From my experience, free Healthcare has extremely long wait lines, and bad quality of service, unless it is an urgent matter. I would guess if the mental illness is not severe, not an urget matter, it will not be treated well.
When you also have private care available, as you do in almost every country with universal healthcare, the proportion who opts to go private is a good reflection of whether people consider the public care sufficient. I don't know about Finland, but e.g. in the UK only about 10% opts for private insurance - most of it as incidental employment perks in higher paying jobs rather than an explicit choice -, despite private insurance here being far cheaper than the US (in part because the NHS offsets some of their costs by renting out excess capacity, and insurers mostly offer "top up" services - e.g. faster access to specialists etc).
The low level of private healthcare spend in countries with universal healthcare - especially in those, like the UK, where taxpayers pay less in tax per capita for public healthcare than in the US (NHS costs less per capita across the whole population, not just users, than Medicare and Medicaid) - to me is a fairly strong indication that most people don't consider them to provide bad quality of service or too long waits.
The private sector in Finland is, compartively, huge. Like, imagine a normal shopping centre and two of the bigger units are private, nationwide doctors surgeries. This is pretty much any larger shopping centre in a reasonably sized town here. The reason is that employers are mandated to provide some kind of health insurance to employees. It is this health insurance that is then responsible for giving you a sick note or ensuring that workplace injuries are taken care of - not the public service. The legal minimum is pretty low, so you can't go to them like a GP in the UK and be guaranteed that they'll do anything if it's not covered by the contract with your employer. Now, employers are free to top this up, so 'yeah the pay's comparable but the healthcare is much better' is a common point of disussion in social groups. In my personal case, which is not that special, it's great! I can book an appointment for basically _now_ (Sunday afternoon) online and go get whatever I want looked at. If I was dependent on the public system, lol no - just like home pretty much.
Anyway, I guess what I'm saying is that it's very much a two tier system, and I think it was long ago realised that a way for working people to 'skip the queue' was becoming needed, as if these people became ill and stopped working then they wouldn't be paying for the public system (through taxes).
Even many Finns don't understand that this is not correct. Employers are not mandated to provide any kind of general health care. They must take precautions to protect you from work-related health risks. So for IT workers a physiotherapist checking that your are sitting in a good position would probably be enough. In a mine or steel work it would be a bit more. When you get sick and go to your company health care doctor, that is a voluntary part of your employment contract, in no way mandated by law. One explanation given in the public uses to be: Employers don't want to wait for employees to queue in public health care forever, they want then to return to work soon. Even that explanation does not sound very convincing to me. After all the average flu is over in a week if see a doctor and in seven days if you don't. As an employer I would not voluntarily pay significant money for it if I hadn't to for one reason or another.
See also my comment https://news.ycombinator.com/item?id=37199110 , it's a really weird, historically grown cost-sharing model that cannot be explained by legal obligations.
I’m not complaining and I’m certain that I wouldn’t see the full cost in my take home pay should the employer remove it, there must be some kind of tax benefits to them, negotiations, etc.
Meanwhile, for millions who would otherwise stretch to afford the latter or skip it altogether, it works extremely well, as it does anytime you just want a bed for the night (the 95% of basic medical treatments), and not jakuzi and 3 restaurant choices.
Edit: As a commenter pointed out it's 50% that use private health care, too. Very few people would exclusively use private health care.
Doesn't mean the free one can't still be "extremely good". I might pay for IntelliJ, even though a free IDE or even editor like Emacs is still extremely good.
And 40% of the population is still a huge number of people, who would otherwise had trouble affording private health care or get the shitty low tier and/or hella expensive private care afforded by the poorer in the US.
It's also not exactly like "50% of the population use private health care". It's more like "50% of the population ALSO use private health care", in addition to the provided free health care.
Well, in the end the employer has reduced your salary by that amount, employers are not known for welfare. Every employee is already entitled for full public health care. Something must be wrong with it if 90% of the employers offer double insurance in away. It's a public secret or gentlemen's agreement that employed people are not supposed to use the public health sector they are entitled to before they need specialist or hospital treatment. The gentlemen's agreement would stop working if basic public healthcare were reasonably good.
Maybe because expectations rise with the availability of other options? Why would one pay for a Porsche when they could drive a Prius?
I live in Germany. Our healthcare system struggles a lot (mostly by design, thanks to incompetent/hostile politicians). I'd still bet the average citizen in Germany has better availability for treatments than the average American.
Most of the basic health care is Germany is not publicly organized, but private. The health insurance system is heavily publicly regulated.
I live in Finland and all of my relatives in Germany, so I see the differences very often.
This is a pseudo-distinction imho. Yes, the doctor's offices and clinics are private institutions and not organized under a single umbrella like in the UK the NHS would represent. However, the vast majority take appointments from publicly insured patients and are in compliance with the guidelines setup by the public health insurances. Also, in most cases publicly insured patients make up the majority of appointments.
Moreover, there isn't really a competition between public health insurance providers. The price difference between providers is negligible and so are the services covered (most providers cover the minimum as outlined by the law plus a few extra things you usually don't ever need).
TL;DR: the German healthcare system is public
In Germany the risk of unnecessary treatment is higher, doctors earn money that way.
In Finland being denied treatment is higher, especially for people not good at negotiating. On the appointment line they will just tell you we have no free times. Only insisting and quoting the law might help. And lying about your symptoms. Waiting for surgery typically lasts many months.
Germany spends around 30% more in health expenses than Finland.
Neither of them is perfect. But when I am really ill, the German system feels easier to work with.
The US of course spends even more in health expenses. But only a limited group benefits from most of it.
I pay for private insurance in one of the countries I mentioned to have choice of doctor and nicer hospital rooms and meant that my (non-urgent) knee reconstruction got done in 6 weeks instead of the 6 months I would have needed to wait for the same surgeon.
Your comparison does not work.
I wanted to have a particular operation and was told I could have it carried out almost for free if I waited for "about a year". Alternatively I could pay for it myself and have it in "a few weeks".
In that kinda situation, a procedure I wanted for myself, I figured I'd just pay. Certainly there wouldn't have been a problem waiting for it, voluntarily. But given the opportunity it seemed like a good decision to make.
In the past I've had work-related healthcare covering me when I had some forearm injuries, caused by climbing, which directly impacted my keyboard usage. My usage of public healthcare involved having brainscans, and other tests before deciding that I was fine. Both cases were nice and straightforward, even without adequate Finnish language skills on my part.
So I think I've had a decent interaction with all three of the systems - paid stuff, which I managed myself, public system, and private healthcare provided by my employer.
Finland: "The time within which you must get access to non-urgent care and treatment is laid down in law."
source, which has list of waiting times: https://www.hel.fi/en/health-and-social-services/data-and-th...
Nowadays more than 50% of Finnish newborns are covered by voluntary private health insurance, although all of them are covered already by public health care. I think that tells very much how much people still trust in the public health system.
[1] https://www.laakarilehti.fi/terveydenhuolto/hoitotakuu-pitaa...
[2] https://www.iltalehti.fi/politiikka/a/f3392e98-c524-4c22-a53...
Difference to the experience of millions who'd rather skip treatments for even basic stuff like dentals than bear the costs...