The measure has been put forward after reviewing the Ministry of Social Affairs' area of administration, she said. The issue has already been raised with the Estonian Health Insurance Fund (Tervisekassa).

"Budget negotiations will continue in the government on Tuesday, where I will also present this proposal to the government, after which it will be agreed how much the visitor's fee will increase," said the minister.

"The health insurance fund is still calculating [what increases are needed]. Co-payments in health care are different and the overall co-payment rate is high. You can't raise it uniformly for everyone, whether by five, 10 or whatever euros. There needs to be a slightly smarter scheme to allow the burden of co-payment to shift from those groups whose co-payments are currently very high to those for whom it is relatively easier to bear that burden," said Sikkut.

Sikkut said the general idea is to protect vulnerable groups: children, the elderly, people claiming benefits, and the unemployed. "People who find it difficult to pay this fee – they must also be granted an exemption or a lower co-payment," the minister outlined.

"Co-payments are already very high in Estonia's health care system, so you cannot raise them for everyone in the same way, but just as we can see with the cap on sick days, it is possible in a difficult budgetary situation to target the benefit better and cap it for the wealthy, so it is with co-payments," said Sikkut.

The SDE politician highlighted areas in the Estonian healthcare system where the co-payment is already very high at 15 percent.

"Clearly there are places where it is necessary to bring down the co-payment. At the same time, there are people who visit a specialist doctor only once or who take prescription medicines – we propose to increase their co-payments. I am talking about shifting the burden of co-payment from those groups who cannot afford to pay the current level of co-payment to those who have better incomes and better health," she said.

Treatment co-payment will increase this year

Sikkut said the average patient co-payment percentage in health care is almost 14 percent in Europe, with 15 percent being the international recommended limit. However, in Estonia last year it was 23 percent.

"It seems likely that the co-payment rate will rise to 24 percent already this year. We are above international recommendations. Co-payments can be reduced by increasing generosity, i.e. by allowing more for tax money: be it cheaper prescription drugs, higher dental benefits, etc. This is what we would like to do in the area of health, and this is why, in the long term, more tax money should be directed to health," said Sikkut.

The minister's proposal has been for the state to pay 13 percent of children's minimum wages to the health fund.

"In this way, substantive concerns could be addressed, be they the succession of health professionals, the high co-payment burden, or the continuing high number of uninsured and underinsured," said Sikkut.

The government decided there would be no additional money for health care next year.

"Where we put the extra money was agreed in the coalition talks and the focus was only on security, that is, defense spending and internal security. We in the government did not agree on additional spending on health care, which is undoubtedly very important so that we have these healthy people who are motivated to defend Estonia. So in these budget negotiations, we will not make a decision on additional health care funding," said Sikkut.

There are plans to use reserves to cover the Health Fund's budget deficit. However, this can only be done if the government grants permission.

"Reserves are built up in the Health Fund specifically for difficult times. If economic growth falls, which eats into social tax receipts, or if some other circumstance prevents revenues from being maintained, services or medicines cannot be taken away from people overnight," said Sikkut.

--

Follow ERR News on Facebook and Twitter and never miss an update!