The health insurance system is built for those who work five days a week, nine to five; however, working relationships have evolved and the old approach is no longer suitable for everyone.

It has been suggested for years that the system for obtaining insurance from the Health Insurance Fund is out of date. The Estonian Artists' Association has raised the topic again (link in Estonian) in the hopes that there will be political will to solve the problem following the spring elections.

"The creative person's compensation is so low and sporadic that, after taxes, there is insufficient money to cover health insurance. You pay the tax and, in a striking example, you fall a few euros shy of the state's minimum and are denied medical care," head of the association Elin Kard said.

Despite the fact that the artists' association launched the campaign, Kard said that due to currently changing labor relations also platform employees, such as couriers and cab drivers, as well as small businesses and farmers are in the same predicament.

Labor and Health Minister Peep Peterson (SDE) said that the current healthcare system has to be changed as an increasing number of people cannot afford to be insured.

"The second issue is that fewer and fewer organizations contribute honestly and in full to the health insurance system so that there is a place to give care," added the minister.

Before the upcoming elections, the minister aims to propose a solution negotiated with employers and trade unions, so that lawmakers would have a sound foundation for resolving the issue.

"Clearly, not only should employment under a contract of employment be taxed, but income should be taxed regardless of its source. We cannot administer a health insurance fund only on the basis of traditional job relationships. A cashier at Maxima [supermarket] does not deserve to be solely responsible for the maintenance of the checkout system," Peterson said.

Aivar Sõerd (Reform), a member of the Finance Committee of the Riigikogu, said that providing healthcare insurance for everyone will cost an additional €38 million, which adds to the fact that the healthcare system is already underfunded.

"Abolishing the insurance principle means creating an undesirable incentive for evading the minimum social tax. The most typical envelope format involves declaring the minimum wage, deducting the minimum social tax and paying the remainder in an envelope," Sõerd said.

Speaking at the Center Party conference earlier this month, former Health Minister Tanel Kiik (Center) said that state health insurance should be expanded to cover 100,000 more people, which would in effect make universal healthcare a norm in Estonia.

Kiik's reasoning is that the co-payment burden for healthcare services is currently too high, and accounts for around 25 percent of total healthcare costs, considerably higher than that in many other European countries.

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