Nikki Haley is wrong: Finland takes care of new moms way better than the US

Authored by vox.com and submitted by aslan_is_on_the_move
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Nikki Haley criticized a very specific target on Twitter this week: the Finnish health care system and how it treats new mothers.

The former UN ambassador was responding to a tweet from Sen. Bernie Sanders (I-VT), who was commenting on the lower costs women face delivering babies in Finland.

Haley jumped in to argue that the Finnish system was “skimping on a woman when it comes to childbirth,” and encouraged followers to ask people there how they like their system. “You won’t like the answer,” she predicted.

Health care costs are too high that is true but comparing us to Finland is ridiculous. Ask them how their health care is. You won’t like their answer. — Nikki Haley (@NikkiHaley) March 20, 2019

Haley ended up, perhaps unintentionally, hearing from a lot of Finns who say they like their health care system just fine. This included one of Haley’s former colleagues, Finnish UN Ambassador Kai Sauer:

1/4 Here some facts: Finland has a high performing health system, with remarkable good quality in both primary and hospital care. The country also achieves good health status at relatively low level of health spending (OECD). — Kai Sauer (@sauerka) March 21, 2019

Sauer is right: Finland’s health care system outperforms the United States on nearly every childbirth-related metric.

American moms are four times more likely to die in childbirth than Finnish moms. The maternal mortality rate in Finland has been going down for years. In the United States, it has risen steadily since 2000.

In Finland, 99.6 percent of pregnant women report getting regular prenatal care, likely a product of their universal health coverage system. In the United States, where millions of Americans are uninsured, only 77 percent of women began their prenatal care in the first trimester.

American babies are twice as likely to die before their first birthday as Finnish babies. In 2017, just 97 Finnish babies died in their first year of life, the lowest number the country has ever recorded.

Finland’s become well-known in public health circles for its “baby boxes,” which the government sends out to expectant mothers and include many of the basics they’ll need for the newborn like clothes, a bath towel, a bib, a book, and even a place for the baby to sleep. (In contrast, when I had a baby here in the United States last year, I didn’t get any free supplies. Instead, I got advice from other new moms to hoard as many diapers and other supplies as I could during my hospital stay, when the nurses weren’t looking.)

There’s a reason the international nonprofit Save the Children ranks Finland second in its Mothers Index, which measures the well-being of moms and children in 178 countries. The United States, meanwhile, comes in at 33rd.

Haley’s tweets make an inaccurate assumption that I see a lot in health policy. They take as a given that more expensive health care is better health care. She suggests that in order to get to lower prices, Finland must be “skimping” on the care it gives women.

We’re often used to price being an indicator of quality. There’s a reason that first-class seats on a flight cost more than those in coach, and why a meal at a Michelin-starred restaurant costs more than one at McDonald’s. For so many things we purchase, the more expensive thing is the nicer thing.

Except it turns out this doesn’t really apply to health care. We have wild variation in health care prices in the United States, and study after study finds no relationship between how much health care costs and what type of quality a patient receives. This is true for the overall cost of the procedure, as well as what the patient contributes (which is usually some share of that overall price). Unlike restaurants or airplane seats, there’s little evidence that the more expensive doctor is the better doctor.

As for how Finland gets its low prices? It isn’t about skimping on care for pregnant women. Instead, Finland does what pretty much all our peer countries do: They regulate the country’s health care prices. The Finns look at health care as something akin to electricity or water, something so essential to life that the government needs to step in and make sure it’s affordable to all.

Sometimes regulating prices will mean some version of rationing. You sometimes see national health systems in Europe, for example, refusing to cover a certain drug because they think the prices are too high.

But in Finland, there is no evidence that there is any sort of rationing in the space of prenatal care and childbirth. Instead, the Finnish system seems to be giving women a health care experience that mothers in the United States should envy.

bleunt on March 30th, 2019 at 17:20 UTC »

Republicans should just avoid talking about Scandinavia at all cost.

Tridamos on March 30th, 2019 at 17:19 UTC »

Health care costs are too high that is true but comparing us to Finland is ridiculous. Ask them how their health care is. You won’t like their answer.

Well... She's not entirely wrong. Finland is apparently so much better at it that it's ridiculous to compare, and I'm sure at least some people won't like to hear how much better it is.

Rumsfeld1001 on March 30th, 2019 at 16:55 UTC »

What!!! Another Republican trying to pretend they know what they are talking about?