ZZZS director worried about long-term coverage of expenses

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Ljubljana – Tatjana Mlakar, the director general of the ZZZS public health insurer, has noted in an interview with the STA that the new obligations imposed on the ZZZS do not have long-term financial coverage, and is worried that this will result in a reduction of rights of insured persons.

Under the 2022 financial plan adopted last December, a EUR 149 million shortfall of revenue over expenditure is planned, but given the new permanent financial obligations, the deficit is expected to be even higher.

“Not all new obligations imposed on our fund have long-term financial coverage,” said Mlakar, adding that the fund did not want to be forced to reduce the rights from compulsory health insurance in any way due to the additional obligations.

The ZZZS insists that, in the event that the health fund fails to cover the difference between revenue and expenditure, the so-called budgetary safeguard should be put into law, like the one applied for the disability and pension insurance fund.

Mlakar noted that the contribution for public healthcare from the Slovenian budget contributes is relatively the smallest among the comparable healthcare models in Europe, “which means that there is still room for improvement.”

The fund will start drafting a supplementary financial plan for 2022 in March, which will include the planned expenditure related to the new long-term care, with the ZZZS serving as the principal implementer of the act.

“For experts in health insurance, this is a completely new activity in social care,” Mlakar said, adding that around 130 new employees would be hired for this purpose, mainly at entry points where eligibility for long-term care will be assessed.

She said that providing enough professional staff would be a problem, and that establishing a completely new and complex information support infrastructure in a short time would also be challenging.

Turning to sick leave and absenteeism, Mlakar noted that the expenditure for sick leave covered by compulsory health insurance had been increasing every year, and in particular since the second half of 2015.

While in 2013 this expenditure amounted to around EUR 225 million, last year it increased to almost half a billion euros, and the amount is only expected to further increase in the coming years.

The number of cases and days of absence from work due to illness or injury is also increasing. Last year, the total number of working days of absence amounted to more than 14 million, compared to 12 million in 2020.

“We urgently need to tackle this problem systematically, by ensuring greater involvement of experts and making a qualitative shift when it comes to decisions on awarding disability status,” Mlakar said.

She argued that the current model should be preserved, while public sector wage policy should be changed in order to introduce more effective performance bonuses, digitalisation launched and adjustments made to the needs of long-lived society.