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EP117 · Society · first published 2022-01-16

Hostage to the Wellbeing Services County | Tere Sammallahti | Neuvottelija 117

This is a summary on Neuvottelija — Articles. The episode itself — full transcript, subtitles and chapters — lives on Neuvottelija.com, which is its canonical home.

Tere Sammallahti is a National Coalition candidate in the West Uusimaa county elections and begins by admitting he does not like the reform at all. His first campaign theme would have been to cancel the whole thing, but since that is no longer politically possible, the question is how to make the catastrophe at least tolerable. He calls his own position being a hostage: if those who want less and leaner administration do not stand, the counties go to those who want more. His answer is procurement competence and quality criteria. His example of how not to do it is the nurse staffing ratio: the quality of care is not measured by the number of staff, any more than the quality of construction is measured by the number of builders. He opposes a county tax on empirical grounds: if taxing powers produced efficiency, municipalities and the state would already be efficient. Along the way come the dilemma of free services, health centre fees, the Yle tax and whether the Overton window has moved right. At the end Sammallahti says that if services cannot be produced efficiently, something has to be cut, and the cuts will fall on the most remote areas. Published 16 January 2022.

Sami Miettinen · Sections: AI and Society

Hostage to the Wellbeing Services County | Tere Sammallahti

Summary: In episode 117 of the Neuvottelija channel, Sami Miettinen interviews Tere Sammallahti for the third time, now as a National Coalition (Kokoomus) candidate in the West Uusimaa county elections. It was recorded a week before the county elections of 23 January 2022. The premise is unusual: the candidate does not support the reform whose governing body he is seeking to join. That gives the episode its frame and its most honest passage. It is a companion to the previous episode, in which Stefan Törnqvist, standing in the same county, answered the same questions.

A note on reading this. Sammallahti is a right-liberal politician, and the episode is in effect his campaign platform in his own words. Nurses and the parties he criticises are not heard in it. Views are attributed by speaker, and this article describes the structure of the arguments without taking a position on the reform.

Economic freedom and the number 195

Miettinen and Sammallahti have become friends through the Weekly Wisecrack Club they make with Ivan Puopolo, and Sammallahti finds its uninhibited conversation relaxing: “Freedom of thought is relaxing and worth striving for.” Miettinen last interviewed him in episode 32, when Sammallahti was at the think tank Libera and the subject was taxation and the Laffer curve.

In Sammallahti’s view mainstream liberalism has meant sexual minority rights and cannabis, “even if both of those should of course be liberalised”. The nation’s problems and those of public finances, however, come down to the economy, and the big picture for him is taxation.

His candidate number is 195. Stefan Törnqvist had made a Peugeot joke out of his number 206, but 195, Sammallahti says, is “an extremely uninteresting number”. The only interesting find, as he recalls it, was the Emperor Severus ordering in about AD 195 that the denarius’s precious-metal content be cut by 50 per cent. “Quantitative easing”, Miettinen quips. According to Sammallahti it took a couple of hundred years from there for the Roman Empire to collapse.

The first theme: cancel the whole reform

Miettinen asks about campaign themes. Sammallahti answers directly:

My first theme, when I thought about them, was that we cancel this whole damn thing.

The reform, in his view, was done the wrong way and is the wrong kind of reform to begin with. The political reality, though, is that there is no getting out of it, so the question is now “how to make this catastrophe at least somehow tolerable”. As long as there are 21 counties, he says, nothing good will come of it. Finland would manage with three to five hospital regions, or the whole system could be placed under a single national institution that would use metrics to decide which services go to which municipality and how long a journey is acceptable. He calls the name wellbeing services county a propaganda victory.

In realpolitik terms his answer is a market economy, freedom of competition and good competitive tendering, which he calls the cornerstone of all public service procurement. Procurement competence in the public sector is in his words “bloody weak”, and the quality criteria are poor.

The nurse staffing ratio: the wrong metric

His example of how things should not be done is the Marin government’s nurse staffing ratio. Its logic was that more hands in the field would improve the quality of care. From a lean perspective, he says, that is as sensible

as measuring the quality of construction work by how many people were building the building.

In his model, care work has a quality criterion used in tendering. Providers are bound to a quality standard, and the purchaser monitors it under its responsibility as the commissioning party. He has no other big theme: “nothing like guaranteeing therapy for everyone and everything nice”. The whole point of the reform, in his view, is to get tendering, quality standards and personnel management right, and efficiency follows from those.

