The Slovenia Times

Long-term care legislation coming, health insurance reform still pending


Faced with a rapidly ageing population, Slovenia has for years been debating the need to adopt legislation on long-term care. The bill should be ready by the end of this year or early next year, but there are still some open issues, according to Šabeder.

A new contribution will probably be necessary to finance long-term care, but Šabeder would not venture to say how high it might be or whether it will be mandatory or voluntary. "I hope the contribution is small, but it will probably be necessary," he said.

The healthcare and health insurance act, which governs much of financing in the healthcare sector, is expected in mid-2020. As Šabeder suggested, it has not yet been decided what will replace the current system of voluntary top-up insurance, which is the main demand of the Left.

"We have to find a solution for a long-term and stable source of financing if supplementary health insurance is abolished. We're talking about half a billion euro, they will have to be secured one way or the other."

In conjunction with the Finance Ministry, the Health Ministry is conducting multiple simulations, ranging from higher contribution rates to a new levy, according to Šabeder.

The Left, for which abolishing top-up insurance is one of the key priorities and one on which its support for the majority government hinges, plans to shortly unveil its own bill, but Šabeder sees no need to hurry.

"I have presented the priorities for this year and next to all deputy groups, including the Left and other opposition parties, and there were no complaints about the timeline," he said.

Šabeder has been kept busy in the first months of his term by general practitioners, who started quitting en masse due to excessive workload and low pay.

As a stop-gap solution, additional funds were earmarked for GPs and their nurses, with new measures now planned, focused on cutting red tape.

GPs have so far been coy about whether these measures will be enough to stop the drain of staff. "Considering the measures that we have already drawn up and the measures coming up, I hope they realize we are truly extending a hand this time," he said.

The situation has been getting worse for years and cannot be resolved overnight. "We do not have a magic wand at the ministry to provide all the missing doctors," according to Šabeder.

Waiting times have also been near the top of Šabeder's agenda. Several stop-gap solutions have been adopted and additional measures are in the pipeline.

An action plan to reduce waiting times for orthopaedic surgery is expected within a month and that will serve as the starting point for action in other segments. "If necessary, private providers will be included as well," said Šabeder.

Previous plans to give additional money to private health institutions in order to reduce waiting times have been met with stiff opposition and accusations that this would be used as an underhand way to chip away at public healthcare in favour of privatisation, but Šabeder denies this.

"This has never been my intention. My sole intention is to work for the benefit of patients," he said.

The management of hospitals is another issue Šabeder plans to tackle. The process was started by Šabeder's predecessor Samo Fakin and the blueprint is expected to be finalised by the end of the year.

The minister said key governance principles would be imported from the business sector, for example management liability and remuneration of employees, but "public institutions must never be like companies with regard to the fundamental objective ... They are designed to provide health services."


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