Joller stressed that while technological development helps cut costs in the healthcare system, no additional money can be put into the system until the areas where funds are "leaking out" have been addressed and rejected using reserves to cover permanent costs.

According to Joller, the root problem with healthcare funding lies in inefficiencies and leaks in the current system.

"My message from the very beginning of my term has been that if we put more money into a system that has holes in it, allowing the money to flow out, then that money will not buy us better health, but something else," Joller said, explaining the system's shortcomings. She said there are losses under the current system that may not be apparent to people outside the medical sector.

"I am an expert and I understand that someone who does not work in healthcare cannot see the places where money simply leaks out of the system," Joller said, referring to fellow "Reporteritund" radio show guest and former social affairs minister Tanel Kiik (SDE).

Joller said the Estonian Health Insurance Fund's reserves should not be tapped to cover deficits or permanent expenses such as sustained pay increases for medical professionals. "The Health Insurance Fund's reserve is intended for times when, for example, unemployment rises, the economy declines in some way or there is a new pandemic," Joller said, explaining the reserve's actual purpose. "By its very nature, it is not appropriate to use the reserve for permanent costs, such as pay increases. That is not sustainable."

Kiik, for his part, expressed concern that leaving the reserves untouched could reduce access to medical care.

"There is, in fact, still an expectation within the sector for additional funding or at the very least that the Health Insurance Fund's existing reserves can be used both to ensure pay increases and to cover other healthcare costs," Kiik said, disagreeing with Joller.

Kiik warned that failing to put more money into the system would have direct consequences for patients: "If the Health Insurance Fund's supervisory board has now decided to move toward balancing the budget without doing so, then the inevitable question is what will have to give. /.../ If there is no additional capacity, diagnoses will be delayed and treatment will be delayed. Ultimately, that simply means even more expensive treatment and potentially additional costs in the social care sector and elsewhere," Kiik said.

Despite the need to optimize spending, Joller said reducing medical services is not the answer. "Experience around the world shows that cutting services can have very serious consequences, which is why the Health Insurance Fund's position is that services will remain unchanged," he said.

Instead, savings are being sought in areas where advances in medicine have reduced costs over time, including laboratory services where prices can now be lowered.

"Laboratory services have changed enormously over time, which is why laboratory service rates were cut and that alone saved €24 million," Joller said. She added that new technologies have significantly reduced laboratories' staffing needs over the decades, making it possible to lower prices.

The ministry is also reviewing hospital network funding models with the aim of linking the services purchased to the actual medical needs of each region.

"We are not simply taking services away. Instead, we are looking at what residents of a particular region need most — for example, people in Ida-Viru County have more respiratory problems, while Southeast Estonia may have other issues," Joller said, explaining the planned changes.

Joller added that in the future, hospital funding will be more closely tailored to local health needs.

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