Recipes for Systemic Change - Helsinki Design Lab

D6 - Evolution of the Welfare SystemHappening in FinlandHappening in Scandanavia1937 National Pension ActIn the 1940’s the notion ofpublic welfare, and with itpublic health, emerges.1943 New health legislation mandatesmunicipal and provincial healthofficers1943 General Hospitals Act1944 A law is passed mandating thateach municipality have a freematernity and child health clinic,a major development1945 Only 4.1 doctors per 10,000people1956 By now, there are 1,500maternity/child health clinics inFinland1948 Tuberculosis Act passed - withearlier vaccination programmesand improved living conditions,curbs the epidemicSweden reforms nationalpension systemHospital development beginsin the 1950's. It will occupythe bulk of healthcarespending through the 1960's.From 1950-69, the number ofhospitals triples.An imbalance betweenhospital care and outpatientcare emerges because of thisspending priority, as well ascost allocation and a shortageof doctors.Control of hospitals istransferred from the state tomunicipalities.The primary concern of the1960’s was the developmentof extensive healthcareservices.Towards the end of the 60’s,even with the developmentof hospitals, there waslittle improvement in publichealth beyond dealing withtuberculosis and infantmortality.By the end of the 60’s,Finland still had the thirdlowest density of medicaldoctors in Europe (afterTurkey and Albania), and thelife expectancy of the Finnishmale is the lowest in Europe.1948 Reform of the National PensionAct1948 Introduction of family allowance1949 Introduction of maternity grants1950 General Hospital ConstructionAct1956 National pension reformed to bemeans-tested and flat-rate, payas-you-gois introduced1956 Social Assistance Act1956 Hospitals Act1956-1957Pension expenditure increases2.5x1960 Three new medical faculties areestablished (initiated in 1960,completed in 1972)1961 Earnings-related Pension Acts1961 Finland joins EFTA1963 Sickness Insurance Act createsa national sickness insurancesystem specifically to addressoutpatient care1969 Finland joins OECD1950’s: Sweden introducesconcepts of Income Security,balancing gender roles1956: Danish governmentreforms take a big first steptowards ‘full old-age pension’Denmark introduces full universalprotection under thenational sickness insurancescheme304