Abstract
Issue/problem
Slovenia maintains its specific type of voluntary health insurance, which is actually a complementary health insurance (CHI). The main criticism against it was in its regressivity as the premium is flat-rate, equal for all insured.
Description of the problem
The share of CHE in total health expenditure (THE) has been growing until recently and now represents roughly 15% of THE. Even if remains an important source of financing, there are still pressures to abolish it. The present government again set its abolishment as one of the priorities. As much as it is regressive in essence, some of the negative effects of regresivity were offset by the State stepping in by paying the copayments for those citizens who are in need of social cash benefits.
Results
CHI contributed to the stability of the funding of Slovenia’s health care system. The space for the increases has become very limited as it covers up to 90% of the price in the case of many medicines, several dental procedures, rehabilitation and similar services. That means that additional increases with offsets to CHI from the compulsory health insurance are not possible. When the need for these emerges, CHI will not be a solution anymore, which means that an alternative needs to be found. From the several options we explored, the most probable is a gradual increase in the compulsory health insurance contributions.
Conclusions
CHI in Slovenia remains a controversial topic although its criticism has lost edge recently. Partly, this was due to the clear demonstration of its contribution to the stabilisation of the THE in the times of austerity. On the other hand, the mass of money in the compulsory health insurance has increased due to the economic growth and the need to offset costs to CHI was reduced. But, as there is little space left for such actions with the new crisis, a clear scenario on how to address the need for additional funds in the health care system is needed.
Key messages
Complementary health insurance contributed to the stability of health expenditure during crisis. The main alternative to CHI is its full inclusion into the compulsory health insurance.
Household Catastrophic Health Expenditure and Unmet Needs depending on the Types of Health Care System