Health as a national asset : can this perspective from Finland help us reform our health sector? PDF
Preview Health as a national asset : can this perspective from Finland help us reform our health sector?
The John W. McCormack OCT 0 9 2002 University of Massachusetts Depository Copy An Occasional Paper Health as a National Asset: Can this Perspective from Finland Help Us Reform our Health Sector? & MD Phyllis Freeman, JD Anthony Robbins, October 2001 University of iVIassachusetts Boston The McCormack Institute TheJohnW. McCormack Institute ofPublicAffairs is a multi-purpose public policy research institute, established in 1983 at the University of Massachusetts Boston and named in honor ofthe lateJohnW. McCormack,former Speaker ofthe U.S. House ofRepresentatives. The institute's components include four centers, each with its own area offocus: the Center for State and Local Policy,the Center for Social PoHcy Research, the Center forWomen in PoUtics and PubUc PoUcy, and the Center for Democracy and Development.The institute also administers UMass Boston's M.S. Program in PubUcAffairs and publishes Tlie New EnglandJournal ofPublic Policy. — The McCormack Institute's fellows and staffs who are drawn from such div—erse fields asjournahsm,poUtics and government, and the social sciences represent vital connections between the University commu- nity and centers ofpower and innovation in the private and pubUc sectors.They are involved in university teaching, survey research, edu- cational outreach projects, and a variety ofpubUcations including books, academic papers, and newspaper columns; they also appear regu- larly as guest speakers, moderators,and paneUsts onTV and radio. Through the work ofthese distinguished academics and practitioners, the institute seeks to contribute to informed pubUc discourse and to play a constructive role in pubUc policy formulation and problem- solving. The views contained in thispaperare those ofthe author(s) and not the John W.McCormack Institute ofPublicAffairs. An Occasional Paper Health as a National Asset: Can this Perspective from Finland Help Us Reform our Health Sector? by Phyllis Freeman, JD & Anthony Robbins, MD October 2001 Digitized by the Internet Archive 2015 in https://archive.org/details/healthasnationalOOfree To request copies of this Occasional Paper call or write the McCormack Institute of MA Public Affairs, University of Massachusetts, Boston, 02125-3393, fax 617-287- 5545. You can reach Professor Freeman at 617-287-7372 or by email: [email protected] . 2 Authors & Acknowledgements Phyllis Freeman, JD is a Senior Fellow of the McCormack Institute of PubHc Affairs, and Professor, College of Public and Community Service, University of Massachusetts in Boston. MD Anthony Robbins, is the Morton A. Madoff Professor and Chair of the Department of Family Medicine & Community Health, Tufts University School of Medicine, Boston, Massachusetts. We thank our friend Jorma Rantanen, long time Director General of the Finnish Institute of Occupational Health, who organized our program and his colleague Suvi Lehtinen, also at FIOH, for her tireless efforts and perceptive annotations to our meetings and informal conversations. This allowed us to grasp more of the social context for healthaffairs than we could have without her. We thank Jaakko Tuomilehto, Professor at the National Public Health Institute who took us inside the history of the North Karelia Project. We particularly appreciate Liisa Elovainio, Director of the Finnish Cancer society, who taught us about cancer in Finland and the strategies for garnering popular support for and participation in data collection and research for prevention and medical care. Gustav Wickstrom, Director of the regional Occupational Health Institute in Turku took us into his community and revealed much about Finland's political culture, adding the perspective from the Swedish-speaking minority within Finland. Both Elovainio and Wickstrom were most generous correspondents and reviewers as we revised the manuscript. It was through this correspondence that we finally understood from Elovainio, how incidence registration plays a vital role in cancer prevention and from Wickstrom, how Finns regard health as a special asset. We thank Kelly Tobin for editorial assistance. 3 Table of Contents Executive Summary 5 Introduction 7 Cardiovascular Disease and the North Kareha Project 11 Early History & Data 11 & Protection Prevention 12 Medical Care & Non-medical Services 14 & Outcomes, Results, Challenges 15 Cancer 17 Reliance on Data, Registries, &: Research 17 Screening for Early Cancer Detection 19 Treatment Programs & Planning 20 Results, Outcomes, & Challenges 21 Worker Health 22 Early History 22 Data & Worker Protection 22 Occupational Health Services: attracting men into medical care 23 Economic Crisis & 'Work Ability' 25 Outcomes, Results, & Challenges 26 Conclusion 28 4
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