Slovenia’s New Govt.: Healthcare Top Priority

By , 22 Aug 2018, 12:34 PM Politics
Slovenia’s New Govt.: Healthcare Top Priority Rhoda Baer for the US National Cancer Institute, public domain, via freestockphotos.biz

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STA, 21 August 2018 - PM-designate Marjan Šarec has made it clear on several occasions that dealing with the crisis in healthcare will be one of the top priorities of his government. However, the stakeholders doubt whether the new cabinet will be up to the task. 

According to unofficial information obtained by the STA, the draft coalition agreement sets out a commitment to a properly funded and managed universally accessible quality healthcare with a clear division between the public and private sectors.

The future government's main task will be reducing unacceptably long waiting times for medical procedures, where the coalition will seek to use up the capacities with public providers before involving concession holders and private practitioners.

"Such an approach is misguided, something that has been testified many times before," Zdenka Čebašek Travnik, the head of the Medical Chamber, has commented for the STA.

Public institutions may promise to provide additional services, but by the end of the year it turns out they failed to meet the commitments, she said; "A political decision to favour public providers for additional services, regardless of the conditions offered by private providers is certainly not in the best interest of waiting patients."

Čebašek Travnik is also uncomfortable with the announcement to separate public from private: "Public healthcare is publicly-funded services, regardless of how they are provided, so it's not quite clear what such a division is supposed to mean.

"From the aspect of accessibility of health services, it makes no difference for patients what the legal status of providers is, whether they are a public institution or a company."

The coalition's commitments are said to include raising the overall funding for healthcare to 9% of GDP by the end of the term, scrapping top-up health insurance, boosting primary healthcare and expanding the scope of services provided by GPs.

The Medical Chamber supports abolishing top-up insurance in principle, noting that this is a question about the sources of funding of public healthcare. "The Chamber primarily advocates increasing public funding for public healthcare," Čebašek Travnik said.

The coalition is also planning to put in place a single centralised procurement system for the purchasing of medical supplies and equipment and an independent institution for the valuation of health services, and introduce an additional levy on alcohol, tobacco and sweet beverages.

The Medical Chamber welcomes those commitments as well as the plan to consider the options for forming a fund to pay out damages for medical errors.

"The coalition agreement that was made accessible to us a while ago set out that the norms and standards would be determined by the Health Insurance Institute in cooperation with professionals. The Medical Chamber believes the norms are in the exclusive domain of the profession," Čebašek Travnik said.

Marjan Sušelj, general manager of the Health Insurance Institute (ZZZS), which manages the public health fund, welcomed the coalition's guidelines, expressing the hope that the new team at the Health Ministry would be able to put them into practice.

Sušelj also hailed the plan to fold top-up insurance into mandatory insurance while preserving the attained level of rights, something that had been planned under the outgoing government. He warned though that a renewed politicisation of issue could block the implementation again.

He described the plan to raise health funding by 9% by the end of the term, with 85% of the funding coming from public sources, as bold.

He also endorsed the plan to pass a new health insurance act that would transform the ZZZS into an active buyer, something that his institution has already started preparing for.

However, he called for careful consideration of the coalition's intention to include some of the now payable dental services into the basket of services covered from mandatory insurance, to prevent "dental aesthetics ending up on the list".

Meanwhile, harsh criticism of proposals contained in a leaked draft of the coalition agreement was levelled by Igor Muževič, the head of the trade union of GPs.

"The agreement is virtually identical with the present one. So are the coalition parties mostly the same. These parties were often warned by professionals over the past few years that they would harm patients with their measures, which in fact turned out."

Muževič added that the results of the outgoing government's measures designed to boost primary care were evident from the latest call for GPs when initially only seven candidates applied for 59 available posts, and after several months only 13.

"It's not hard to predict that political control of healthcare, ever longer waiting times and corruptive practices will continue. And again, everyone but the politicians will be blamed. I believe we have reason to be concerned for patients," Muževič said.

Instead, he believes the coalition should commit to amend public procurement legislation and to giving patients "free choice to pick their doctor and get the service they need on time".

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