Public health and inequality after adeep economic crisis:the case of FinlandJaakko Kiander, PhDAdjunct professor, Universi...
Financial crisis and deep recession inFinland in 1990-94• First: period of boom and exuberance 1987-89• Then: bursting of ...
Output losses7080901001101201301401501985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 20003
Unemployment rate0246810121416181985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 20004
Economic policy and public finance• Economic policy focused on maintaining stableexchange rate• Rise of unemployment was a...
Fiscal policy and public spendingon health• Major cuts in the number of public sectoremployees (incl. health care)• Cuts i...
Result: Finland lagging behind• As a results, public health expendituredecreased in Finland in the 1990s while itincreased...
Total health expenditure as percent ofGDP in 20000246810121416Finland UK USA Sweden Denmark France GermanyPrivatePublic8
Out-of-pocket payments as percent oftotal health expenditure in 20000510152025Finland Sweden USA Germany UK Denmark France9
Long term consequences ofunemployment and fiscal squeeze• Financial crisis had long-lasting impact onpublic services, incl...
Collapse of the ideal of universalservices?• Socio-economic differences in health and lifeexpectancy now more pronounced• ...
Conclusion• Macroeconomic development and financialstability seem to be important factors ofnational health and well-being...
Upcoming SlideShare
Loading in …5
×

Jaakko Kiander, Senior Vice-President, Ilmarinen Mutual Pension Insurance Company, Finland

776 views

Published on

Published in: Economy & Finance, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
776
On SlideShare
0
From Embeds
0
Number of Embeds
5
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Jaakko Kiander, Senior Vice-President, Ilmarinen Mutual Pension Insurance Company, Finland

  1. 1. Public health and inequality after adeep economic crisis:the case of FinlandJaakko Kiander, PhDAdjunct professor, University of HelsinkiSenior Vice President, Ilmarinen Mutual Pension Insurance Company1
  2. 2. Financial crisis and deep recession inFinland in 1990-94• First: period of boom and exuberance 1987-89• Then: bursting of bubbles, banking crisis,currency crisis, deep recession 1990-94– Bank failures– Mass unemployment– Budget deficits and increasing public debt– Austerity: deep cuts in public expenditures2
  3. 3. Output losses7080901001101201301401501985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 20003
  4. 4. Unemployment rate0246810121416181985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 20004
  5. 5. Economic policy and public finance• Economic policy focused on maintaining stableexchange rate• Rise of unemployment was accepted as aprice of monetary stability• Public bank support and rising unemploymentincreased public expenditures• Fiscal austerity as response: cuts in publicservices and income support programmes5
  6. 6. Fiscal policy and public spendingon health• Major cuts in the number of public sectoremployees (incl. health care)• Cuts in provision of health care services• Cuts in health insurance coverage of medicalexpenses• Gradual recovery in service provision after20006
  7. 7. Result: Finland lagging behind• As a results, public health expendituredecreased in Finland in the 1990s while itincreased in other countries• Out-of-pocket expenses increased toexceptionally high level• BUT: on average, national health and lifeexpectancy improved7
  8. 8. Total health expenditure as percent ofGDP in 20000246810121416Finland UK USA Sweden Denmark France GermanyPrivatePublic8
  9. 9. Out-of-pocket payments as percent oftotal health expenditure in 20000510152025Finland Sweden USA Germany UK Denmark France9
  10. 10. Long term consequences ofunemployment and fiscal squeeze• Financial crisis had long-lasting impact onpublic services, including health care• Public expenditure has not fullyrecovered, private funding became moreimportant• On average, overall health situation hasimproved…• …but as a result of fiscal squeeze, the servicesof the poor and old have deteriorated10
  11. 11. Collapse of the ideal of universalservices?• Socio-economic differences in health and lifeexpectancy now more pronounced• Better-educated, better off males live muchlonger than poor and uneducated• Growing differences in access to services• High medical cost (prescription drugs!)problem for low income pensioners11
  12. 12. Conclusion• Macroeconomic development and financialstability seem to be important factors ofnational health and well-being!12

×