Text file: 2159.txt
author: katja
downvotes: 0
end consideration date: 2011-12-02
id: '2159'
number comments: 11
number views: 4513
proposal type: Competent authority response
response: "Response from the Ministry of Health\nThe Ministry of Health, under the\
  \ mandate of Minister Maru\u0161i\u010D, prepared the \"Upgrading of the Health\
  \ System by 2020\", which foresaw the abolition of supplementary health insurance\
  \ and the payment of services in a reformed and redefined basket from only one source.\
  \ We have also prepared an analysis and proposal for a new financing method that\
  \ is more solidarity-based and equitable, to cover the loss of income due to the\
  \ abolition of supplementary insurance. Because of the rationalisations implemented\
  \ in the health system and because of the lower administrative costs (because there\
  \ would be no more insurance companies collecting the supplementary health insurance\
  \ premiums), the new proposed levy would raise less money and leave more income\
  \ for citizens, as the new levy would be lower for all citizens than the current\
  \ premium.\nIn the Upgrade, we have assumed that the financing of the basic basket\
  \ of rights will be fully covered by the compulsory health insurance. Other rights\
  \ not covered by the basic basket of rights will be covered privately. With the\
  \ abolition of supplementary health insurance (SHI), the full amount of the funds\
  \ used for claims in the insurance companies providing SHI will be collected through\
  \ a cash levy. The original proposal included an increase in the contribution rate\
  \ on the employee side (in line with the current premium payer, who is also an employee),\
  \ which also results in a shortfall in the income tax budget, and the proposal was\
  \ therefore adjusted towards the creation of a new cash levy.\nThe current basket\
  \ of entitlements is also covered by \u20AC350 million from supplementary health\
  \ insurance, which is the amount of the damages or resources that insurers actually\
  \ allocate to the health system and to citizens. If the same resources were transferred\
  \ to the public purse as are currently allocated to health by supplementary insurance,\
  \ citizens would be left with \u20AC35 million (2010 figures), the difference between\
  \ the premiums collected and the claims paid out. To improve access to health services,\
  \ we have proposed an appropriate redefinition of the basket in terms of ensuring\
  \ timely and geographically appropriate access to key health services, at the expense\
  \ of eliminating unnecessary services for citizens and rationalising and reorganising\
  \ the health system. The redefinition of the basket would be in terms of a rethinking\
  \ of the list of medicines, the exclusion of certain spa treatments that are not\
  \ part of a single treatment, the exclusion of those non-emergency ambulances that\
  \ are not medically indicated, and the transfer of the financing of social entitlements\
  \ to the social coffers. The health system would also be reorganised and the operations\
  \ of public health institutions rationalised (human resources, investment, integration\
  \ of institutions).\nAs citizens would no longer have to pay premiums for supplementary\
  \ health insurance, the rationalisation, reorganisation and redefinition of rights\
  \ would nevertheless not be sufficient to cover the gap that would be created by\
  \ the abolition of premiums, the missing funding for health would necessarily have\
  \ to be provided from public sources - either by raising the contribution rate of\
  \ employees, transferring the financing of certain rights to the budget or by introducing\
  \ a new levy, which has been shown to be the most acceptable in the analyses and\
  \ is therefore presented in more detail below.\nA levy to replace the supplementary\
  \ health insurance (SHI) premium is compulsory for all persons who have the status\
  \ of insured person in the compulsory health insurance and who voluntarily take\
  \ out SHI insurance in accordance with the current Law on Health Care and Health\
  \ Insurance (ZZVZZ).\nThe levy is statutory and compulsory and therefore has the\
  \ character of a public levy; the funds are collected in the social insurance fund\
  \ and therefore have the character of a public resource.\n3. The levy is a revenue\
  \ of the compulsory health insurance, which is implemented by the Health Insurance\
  \ Institution of Slovenia (ZZZS).\n4. The levy is paid out of the taxable person's\
  \ disposable income (after payment of contributions and taxes - net income).\n5.\
  \ The amount of the benefit is determined by the classification of the taxable persons\
  \ into classes on the basis of gross income; pensions are converted into gross amounts\
  \ for the purpose of classification into a benefit class and for comparability purposes.\n\
  6. The calculation of the amount of the levy is based on the resources needed, which\
  \ are estimated at EUR 262 million.\n7. The start-up costs for the introduction\
  \ of the new levy and the set-up of the system are not taken into account (they\
  \ will not be covered by the levy).\n8. The following variants of the amount of\
  \ the health levy are calculated under different assumptions:\nTable 1: Amounts\
  \ of the levy to cover the basic basket of health care entitlements under different\
  \ assumptions, in EUR\n \nBenefit classes\n Option 1\nOption 2\nOption 2 Option\
  \ 3\nOption 4\nup to 60% of the average salary\n12\n13\n13\n14,5\n60% to 140% of\
  \ average wage\n15\n15,5\n16\n14,5\n140% to 200% of average salary\n20\n22\n23\n\
  14,5\n200% of average wage and above\n25\n25\n25,5\n14,5\nTOTAL REVENUE (in million\
  \ euro)\n264,2\n263,3\n264,6\n263,0\n\n9.Assuming that \u20AC44 million is to be\
  \ provided for long-term care, the following variations of the amount of the long-term\
  \ care benefit are calculated under different assumptions:\nTable 2: Amounts of\
  \ the long-term care levy under different assumptions, in EUR\n \nBenefit classes\n\
  \ Option 1\nOption 2\nOption 2 Option 3\nOption 4\nup to 60% of the average salary\n\
  2\n2\n2\n2,5\n60% to 140% of average salary\n2,5\n2,5\n2,5\n2,5\n140% to 200% of\
  \ average salary\n4,5\n4,5\n5\n2,5\nfrom 200% of average salary onwards\n5\n5,5\n\
  5,5\n2,5\nTOTAL REVENUE (in million euro)\n46,2\n44,1\n44,2\n45,4\n\nDespite the\
  \ preparation, design and successful coordination on the government side, the health\
  \ system upgrade was unfortunately not completed due to the snap elections. We hope\
  \ that the next government will take into account all the analyses made and take\
  \ the health system in a direction that will first and foremost ensure the health\
  \ of the citizens of Slovenia, while taking into account the values on which the\
  \ upgrade is based: solidarity, equity, efficient and rational use of resources,\
  \ and stability of public financing."
response date: 2011-12-16
response due date: null
sent date: 2011-11-03
title: Supplementary health insurance should be abolished
upvotes: 24
url: https://predlagam.vladi.si/predlog/2159
