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New health minister doesn't support incentive-based or private health care

Minister of Health and Labour Riina Sikkut (SDE).
Minister of Health and Labour Riina Sikkut (SDE). Source: ERR

Minister of Health and Labour Riina Sikkut (SDE), sworn in earlier this week, does not support changing Estonia's health care system away from the current solidarity-based model. Sikkut rejects the idea of a new model based on punishing people for unhealthy lifestyle choices as well as the state getting private companies to run its insurance funds.

Sikkut pointed to the killer argument in favor of state-run healthcare, namely that the administrative cost of less than 1 percent of state-run funds couldn't be matched by any private provider, not even talking about the privates also wanting to make a profit.

In her interview with daily Postimees published on Friday, Sikkut also commented on Thursday's manifesto published by the Eesti 200 group, a new and so far non-partisan political initiative (ERR News reported). The manifesto calls for a new approach to health care that would reward healthy lifestyles.

"Solidarity and health care is my favorite topic, it's what I've studied and analyzed. My conviction has only grown that this is the best solution for the financing of health care," Sikkut told the paper.

A system that rewarded some and punished others for the way they lead their lives is hard to imagine within the established values of Western-European societies, the minister added.

"A classical insurance system takes individual risk into account. This means that if you have a chronic disease, if you are old, if you've had some accident, if you have a disability, it's very difficult to get insurance on the private market. In the United States there are whole social groups that private insurers won't cover," Sikkut said.

Tying the health care system to rewards and punishment regarding lifestyles isn't viable either: "It isn't fair to punish someone for choices made decades ago, or for things that they hardly control themselves," Sikkut argued. "In my opinion it's very hard to decide not to cover smokers' health care costs, but to cover those of extreme athletes because sport is good for you. But who is more likely to end up in intensive care?" Sikkut asked.

Introducing such a system would inevitably hit people hard whose current state of health was caused by decisions made a long time ago. "How can we decide to punish past behavior? Could be the health lessons someone received in school didn't offer the right information, could be they couldn't afford to live well. To tell them now to cover their health care expenses themselves or do more about it in my opinion is unfair," the minister added.

The current system where society invested in its health collectively saves people from having to worry about every tiny health problem, and from the permanent fear of potentially being unable to cover treatment expenses.

Editor: Dario Cavegn

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