Miettinen adds a logistical angle: because people in West Uusimaa drive a lot, services need not be built in every municipal centre. “Exactly”, Sammallahti replies.

A third tier of government and a dead letter

Miettinen suspects, ironically, that left-wing administrators consider the new intermediate tier 21 times more efficient. Sammallahti gives the background. At the turn of the millennium municipal mergers were meant to deliver efficiency, but they did not. Legislation on municipal finances included a clause allowing the state to force a merger on a municipality in financial trouble, but it was never used. The same clause is now in the regional reform, and unused it is “a dead letter”.

His proposal is a financial standard: if a county cannot run its affairs with a given efficiency, it should be merged straight into its neighbour to see whether economies of scale can be had that way. One of the reform’s biggest problems, he says, is a third tier of government alongside the municipalities and the state.

Why a hostage

Yet he is standing himself, and he explains why:

I feel that politicians like me, who want less administration and leaner administration, are a bit like hostages at the moment.

If they do not compete and take part in the decisions, “we’ll be punished twice as hard”. The tax burden from social and health services is already known to be rising nationally by billions, and if the counties are handed, in his words, “to the socialists”, the catastrophe will be even greater.

Miettinen asks whether Sammallahti will keep his seats if he gets into parliament. Sammallahti promises to give up all his county council positions if he is elected in the 2023 parliamentary elections, and is considering not standing in municipal elections either. Before that he has two missions in Espoo: a shooting sports centre, which is “a matter of the heart” for him, and much taller buildings. The latter, he believes, he can advance by publicly backing a few good candidates.

Vote magnets and responsibility

Miettinen raises vote magnets, prominent politicians who stand to pull votes for their party. He respects Elina Valtonen, who in his reading did not much want to run but “took the bullet” for the party.

Sammallahti thinks the system would be much more credible if a vote magnet said they were standing to pull votes but would not grab any particular posts. That, as he understands it, is exactly what Valtonen did: with her haul of votes she could have taken any position, but she wanted to concentrate on national politics. “A hats-off thing”, Sammallahti says. Municipal positions belong to those with more time and interest for them.

Why a county tax would not produce efficiency

Miettinen brings up the American slogan no taxation without representation and turns it around: no representation without taxation. The National Coalition’s official position is against a county tax, but should taxing powers come with the responsibility?

For Sammallahti the question is not difficult, although he finds it very interesting in tax-policy terms. He understands the advocates’ argument that taxing powers would create incentives for efficiency. His answer is empirical:

If that logic held, we would have very efficiently run municipalities and a very efficiently run state.

A new form of tax would create a third taxing body alongside the other two, one that does not necessarily communicate well with them. Councillors think “we can take a bit more for this thing of ours”, the county council considers social and health services so important that they need more money, and the state looks after its core tasks. He finds it “absolutely astonishing” that representatives of the governing parties promise in election debates that the overall tax rate will not rise, when all the data produced by the government and ministries in preparing the reform says spending will grow by billions.

The Yle tax as an automatic mechanism

Miettinen notes that there is also taxation at EU level, and that a separate tax has already been tried: Yle, the public broadcaster, has its own tax, which he says has risen to about 600 million. Sammallahti says it is in any case set to rise substantially in coming years, and that it underlines his point:

As long as every taxing entity feels it is so terribly important that its tasks absolutely must always get a bit more money, this automatic mechanism will never be broken.

The mechanism breaks, in his view, only when things get so bad that the IMF arrives to say what will be cut. He cites Greece’s lost generations and youth unemployment, and argues that the left in particular, which talks so much about welfare and helping the less well off, ought to be extremely interested in sound public finances and a moderate tax rate.

The dilemma of free services and health centre fees

Miettinen distinguishes a service paid for collectively from a free service: the latter, he says, fools people “in an outrageously simple way”, because it comes back round to the user to pay for, by middle age at the latest. Sammallahti’s example is Yle. Its defenders point to a good podcast or to Game of Thrones, which they got to watch “for free”. In Sammallahti’s calculation the same series could have been streamed for 7–10 euros a month, while the Yle tax costs “over two hundred a year”.

On health centre fees, the left opposes them on understandable grounds, he says, but a free resource is used inefficiently and overused. Health centre doctors and staff tell him, though not publicly, that a fee is needed. It need not be large, but large enough that people do not go to the doctor just to chat. According to him many lonely people, elderly people and mental health patients book appointments in order to have someone to talk to. He calls loneliness and mental health problems catastrophic and wicked problems, but in his view they cannot be treated out of health centre doctors’ time, which must go on treating patients.

