TASR, Teraz.sk - 31.7.2013 EN


IHP: Expropriation of Health-insurers Is Last Resort, Not Main Option

      Bratislava, July 31 (TASR) - The re-introduction of a unitary state-run health-insurer won't guarantee that the money in the health-care system is used in a more efficient way; and on top of that, it could bring about the danger of significant economic losses on the part of the state with respect to private health-insurers, TASR was told by Institute for Health Policy (IHP) board of directors chair Tibor Sagat on Wednesday.
      "We should aim neither for a unitary, nor a plural health-care system, but a system that would include the principal features declared by the World Health Organisation. That means that good-quality health care should be accessible to all people equally. It is unacceptable that certain elements in the system benefit from it to the detriment of others, as is often the case at present. For example, there are laboratories that have their own contracts signed with insurance companies instead of with hospitals, and we have a very expensive health emergency response system," asserted the chairman.
      Sagat, who served as health minister in 1994 and between 1998-2000, cautions, however, that making changes to the health-care system is remarkably difficult, with the transformation process spanning more than one tenure. It can be successfully carried out only after an agreement across the whole political spectrum, expert organisations and civil associations. "Otherwise, it could come to the worst possible scenario, with the unitary system being overtaken by economic groups primarily aimed at making a profit," added Sagat.
      Advocate and IHP advisor for health legislation Jana Martinkova added that it's absolutely irrelevant whether the system is a unitary or plural one, as this won't help tackle the current inappropriately set mechanism of financial flows within it. She asserted that the Government-sponsored plan to expropriate the two private health-insurance companies is the most expensive, most risky and least efficient alternative in efforts to make the health-care system in Slovakia run more efficiently.
      "Without curbing cost efficiency, the financial burden placed on people will grow constantly, despite the fact that the profits recorded by the private health-insurers can be considered clear evidence that there are enough resources in the system," emphasised Martinkova.
      The advocate observed that instead of merging the institutions, a well-founded alternative appears to be to amend certain pieces of legislation such as the health-care act, the act on the extent of health care covered from public health insurance, the act on budgetary rules, the act on the health-insurance system, the act on health-insurance companies, and the act on providing health care. "[The Government] should resort to expropriation in case of need only after these less radical alternative measures have been carried out; otherwise, it won't be possible to defend the legitimacy of the measure in front of an arbitration court or the Constitutional Court - at the expense of us all," said Martinkova.
      Meanwhile, the plan to re-introduce a unitary health-care system is to be carried out later than originally intended by Prime Minister Robert Fico's Cabinet. According to information acquired by TASR, the now-drafted legislation counts on merging health-insurers as of January 2015.
      IHP was established in 2004 by three former health ministers Alojz Rakus, Tibor Sagat and Roman Kovac as a non-profit organisation of people who are trying to create the conditions for forming health policy, based on principles defined by the World Health Organisation (WHO). The main aim of the association is to come up with ideas to improve the system of providing health care in Slovakia, optimise working conditions, boost the social standing of health-care workers, and support active public participation in Slovakia in the processes of health policy creation.