Parties making healthcare pledges, less clear where funding will come from

A hospital bed.
A hospital bed. Source: Olev Kenk/ERR

In the run up to the March 5 Riigikogu election, all the major political parties have pledged to shorten treatment wait lines and to provide more effective medical care in more outlying areas of the country. At the same time, little has been said about the sources of this funding, ETV news show "Aktuaalne kaamera" (AK) reported Monday.

Almost all the parties have also stressed that the family doctor system needs additional funding and staffing, while the specter of further shortages in funding of tens or even hundreds of millions of euros in the coming years is also looming, AK said.

The more laissez-faire oriented parties, namely Reform, Isamaa, Eesti 200 and Parempoolsed, say that the private sector and private health insurance should be leaned on more.

Isamaa's secretary general, Priit Sibul, told AK that: "The current system no longer works, and it makes no sense for us to lower the bar."

"In any case, resources are lacking in health care, but if there are people who are ready to pay extra, it makes no sense to lower the threshold to the extent that everyone has long wait times, and suffers," Sibul went on.

Isamaa, Eesti 200 and Reform all consider preparing personal healthcare plans also, which, Sibul said, should mean those not signed up to that plan (in terms of looking after their own health) should pay more in their premiums.

Those who stick to the plan and doctors' recommendations would see lower health insurance premiums, he added.

Diana Ingerainen, a family doctor who is also running for Eesti 200 on March 5, it is important to change the Estonian healthcare system, according to her, the problem is not so much the lack of money or doctors, but the courage to make a decision.

She said: "We have to look at everything together: Ambulances, ER, hospitals, family doctor's pharmacies etc. all in the one system, and organize this network so that it meets the health needs of our people."

Meanwhile, Social Democratic Party (SDE) Health Minister Peep Peterson, also running in the election, said: "The most important thing for us is that we fix the financing model, and make it sustainable," adding that the national health insurance system was in need of an overhaul.

University of Tartu Professor Ruth Kalda told AK that going down the private route would lead to a rise in preexisting inequalities in the Estonian healthcare system, as many people have no options for buying their way up the wait line, as it were.

Kalda, who was particularly prominent in the media during the Covid pandemic, told AK that: "We certainly have a large number of health care workers, but their number is not being added to so quickly."

"If we bring more private companies to the market today, it will absorb quite a lot of health care workers from this health insurance system anyway. We have a large number of service providers, who will not be added to. I am afraid that this prolongs queues and the availability of treatment for others," she went on.

Of the other specific party pre-election pledges, the Conservative People's Party of Estonia (EKRE) has promised more funding key to the family doctor system, free basic dental care once per year for those who are insured, and also wants to stop the finance of abortions from the health insurance fund budget.

Reform would place a greater role on nurses in the healthcare system, would hire more doctors from outside Estonia, providing them with the necessary language and other training, and set up the personal healthcare plan noted above.

Center says it will provide additional money to health care, develop and maintain at least one hospital in each of Estonia's 15 counties, and increase enrollment in both medical and nursing education.

The Greens pledge to increase health care spend to 9 percent of GDP, reduce patient co-payments for prescription drugs, and charge double the visit fee for those who fail to show up at an appointment.

Parempoolsed say they want to direct more of the money from the Health Insurance Fund (Haigekassa) to private medical institutions, boosting people's personal responsibility and private health insurance.


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Editor: Andrew Whyte, Marko Tooming

Source: 'Aktuaalne kaamera'

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