Natalie Mets: Time to adopt universal health coverage

Natalie Mets.
Natalie Mets. Source: Private collection

To reduce medical treatment waiting times and provide both dental and mental health care, daring and smart decisions must be taken, writes Natalie Mets (SDE)

In Estonia, health insurance is a privilege rather than a social safety net that protects everyone. The Praxis survey revealed that these social protections do not cover 64,500 Estonians, among whom are platform workers and self-employed, among whom are 10,200 independent artists.

It is time for Estonia to adopt universal health insurance, a system in which all individuals have access to necessary medical care when needed.

In the most European Union and OECD countries, 99 percent of the population has access to free healthcare. Among these nations are Finland, Denmark, Georgia, Australia and a number of Asian and African states.

With 14 percent of its population uninsured, Estonia ranks among the bottom third of EU and OECD member nations. 

While universal health insurance is primarily concerned with freelance creatives with irregular incomes, the issue is increasingly affecting many others in new non-traditional working relationships in a rapidly evolving society. To keep up with a changing reality and protect all of its citizens, the state needs to adapt.

It appears that there is a lack of awareness about the fact that, while emergency medical care is guaranteed to all Estonians, it is also the most expensive form of treatment. People go to the emergency unit when their health condition has deteriorated to a critical level.

If a (universally) insured person visits a family doctor on a regular basis, it is possible to detect and treat a developing health condition at an early stage. This keeps the disease from worsening, improves the person's health and saves money for the health insurance fund.

According to the Estonian Health Insurance Fund, 31,319 uninsured people received treatment in the first half of 2022 and the state paid over €6,2 million in their bills, which is a 57 percent increase from the previous year (half-yearly comparison). The state incurs costs for treating all of its citizens anyway and this would be considerably lower under universal health insurance plan.

Alongside the implementation of national healthcare, the tax behavior of Estonians could be improved as well. This can be accomplished by enhancing the Tax and Customs Board's capacity to monitor tax collections and supervise the payment of taxes by both individuals and businesses, thereby putting an end to the current reality in which 22 percent of workers accept the payment of concealed (envelop -ed.) salaries.

The tax discussion will unavoidably begin this fall and healthcare funding will certainly play a significant role, as the current funding scheme is not sustainable.

Daring and smart decisions will be needed to shorten waiting lists and make dental and mental health care accessible.

Even if these steps appear stressful or unmanageable at first, they lead us closer to the goal of becoming a healthier and happier nation.


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Editor: Kristina Kersa

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