Working-age people who do not pay social tax would be most affected if a proposal is adopted to make health insurance mandatory for all.

A recent report showed just over 7 percent of Estonia's population lacks health insurance of any kind, the second worst figure in Europe on this metric. In terms of numbers, this is around 90,000 people.

While many people may not have private health insurance, all by-the-book wage earners will have state health insurance included in their payroll. The state similarly covers healthcare costs for minors and the elderly.

Despite this and the fact that health insurance is mandated by law, 10 percent of working-age women and 14 percent of working-age men remain uninsured.

Three healthcare experts proposed making health insurance properly mandatory, while placing responsibility for paying for it on individuals themselves - as is the case in, for instance, Lithuania and the Netherlands.

One of the three experts who contributed to the recent piece, Andres Võrk, noted that failure to pay would be revealed once the individual sought medical care, as they would be indebted to the state. If they were not earning and so were unable to pay, under the Võrk proposal the state would recover this debt if and when the person started earning an income – as happens, for instance, with child support payment defaulters.

As things stand, private health insurance premiums are calculated on the basis of average wages. Võrk proposed this change to, to be based on the minimum wage. This would at present lead to a monthly health insurance contribution of €115.

Finance Minister Jürgen Ligi (Reform), who is also a member of the Health Insurance Fund's (Tervisekassa) supervisory board, said the proposal for fully mandatory health insurance is a step in the right direction. However, the devil is in the detail, Ligi said.

"First, how do you ensure that everyone has sufficient ability to pay. Second, how do you avoid that type of insurance of convenience, where a person pays only the minimal amount yet still gets insured. Though it must be acknowledged that the problem has been identified correctly," the minister said.

Ligi said, however, he does not support the idea of tying private health insurance premiums to the minimum wage, as Võrk had suggested, on the grounds this could allow people to obtain coverage for lower payments than would be equitable.

Meanwhile, Isamaa's Tallinn deputy mayor and former government minister Riina Solman rejected the proposal wholesale, on the grounds of it being an added burden of payment at a time when people are already struggling with the cost of living.

"In the current situation, where the economic downturn has taken practically the last of many people's money, even €10 at the end of the month is significant. And if we are talking about a payment of €115 according to the calculations, then this would be an additional tax that many people simply cannot afford," said the deputy mayor of Tallinn.

When he was Minister of Social Affairs, a decade ago now, Social Democrats (SDE) MP Jevgeni Ossinovski proposed guaranteed health insurance for all residents of Estonia. Ossinovski said he did not find it reasonable to place that obligation on individuals themselves, as the uninsured are not a single homogeneous group.

This group includes the "conveniently uninsured" people Ligi referred to – those who could realistically afford health insurance but instead choose to take dividends and benefit from other tax advantages.

"In those cases, it would of course be viable, and reasonable, for the state to apply stronger pressure to ensure those people pay their social tax," the SDE MP said.

"Alongside such people, company owners for instance, have to be set people at a very different tier in society, however, according to Ossinovski. "This group also surely includes socially vulnerable people who would not be motivated to pay even if enforcement proceedings were initiated against them, and would instead respond in other ways. So the state is unlikely to recover that money."

Data shows that in the EU, only Romania has a higher proportion of uninsured people, when it comes to medical insurance, than does Estonia, while Estonia is also on this metric not far behind the U.S., often held up as an example of how not to have a functioning healthcare sector, at least when it comes to the poorest in society. Võrk was joined by health economists Triin Habicht and Kaija Kasekamp in arguing that making health insurance mandatory would resolve this issue.

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