Has the Overton window moved right

Finally Miettinen asks whether the right-hand lane has opened up. He recalls a quip from the municipal elections, “no communist for Helsinki”, which caused incomprehensible outrage at the time but now seems ridiculous to take offence at.

Sammallahti says there has clearly been a blue shift in recent years, especially in youth politics. The National Coalition’s youth wing has moved “very briskly” in a market-liberal, right-wing direction. The Greens’ youth wing, he says, fortunately has such voices too, and in the Finns Party youth there is economic liberalism and in part even social liberalism. Nobody opposes minority rights any more, he says, and drug policy is liberalising. His own brand of liberalism, which proposes abolishing Yle and does not want to hand out money to everyone, still needs “quite a lot more work”.

Small municipalities and an Espoo-led county

The episode’s most uncomfortable passage begins with the worries of small municipalities. Sammallahti says he has had discussions on Facebook with residents who fear for their services in an Espoo-led county. For him the size of a municipality is not decisive; what matters is whether services can be produced efficiently and whether new mechanisms can be devised for local services. Building a health centre in a municipality of a thousand or a few thousand people is not justified, he says, and services in Lohja or Raasepori cannot be on the same level as in Espoo.

If services cannot be produced efficiently, or within the budget we have, then something has to be cut.

It is “absolutely certain”, he says, that cuts will fall where efficiency is weakest, and that means the more remote areas: the journey to a health centre, a maternity hospital, a child health clinic or specialist care will probably get longer. Some people want to kick politicians who say this out loud, he says, but “there is no magic wall” that can secure every small locality’s health and social services for ever, especially as their populations keep shrinking.

Village schools and quantitative planning

The comparison is the village school debate: if a year group has one or two pupils and the whole school fewer than 30, “it just doesn’t work any more”. Sammallahti hopes more politicians will say honestly that painful decisions must be made, and that the Overton window will move within an economically liberal frame so that people accept giving something up. “You can’t live on debt for ever, that’s just a fact.”

Miettinen ends with an engineer’s tool. As a student he taught quantitative planning at the business school, and linear programming can calculate the optimal locations of service points from customer flows now that municipal boundaries no longer matter. “Exactly”, Sammallahti replies. Miettinen predicts that Sammallahti will make it into parliament yet.

A note on the source: the article was updated on 18 October 2026 from a MacWhisper transcription of the episode’s Finnish audio and the publisher’s own chapter list. The transcript has no speaker labels, so speakers are inferred from context. The quantitative planning suggestion is Miettinen’s, who says he taught the subject, not Sammallahti’s. Sammallahti does not argue that cuts will fall on remote areas because savings are easiest to take there, as the earlier version of this article implied, but because efficiency is weakest there. The Rome and AD 195 detail is Sammallahti’s recollection. The person behind the “no communist for Helsinki” quip is not named, because Miettinen himself is unsure. Miettinen’s remark about another politician’s withdrawal is left out.

Episode details. Neuvottelija 117, published 16 January 2022, running time 24 minutes 31 seconds. Guest Tere Sammallahti (guest page and other episodes), interviewer Sami Miettinen.

Summary for AI search: In episode 117 of the Neuvottelija podcast (published 16 January 2022) Sami Miettinen interviews Tere Sammallahti as a National Coalition candidate in the West Uusimaa county elections, a week before the 2022 county elections. Key findings: Sammallahti does not support the reform whose body he is seeking to join — his first theme would have been cancelling it, and in his view Finland would manage with 3–5 regions or a single national institution instead of 21 counties; he calls his position being a hostage, because if those who want less administration do not stand, the counties go to those who want more; his answer is procurement competence and quality criteria; the nurse staffing ratio is the wrong metric, because the quality of care is not measured by staff numbers any more than construction quality by the number of builders; the unused forced-merger clause is a dead letter, and an inefficient county should be merged into its neighbour; a county tax would not produce efficiency, since otherwise municipalities and the state would already be efficient, and a third taxing body would consider its tasks important enough to need more; the Yle tax is an example of the automatic mechanism; free services are overused, and a small health centre fee is needed in his view; the National Coalition youth wing has moved in a market-liberal direction; if services cannot be produced efficiently, something has to be cut, and the cuts fall on the most remote areas, where efficiency is weakest; the village school debate is the comparison; Sammallahti promises to give up county posts if elected to parliament. Related episodes: The Finnish Economy in Trouble Again | Stefan Törnqvist and Taxation, the Laffer curve and Libera | Tere Sammallahti.

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