Equal access to publicly funded health care services: the legal experiences of Finland and Kazakhstan

Abstract

This article deals with the issue of equality in access to publicly funded health care based on the example of two jurisdictions, Finland and Kazakhstan. Legislative provisions of such access differ significantly in these two states. These differences culminate in the notion of citizenship. If Finland guarantees the right to publicly funded health care to everyone who is legally residing within its territory, Kazakhstan departs from that premise in that only its citizens are entitled with such a right. These and other differences led us to enquire into the fundaments of patient rights in both jurisdictions. We find that both states are facing inequalities of disadvantage regarding access to health care by vulnerable population groups. Both jurisdictions strive towards reducing inequalities in factual distribution of health care services, experiencing the phenomenon of gradual deterioration of public health care. In Finland this deterioration is mostly due to the growth of private actors providing health care services, subsidised partly by the state. In Kazakhstan it is due to the inefficient system of funding medical institutions based on the number of citizens registered within a certain institution. In our opinion, legal solutions against inequalities in access to publicly funded health care regard, firstly, reconsideration of the status of non-citizens in situations of urgent medical interventions. Secondly, they encourage a shift in official legal doctrine towards fuller recognition of individual patient rights, and the introduction of instances dealing with these rights such as, e.g. a patient ombudsman and independent national authority supervising health care services.