hanna Mantyla， of the Finns Party， said at a press conference on Wednesday， however， that a system of "multiple producers" would be acceptable if it was "under proper control."


　　In initial reactions to the announcement， the Confederation of Industries， profiled as the leading lobbyist for Finnish business interests， praised the governmental plans. However， former Social Democratic Party health minister Susanna Huovinen said her party would never have accepted this kind of system. She warned about the impact of operators whose primary goal is just to make profit.


　　The current Finnish public health care system is run by municipalities. The public primary care has been plagued by long waiting times of up to three months to get an appointment. The situation has led to a situation where a large part of the nation is using employment-based health services or private doctors offices with partial reimbursement of the cost from the National Social Insurance System.


　　Hospitals， meanwhile， are nearly all publicly run and function fairly well. Even private practitioners send their patients to public hospitals.


　　The cost to the patient is not expected to change， but the government believes it could save in health costs. Most Finnish municipalities currently charge nominal fees under 20 euros (23 U.S. dollars) to see a doctor， but in Helsinki， for example， the public service is free.


　　In the new system， "public money would follow the patient" and he or she would pay the same fees irrespective of whether the doctor is employed by a commercial or public company， as long as they are approved by the authorities to get public health money.


　　The change could meet trade union resistance as well. The process of converting administrative production units into companies has so far been applied mainly to municipal catering or bus services. Even small scale changes have often caused strikes and difficult bargaining.


　　In an attempt to appease public sector medical professionals concerned about their future， Conservative interior minister Petteri Orpo underlined that the new companies in the public sector would "indeed be publicly owned" and he dismissed the argument that it meant outsourcing or privatization.


　　Financing of the new health care system would come from the state level， not through municipal taxation any longer， basic services minister Juha Rehula explained. There had been speculation earlier that the new health regions would be authorized to collect a special health tax.


　　The cost of health care would be embedded into the income tax and should not increase anyone's tax rate， Rehula said.


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