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Too many unanswered questions

6.10.2016

As a long-serving city councillor and member of the city board I can honestly say that I have never received as many letters of protest concerning the future funding of key public services as I have this autumn. Adherence to the frame budget for 2017 is likely to mean severe cuts in spending on education and services for the elderly. The overwhelming majority of the messages I get voice genuine concerns about the wisdom of making cost savings in education, suggesting that down the line a much larger increase in social welfare costs will be the end result. The city’s financial situation, though much improved during this council term is still tight and, unless tax incomes rise markedly, is almost certain to get worse as a result of reforms in the social and health sectors.
Finland’s government has been quick to emphasise that the ongoing social/health reform will be cost-neutral for municipalities. In Jyväskylä’s case this seems not to be the case, as funding channelled to the city from central government is set to fall. The architects of the reform currently seem to be focused on the new structures rather than the substantive questions. How will the planned 3 billion euro cost savings be achieved in a new system based on freedom of choice and numerous private providers of primary healthcare and social services? What has happened to the idea of integration if customers are faced with a number of competing healthcare providers all using different IT systems and support services – laboratories, for instance. Will patients increasingly have to pay a higher proportion of healthcare costs from their own pocket as consequence of the introduction of the ‘money following the patient’ principle? How do we ensure that healthcare services remain in Finnish hands in a system where capital-rich multinational healthcare groups will undoubtedly try their hardest to do two things: win market share quickly and minimize their exposure to tax.
But back to the city’s budget for 2017. With the municipal elections scheduled to take place in April, political parties of all colours will have little appetite to push through the big cuts in education and social services entailed by the frame budget. Responsible political groups of the centre-left must underline clearly that balancing the city’s finances and continuing to fund education and social services properly are not incompatible – but this does demand new borrowing or a moderate increase in the tax rate. Wise citizens generally recognize that a small hike in taxes is the best option when their health or the education of their children is at stake. That willingness to accept higher taxes has also been a key theme of the messages I have recently received.

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