HPI

Health care facilities owed at the end of September on insurance for Social insurance company (SIC) more than 76.6 million euros. This means that since the end of the last year their accounts receivable rose by 27.9 million euros. It results from the information of Social insurance company to the government. Accounts receivable towards the government-run health facilities attained at the end of September 47.9 million euros. At the same time the health facilities owe to the suppliers of medical devices 92 million euros. Most of the liabilities represent the liabilities of government-run hospitals. Slovak Association of Medical Device Suppliers (SK-MED) claims that health care facilities by their action violate both the Business code and the European regulation on the fight against delayed payments.

The intention of the government to build a new hospital in Bratislava with the help of private capital appeals to investors. The willingness to cooperate has already been revealed by Penta, the entrepreneur Ivan Kmotrík and the company Medirex. All of them already do business in health sector. It will be the first teaching hospital in Slovakia where a private investor should enter. The construction of new health facility for 250 million euros has to be paid solely by the investor. The investment should be returned to the investor by long-term contracts with health insurance companies, which will be provided by the government. The investor should also administer the hospital for a pre-agreed time whereby the ministry would lose a part of its reach on the operation of the facility. However, it claims it does not mean privatization yet a PPP project.

Government will pay on health insurance contributions totally 1.15 billion euros next year. This is assumed in the budget proposal for 2014, which was approved by the government. Still it has to be passed in the parliament. Hence the down payments for the premium paid by government should in 2014 decline compared to the budget approved for this year by 111 million euros. Government also assumes that the number of insured will decrease from this year’s 3.15 million to next year’s 3.12 million. The exact rate for the government insured is not stated in the budget. According to minister of health Zuzana Zvolenská the rate is 4 percent. According to Peter Pažitný from HPI it equals by calculation only 3.82 percent.

The European Commission initiated an examination of whether the state gave its insurers illegal state aid. The initiative of investigation was given private insurance company Dôvera in April 2007. Already non-existent Joint health insurance company (JHIC) (Spoločná zdravotná poisťovňa) merged with the General Health Insurance Company (VšZP). The Commission examines the repayment of JHIC debt by state joint-stock company Veriteľ from 2004 to 2005. Debt was repaid in two instalments - one in the amount of 52.7 million euros and the other 28 million. According to Dôvera HIC, in 2006 JHIC should get subsidy from the Ministry of Health of € 7.6 million. The Commission examines also fact, that in 2010 state has paid capital increasing of amount € 65.1 million of General Health Insurance Company.

In the centre of Bratislava begins construction of a new building of Hospital of St. Michael, which belongs under the Ministry of Interior. Work on the hospital was officially opened by tapping on the foundation stone by Minister of Interior Robert Kaliňák, Minister of Health Zuzana Zvolenska and hospital director Marian Križko. The project, according to preliminary estimates, will require 49.7 million euros. Two thirds of this amount is earmarked for the construction of the building, the rest should be used for equipment. According to Kaliňák, the construction of a hospital will finance hospital by itself, seeing that the money for this purpose has already got more than five years from the state-owned assets.

Suppliers of hospital are losing patience once again. More and more claims against hospitals are selling to the specialist on their recovery. Only public hospitals already owed by such companies five million euros. Business with claims against hospitals can still grow, however, only large state hospitals have debts for 200 million euros. The same situation is in the smaller county hospitals. The biggest owner of such debt is company Magellan. It has claims against 40 Slovak hospitals. This company has also business in Poland and the Czech Republic, where has claims of fifty facilities. Since 2008 when it starts operate in the Czech Republic, according to chief of company Ladislav Valábek, have not led any execution against hospital.

Slovakia has from now a new broader list of diseases. The amendment of the Act on health care entered into force that spread the present. The modification of the list was the needed for the introduction of a new way of rewarding hospitals – DRG system. The legal standard also regulates the medical terminology according to current standards and practices. The amendment was pushed by Richard Raši of Smer-SD. He pointed out that in Slovakia was no revision of the International Classification of Diseases and Related Health Problems (ICD-10) since 1993. Since 2011 ran the preparation of revision of current version and expansion of new diagnoses or groups of diagnoses. Preparation of introducing a new way of rewarding hospitals is not under the original plan, the introduction is expected in 2016.

The first round of the tender for licenses for emergency ambulance did not end successfully for several regional hospitals. They have been replaced by private or state companies. Emergency ambulances (EMTs) are considered one of the most profitable areas in the health sector, so hospitals will probably miss the sources. Licences will be re redistributed after six years. As is clear from the published results of the tender, the licenses to operate 76 ambulances ground emergency medical services are reallocate among the LSE-Life Star Emergency, Falck Záchranná, Záchranná a dopravná zdravotnícka služba Bratislava and Záchranná služba Košice. Conversely, the licenses lost hospitals in Trstená, Čadca, Bojnice, Spišská Nová Ves, Myjava, Partizánske, Námestovo and Poprad. Regional Hospitals wish to appeal against the results of the first round of the tender for EMTs. 

8 July, 2013 was approved Transformation Act by board of the Minister of Health. Even in June, the Unitization Company had to ask Public Procurement Office to check upcoming procurement for consultant. Transformation Act, which would have been payable from May has not been official presented by ministry yet. When it does so, it is not clear. According to Communications Department of Ministry, the law is ready but the deadline for submission is unknown. Similarly, the public procurement which should come to an end in April was not pronounced yet. The Ministry has introduced its condition and pronouncement should be after the disclosure of mentioned Act.

By next year, the health sector should get over 1.3 billion euros from the state budget. As is clear from the state budget, most of this amount, nearly 1.21 billion euros should be payments for state-insured. According to the current draft, state plans to pay less for its policyholders next year. The rate should be at a basic level guaranteed by law – four per cent of the tax base. The proposal does not like the Health Insurance Association, Association of hospitals of Slovakia, Slovak Medical Chamber, Slovak Chamber of Nurses and Midwives and Medical Trade Union.