Text file: 1818.txt
author: janez novak
downvotes: 1
end consideration date: 2011-06-19
id: '1818'
number comments: 17
number views: 4559
proposal type: Competent authority response
response: "Response from the Ministry of Health\nAs regards the increase in contribution\
  \ rates, the proposal is aimed at raising funds in a new way, which is above all\
  \ more efficient and more solidarity-based, or in other words: the poor will pay\
  \ less, the rich more, and contributions will be collected in one place instead\
  \ of two (which entail double administrative costs). In the current system, citizens\
  \ pay a premium for a supplementary health insurance which covers co-payments for\
  \ almost every health service. If the co-payments are abolished, with a corresponding\
  \ reorganisation of the Health Insurance Institute and rationalisation of the providers'\
  \ operations, it will be necessary to define a basket of rights for each citizen\
  \ that will allow access to the health services we need, which will be covered from\
  \ a single source, namely from the funds collected through the contribution rate.\
  \ All services that are above-standard and not essential to ensure health, but only\
  \ contribute to the comfort and convenience of the insured person when receiving\
  \ health services, can be covered by voluntary health insurance. Whether or not\
  \ to take out this insurance is a matter for the citizen to decide, but we want\
  \ to ensure that the decision to take out voluntary health insurance does not in\
  \ any way impede our access to the basic health services in the basket.\nIn the\
  \ current system, by paying a contribution, we only have access to a part (5%-95%)\
  \ of the service. Therefore, with regular contributions, which are solidarity-based\
  \ and paid according to our income, we can use almost no service unless we pay a\
  \ co-payment. However, we can also cover this extra cost under a supplementary health\
  \ insurance. Given that the premium is around \u20AC27 (it varies slightly between\
  \ insurers), paying it is not problematic for the rich, but \u20AC27 a month is\
  \ certainly not unproblematic for the unemployed, pensioners and other citizens\
  \ whose incomes are low. Without paying the premium, the extra costs are so high\
  \ that some citizens cannot afford them.\nThe proposal to raise contributions must\
  \ therefore be looked at in its entirety - it is a rise in the solidarity contribution\
  \ at the expense of abolishing the single, non-solidarity premium. We agree with\
  \ your assertion that people no longer have anywhere to take for scroungers - that\
  \ is why we want to abolish the premium that transfers money from the poor to the\
  \ rich and make the collection of money more solidarity-based.\nTo make it easier\
  \ to understand, let's take the example of a citizen with an income of \u20AC400,\
  \ on which he currently pays a \u20AC27 premium, but would (under the current proposal\
  \ of a 2% increase in the contribution rate) pay a \u20AC8 contribution. In the\
  \ case of a citizen with a high income, say \u20AC3 000, he/she now contributes\
  \ a premium of \u20AC27, but will now pay \u20AC60.\nYou should be aware that, as\
  \ a result of the rationalisation and reorganisation measures in the health system,\
  \ we are collecting less money overall than we have done so far. Due to inefficiencies\
  \ and the collection of contributions and premiums through two treasuries (the insurance\
  \ company and the Health Insurance Fund), we have had double administrative costs\
  \ (not to mention advertising, contracts, reserves, profits) - these administrative\
  \ costs will no longer exist under the new proposal. It will also require a fundamental\
  \ reorganisation of the payer, which will have to actively commission those health\
  \ services that citizens need in sufficient quantity and quality, with the aim of\
  \ avoiding waiting times and providing quality and safe services for all of us.\n\
  In the area of medicines, the Ministry of Health and the Health Insurance Fund have\
  \ also taken a number of measures in the last year. To mention just the public procurement\
  \ systems, price regulation for all medicines that do not enjoy patent protection,\
  \ non-discrimination between generics and originators, interaction between the pharmaceutical\
  \ industry and other stakeholders in healthcare; and further measures are in the\
  \ pipeline, such as reimbursement, generic prescribing, therapeutic parallels, renewable\
  \ and electronic prescriptions.\nAs regards the payment of contributions by employees,\
  \ the self-employed and farmers, it will be necessary to accept that contributions\
  \ to the health fund should be made in accordance with one's income and irrespective\
  \ of which category one belongs to. The contribution base for the self-employed\
  \ and farmers is currently determined according to the insured person's earnings,\
  \ which exclude the accrued contributions for compulsory health insurance and the\
  \ reduction and increase of the tax base, except for the difference in interest,\
  \ in accordance with the law governing personal income tax, provided that the tax\
  \ base does not exceed the minimum annual wage for employees in the Republic of\
  \ Slovenia, which is at least equal to the minimum wage. However, it should be borne\
  \ in mind when designing new solutions in the legislation that the amounts contributed\
  \ to the Treasury by self-employed entrepreneurs are below average, as most self-employed\
  \ people calculate their contributions on the minimum wage. This is not to say that\
  \ such a solution is illegal, because it is in line with the law. But we can ask\
  \ ourselves, is it really fair? Why should, for example, limited companies be allowed\
  \ to pay from the minimum wage? And where is the control? Is it true that most sole\
  \ traders are on the minimum wage? Although the consequences are being felt in the\
  \ health sector, this is not a problem that can be solved by the Ministry of Health,\
  \ but by the control of the tax administration. Data from a study by the Faculty\
  \ of Economics show that in 2008, private employees contributed EUR 565 less than\
  \ the average contribution to the NHIF, while private employees contributed EUR\
  \ 414 less than the average contribution. This means that employees are subsidising\
  \ the self-employed, farmers and other categories in these amounts. There are probably\
  \ several reasons for the discrepancies, as there are also several inequalities\
  \ between the different categories of persons liable for health contributions and\
  \ inequalities in the receipt of benefits under compulsory health insurance (upward\
  \ limitation of the base, entitlement to benefits in the event of non-payment of\
  \ contributions, etc.).\nTo your last paragraph: labour costs will be less burdensome\
  \ under the new system, but the disposable income left in the pocket will be higher.\
  \ And this with a higher contribution rate, a system without supplementary health\
  \ insurance and better access to health services. If you are interested in more\
  \ detailed information on income redistribution, payment levels now and then, you\
  \ can find it in the Health System Upgrade to 2020, published on the MoH website.\
  \ We are on the right track and we support and stand behind the proposed solution.\
  \  "
response date: 2011-07-12
response due date: null
sent date: 2011-05-20
title: PREVENT the increase in contributions to the EHIC
upvotes: 17
url: https://predlagam.vladi.si/predlog/1818
