The Slovenia Times

Slovenia Awaits Yet Another Attempt at Health Reform


While the minister still enjoys the support of most of the coalition partners, the opposition New Slovenia (NSi) has given her six months to draft a reform or face an ouster motion.

But economist Sašo Polanec believes that until a consensus is reached on what kind of a health system Slovenia should have, no major changes can be expected.

At this point, those acquainted with the faults of the current system agree that the health system should be depoliticised.

Polanec, a lecturer at the Ljubljana Economics Faculty, believes the health system should be completely overhauled.

One of the biggest problems in his opinion is that the government administers the public health insurer, the Health Insurance Institute (ZZZS).

"When the ZZZS tried to cut the waiting times by auctioning off a part of the funds available, the then PM Alenka Bratušek blocked the proposal," he illustrates.

Immunologist Alojz Ihan agrees the ZZZS should be given more powers. "The ZZZS cannot make its own decisions. It is a kind of a janitor rather than a manager who could really negotiate the prices with hospitals."

The ZZZS's health services pricing policy, which is over 20 years old, also urgently needs to be updated, Ihan believes.

Hospital management, on the other hand, should be given free reign to make business decisions and should be held responsible for poor financial results.

A researcher at the Faculty of Administration, Bruno Nikolić, believes oversight of hospitals' management, efficiency and labour costs should be improved.

Hospitals should also strive to get more money on the market, according to him.

Polanec says the pay system should in turn reward productivity.

Regarding past proposals for scrapping the system of top-up health insurance, both Nikolić and Polanec agree this would not be wise.

Nikolić would follow France's example and reduce the health contributions levied on labour and instead expand the tax base to capital gains and gambling winnings.

Polanec says abolishing top-up health insurance would benefit some 600,000 pensioners at the expense of some 800,000 people in employment. "It is a matter of political interests."

Political interests will also decide on whether the Slovenian health system will now finally be reformed.

So far, many attempts have been made at overhauling the system, none of them successful. In the past 15 years, as many as eleven health ministers had been involved in this issue but most of their motions did not even make it to parliament.

The first serious attempt at reforming the health system was made by Minister Dušan Keber in the Janez Drnovšek government of 2000-2002, while notable efforts were also made during Borut Pahor's stint as prime minister in 2008-2012 by Borut Miklavčič and his successor Dorijan Marušič.

Incumbent Minister Kolar Celarc has said she will present her guidelines for a reform after a thorough analyses of the situation and based on a strategy for 2014-2020. The guidelines should be ready in six months.


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