Rising medical costs are putting a strain on Slovakia’s health insurers, with the state-run General Health Insurance Company (VšZP) the hardest hit, with a projected year-end loss of €169 million.
The Health Surveillance Agency (ÚDZS) has warned of the potential negative consequences and asked VšZP to present measures that would allow the losses to be recovered without affecting insured persons or health care providers.
According to ÚDZS, the resource shortage does not affect all three health insurers equally.
State-owned enterprises under pressure
Two private health insurers are also expecting losses in 2024: Dovera expects losses of €70 million and Union €17 million, but have enough funds to cover all claims of insureds and providers. They estimate that this year’s revenues will not be able to fully cover expected expenses, but state funding for the sector last year has ensured sufficient cash reserves.
The real problem lies with VšZP, of which the state is the only shareholder.
“This issue is urgent. If effective measures are not taken, the expectations of healthcare providers may not be met. On behalf of ÚDZS, I can say that we are ready to actively participate in solutions that will serve the entire industry,” said ÚDZS Chairman Michal Palković.
Palkovic and ÚDZS are in negotiations with VšZP management to determine next steps to de-escalate the situation.
Health Minister Zuzana Dorinková said she had been in contact with the heads of VšZP and ÚDZS regarding the current economic situation of the largest and only state-owned health insurer.
“Following the ÚDZS conclusions, I am waiting for the presentation of recovery measures by VšZP, which I believe will be presented within the next few days. As soon as we know the proposed measures, I will inform you about the next steps regarding VšZP’s financial stabilization,” Minister Dríncová added.
The ministry did not respond to EuraActive’s questions.
Response of VšZP
The health insurance company has expressed its determination to gradually reduce losses: together with ÚDZS, it has set up a working group to monitor the economic development of VšZP, identify the most at-risk areas and propose measures, which will then be implemented and evaluated.
According to a VšZP statement, the estimated loss was mainly due to rising healthcare costs, which “are forecast to increase by more than EUR 220 million across all segments, with the costs of medicines and medical equipment expected to increase by EUR 78 million, inpatient healthcare costs by EUR 81 million and outpatient healthcare costs by EUR 34 million.”
Proposed measures are insufficient
ÚDZS received the proposed measures but found them insufficient and asked VšZP to amend them.
“We expect VšZP to come up with measures that are in line with the consolidation of public resources. At the same time, we believe there is still room to introduce cost-cutting measures so that the state insurance company’s operations become truly efficient,” Palkovic told TASR.
Recurring issues
Year-end deficits at state health insurers have plagued Slovakia’s health care system for years, across several governments and health ministers.
The Ministry of Health has traditionally solved this problem by providing additional funding to VšZP.
ÚDZS believes that before discussing additional funding for health insurers beyond the approved budget, efforts should be made to find internal reserves and improve long-term efficiency.
“Recurring issues of resource shortages are in part due to deficiencies in the budgeting and regulatory framework and will need to be addressed. ÚDZS therefore welcomes the Ministry of Health’s intention to establish a Health Budget Committee to address these issues on a regular basis and continuously assess the situation,” ÚDZS said in a statement.
Opposition lawmakers Jana Bit-Ciganikova and Tomáš Szalay, both from the Liberal and Solidarity parties, also rejected the idea that the government should again subsidise insurance companies.
According to Bit Ciganikova, it is unfair to provide additional funds only to VšZP: “What kind of system is this where money that should be used for healthcare is only used to subsidize incompetent appointees at the state insurance company?”
Euraactive asked the Ministry of Health to elaborate on the possible measures it was considering and how the problem could be resolved in the long term, to which the Ministry simply replied that it was “focusing on the situation with VšZP and will report back afterwards.” [the public] About solutions.”
[By Filip Áč, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]
