The distributional effects of social and health care in Finland (SOTE-SISU)


2019 -

Unit at THL:

The Welfare State Research and Reform

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This study examines the effects of out-of-pocket payments (OOPs) and their changes on households’ livelihood in various population subgroups. Special attention is paid to how much OOPs increase the number of households eligible to last-resort social assistance and how often social assistance is not applied for among eligible households. The behavioral effects of the changes in OOPs are considered. In addition to the payments, the redistributional effects of social and health care are analyzed together with income transfers and taxation. 


The research is a collaboration between National Institute for Health and Welfare (THL) and Social Insurance Institution of Finland (Kela). It is based on extensive administrative registers and microsimulation method. We use Finnish tax-benefit microsimulation model SISU complemented with detailed microdata on the use of social and health care and related OOPs. The analysis covers payments for public social and health care, medicines, health-related travel expenses as well as private health care.

The project is part of INVEST-flagship.
Read more about INVEST

This subject was previously studied in the project: An Ex-ante Evaluation of Out-of-pocket Payment Reforms in Finland 2010-2018 - The Effects on Income Inequality


  • Kela
  • Statistics Finland
  • Ministry of Social Affairs and Health
  • Ministry of Finance


THL, Kela, Academy of Finland

Contact information

Jussi Tervola
Research Manager
E-mail: [email protected]
Tel. +358 29 524 6134