Health minister to present long-awaited reform package
Kolar Celarc was forced to accept the 12 December deadline by the junior coalition partners in exchange for them supporting her in a no-confidence motion in November.
The coalition partners' assessment of the legislation will probably also determine Kolar Celarc's fate in government.
While the minister enjoys the support of Prime Minister Miro Cerar and his Modern Centre Party (SMC), the Social Democrats (SD) and Pensioners' Party (DeSUS) have been more reserved.
Both junior partners have suggested the perceived quality of the reform package would determine whether Kolar Celarc stays on as minister or not.
The package to be unveiled today includes a reform bill, amendments to two acts, and the guidelines for another piece of legislation.
Health care and health insurance bill
The reform health care and health insurance bill is the centrepiece of the health reform package since it determines the financing of the health system. Despite that, little is known about its specifics.
Judging by the coalition agreement, voluntary top-up insurance will be abolished in favour of a new contribution. The levy would be progressive depending on income, as opposed to the current system of flat top-up payments regardless of income.
This would in effect create a single-payer system around the public Health Insurance Institute (ZZZS) while driving two private health insurers and the mutual health insurer Vzajemna out of business.
Given its impact on the insurance market, it is also the most bitterly contested portion of the reform package and pundits believe the recent barrage against Kolar Celarc is largely the result of the proposed abolition of top-up insurance.
Additionally, the plan is to determine the basket of rights in the law; certain rights are presently set in insurance rules, which the Constitutional Court has ruled as unconstitutional.
The coalition agreement also speaks about transferring certain costs, for example doctor specialisations, from the health insurer directly to the budget.
Amendments to the health services act
Amendments to the health services act were first unveiled over a year ago, at which point they dealt mostly with concessions for private practitioners. On the basis of public debate, the number of issues to be changed expanded significantly, but concessions remain at the heart of the bill.
The bill abolishes indefinite concessions and introduces concessions limited to 30 years maximum that cannot be sold or inherited.
Doctors in the public system that also work in the private sector will only be allowed eight hours of work per week in the private sector, a proposal that has been met with stiff resistance from doctors' groups.
Amendments to patient rights act
The minister is also expected to present amendments to the patient rights act, whose core change will be accelerating the processing of the most urgent cases.
On the other hand, the bill would prevent patients from entering multiple waiting lists for the same treatment, a move designed to clear up current waiting lists of duplicates.
Guidelines for bill on management of public health institutions
The Health Ministry has started drawing up a bill on the management of public health institutions. The details have not been revealed, but the chief aim is to give managers more powers in order to improve the efficiency of management.
Pharmacies bill
The health reform package also comprises the pharmacies bill, which will not be presented today since it has already been cleared at committee.
The bill explicitly bans vertical integration between pharmacies, wholesalers and drug makers, while it also determines the minimum scope of the network of pharmacies.
It would introduce seamless pharmacy care so that on being discharged from hospital, patients should get the necessary medications for the time until their first GP appointment.
The bill stipulates that any financial surplus generated by publicly-owned pharmacies will have to be spent on the core activity. This is to prevent the channelling of profits into municipal budgets.