International social security more topical than ever


Many Finns move to another EU country for work, studies or retirement and use the health care services of the new country of residence. Tourists may also need health care services suddenly. An increasing number of foreigners also become clients of the Finnish health care services. Therefore, cross-border healthcare is already very common.

The EU’s Patients’ Rights Directive that entered into force in 2011 obligates to treat clients coming from another member state to Finland for treatment in the same manner as the residents of the municipality in question. Language skills are still the most important factor in seeking treatment outside the country of residence.

– It is difficult to form a successful treatment relationship, if the doctor and patient do not share a common language. Differences in patient record entry practices and foreign-language patient records in general and concern over steep treatment costs may also prevent seeking treatment outside the country of residence, says Ministerial Adviser Noora Heinonen of the Ministry of Finance, who worked as Head of Unit at the Contact Point for Cross-Border Healthcare in 2013–2016.

Often, it is complicated how costs incurred by using health care services abroad are reimbursed. For example, treatment costs of Finns seeking dental care in Estonia are reimbursed, but those seeking dental care in Russia do not receive any reimbursement.

– In the future, we must reconsider whether geography forms appropriate and equal grounds for receiving reimbursement. We also have to remember that EU legislation obligates only the reimbursement of health care costs incurred in the EU and EEA countries and Switzerland. Finnish legislators should decide whether costs incurred in other countries are to be reimbursed at all.

International social security concerns supranational regulation and the consolidation of legislation of different countries. It is made up of norms that safeguard the entitlement to treatment of an EU citizen travelling from state to state. They also determine the payment responsibility of the countries over the treatment costs incurred.

How is international regulation reflected on the social security of Finland and our legislation? Can our health care system, where services are now arranged according to the place of residence, be aligned with the European system, which is based on insurance?

These and many other topical questions are answered in Kela’s new theme book in Finnish “Sosiaaliturvan rajoilla – Kirjoituksia kansainväliseen sosiaalioikeuteen”.

Source: Kalliomaa-Puha L, Tuovinen A-K (eds). Sosiaaliturvan rajoilla. Kirjoituksia kansainvälisestä sosiaalioikeudesta. Helsinki: Kela, Teemakirja 16, 2017.

You may travel abroad from Finland to seek health care services, but you are only entitled to reimbursements for costs incurred in the EU and EEA countries and Switzerland. You are entitled to access treatment in another EU country in the same way as the residents of the country. You will receive medically necessary treatment in another EU or EEA country or in Switzerland if you fall ill suddenly or require treatment for a worsening chronic condition, or on account of pregnancy or childbirth.