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Center whip: Two options for finding extra funding for Estonian healthcare

Tanel Kiik (Center).
Tanel Kiik (Center). Source: Siim Lõvi/ERR

Riigikogu Center Party whip Tanel Kiik sees two avenues for finding additional funding for healthcare – either allocating additional operational support to the Estonian Health Insurance Fund (Tervisekassa, EHIF) at the expense of other tax revenues, or increasing taxes.

Kiik told ERR that the unsustainability of the Estonian healthcare system's financing model has been pointed out for years already by the think tank Praxis, the Foresight Center as well as local and international healthcare organizations alike.

"We need a cross-party agreement to strengthen and to ensure the sustainable financing of a solidarity-based healthcare system," he said.

"Continuing with the current funding model would mean waiting lists for care getting longer, the healthcare worker shortage getting worse and people's copays going up – in short, the crumbling of the solidarity-based healthcare system," the former health minister warned. "This cannot be allowed."

Kiik said that both of Jüri Ratas' governments strengthened the country's solidarity-based healthcare system.

"During Minister of Health Jevgeni Ossinovski's (SDE) term, [the state] started paying health contribution taxes on behalf of non-working old-age pensioners as well, which brings hundreds of millions of additional funding to the sector," he recalled. "During my time as minister, we allocated an additional €540 million in operational support to the EHIF for the years 2021-2024, which has helped the healthcare sector to manage for now. Now it's time to take the next steps."

Broadly speaking, he said, there are two options for coming up with additional money for the sector.

"Allocating additional operational support to the EHIF at the expense of other tax revenues – such as the state paying health insurance taxes for children, the way it currently does for non-working old-age pensioners – or increase health insurance tax collection by broadening the tax base, i.e. the sources of income on which health insurance taxes are paid," Kiik described.

"Growing by the year is the number of people not working under traditional employment contracts and who often don't contribute to the common healthcare budget, but who need healthcare services like the rest of us," he pointed out. "Alongside a healthcare financing reform, health insurance should be ensured for all persons living in Estonia – meaning universal health insurance should be implemented as in the majority of other EU states."

Speaking in an appearance on ETV's "Esimene stuudio" last week, Minister of Health Riina Sikkut (SDE) said that the state is no longer able to maintain the Estonian healthcare system at its current level.

According to Sikkut, the country's healthcare system is facing a projected deficit of €170 million in 2025.

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Editor: Aili Vahtla

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