Coalition-to-be will have to address healthcare funding challenge

A family doctor's waiting room.
A family doctor's waiting room. Source: Aili Vahtla/ERR

Since the Health Insurance Fund (Haigekassa) budget is set to be in the red to the tune of around €100 million next year, the embryonic Reform-Eesti 200-SDE coalition cannot put off the healthcare issue further, and indeed is set to discuss this next week, ETV news show "Aktuaalne kaamera" (AK) reported Friday.

Of possible solutions, Andres Võrk, analyst at the University of Tartu, told AK that he didn't think private health insurance was the way to go.

"I don't see any economic arguments there as to why we should introduce private health insurance," he said.

"However, there may be political considerations too, where a certain part of the population, who are netter off anyway - higher-paid professionals - are dissatisfied with the current organization of health care financing," Võrk went on.

Reform's Minister of Social Protection, Signe Riisalo, told AK that new sources of additional funding need to be sought, since the health fund is likely to see an even more significant deficit in the coming years.

Margus Tsahkna, from Eesti 200, meanwhile said that private health insurance provided by an employer was preferable.

"Currently, unfortunately, the system has gone in the direction of people purchasing access to health care, for money," Tsahkna said.

"What we want to do is to place the [healthcare] solidarity system into the same picture as private financing. This is the first level, where the family doctor acts as 'gatekeeper', referring patients, while the pot of money gets larger. /.. ./ We are not reinventing the wheel, but rather we are looking at how we can obtain more money for the healthcare system," Tsahkna, a former defense minister, continued.

While Eesti 200 finds private health insurance a solution, the Social Democrats do not.

Jevgeni Ossinovski, the party's former health minister, said that while the agreement between the three parties right now is that the existing health care financing model must be reviewed throughout this year, "The Social Democrats are creators and maintainers of the solidarity-based health care system, and we will certainly not be going along with proposals that increase inequality within the health care system," Ossinovski told AK.

So far, previous administrations had been able to sidestep the issue, but this is no longer the case

The current, solidarity-based health insurance works on the principle that wage earners pay not only for themselves, but also for the treatment of their children and the elderly. 

With an aging society and a shrinking taxpayer base, covering current medical costs is already challenging, before service price rises likely in future are factored in, AK reported.

Andres Võrk at the University of Tartu said that higher wage-earners prefer to pay for their own private health insurance, rather than seeing the tax burden rise via increased social or income tax rates.

The coalition negotiations are now in their fourth week.


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Editor: Andrew Whyte, Merili Nael

Source: 'Aktuaalne kaamera'

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