—
News
According to analyses of Transparency International Slovakia (TIS), Ministry of Health decides which drugs will be covered by health insurance not always in accordance with applicable regulations. TIS analysis points out that half of the applications for new drugs in the past year have not been settled up within the statutory period of six months; the ministry generally lacked expert opinions, and never once was assessing the cost-effectiveness and impact on public finances, despite the fact that the law requires it. Health insurance companies paid annually on drugs 850 million euros, what represents about a third of the total cost on health care from public sources. The analysis examined the categorization of drugs for about one year.
Hospitals, which will do more surgery, will get more money. For each patient after surgery in 18 selected surgical disciplines should get hundred euros extra. This is new philosophy of funding by General Health Insurance Company (VšZP) which should be valid from April this year. This new way of funding is relevant for all university, teaching and general hospitals. The aim of this measure is to decrease the waiting times. State General Health Insurance Company also wants to check the evidence for waiting lists in hospitals. If it finds that some patients are preferred or there is mess in evidence, hospital receives a fine. If hospital fails to dispose patient from evidence, at first notify the provider and after repeated warnings, the hospital may not gets paid for the surgery or gets paid only part of it.
Health insurance companies will return for the fourth quarter of 2012 hundreds of thousands euros for surcharges for thousands of disabled and retired patients. Policyholders will receive the money automatically to the account, so there is no need to apply for them. General Health Insurance Company will send back surcharges for pharmaceuticals to 23.517 policyholders, in amount € 448.206. Health Insurance company Dôvera will send back surcharges for pharmaceuticals to 5.886 policyholders, in total amount of 112.213 euros. Union Health Insurance Company will return to 1.500 policyholders the payments in total amount of more than € 30.600.
The issue of overtimes of doctors in hospitals remains unresolved. Trade unionists are asking for comprehensive solution. The proposal, they offer, however, according to the Minister of Health Zuzana Zvolenska, does not solve anything. There is no agreement; however, patients should not be endangered. Both sides, though they have not found a common solution of overtime issue, confirmed that doctors’ services are secured for now. Medical Trade Union justifies the request for solution of overtime issue by the effort of cleaning the chaos in the service schedules. Unions asked for determination of maximum overtimes for physician per month.
Prime Minister Robert Fico admitted that one insurance company does not have to be in January 2014, as the government planned. Minister Zuzana Zvolenska says that the planned date of one insurance company is still real. The plan of project is written that from May will be valid a new Act of transformation and by the end of this month will be finished the public procurement on advisor for the project. However, Ministry has not started the selection procedure and has not introduced the proposal of new law. Approval of new Act takes about three to four months. Ministry of Health Zuzana Zvolenska promised that this deadline will not be shortened. Submission of an Act of transformation and public procurement on advisor to the Ministry is expected in the coming days. When exactly it will be Ministry did not say.
Debt of medical facilities on unpaid premiums to the Social Insurance Company reached at the end of February 55.1 million euros. Compared to the end of 2012, there was an increase in receivables of € 6.4 million. Debts of facilities in the scope of Ministry of Health represented at end of the February more than 56.2 per cent of total assets, i.e. 31 million euros. Compared to January, the debts increased by more than 2.5 million euros. Transformed medical facilities have debt of € 24.1 million. Compared with the previous month, receivables of these medical facilities increased by almost 700.000 euros.
Staff members of hospital who owe to Social Insurance Company on outstanding contributions do not have to be worried. According to spokesman of Social Insurance Company, they are entitled to a benefit from Social Security even if the employer unpaid the premiums.
DRG system, more transparent and equitable system of hospital payments, should work in 2016. Since April the Healthcare Surveillance Authority will start to train people. Training of nearly 3.200 people wants to catch by the end of next year. Trainings will cost more than seven million euros and should be paid mainly from EU funds. Eight people have been already trained in Germany, in a country whose DRG model we assume. The model will cost 1.4 million euros. The introduction of the new system is perceived positively by several hospitals and health insurance companies.
Materials for teaching health professionals who will be responsible for the launch of a new system of financing hospitals in practice are ready. However, the legislation is still lacking. Without it, according to the President of Healthcare Surveillance Authority Monika Pažinková, it cannot start.
Minister of Health Zuzana Zvolenska wants the public hospitals were in balanced economy in 2015. Ministry of Health wants to erase debts in next two years in its 13 facilities – the big university and teaching hospitals. Late last year, these hospitals owed about 320 million euros. Half of this amount consisted of overdue liabilities. How long hospitals pay invoices, the ministry does not know. Suppliers complain about long, even several years repayment period. Ministry wants to make hospitals align their management especially by layoffs, buying cheaper medicines, reducing operating costs and increase the charges.
Reducing the loss of public hospitals began Ministry of Health already last. Loss of 156 million euros, according to Minister Zvolenska, hospitals cut to 116 million last year.
According to data from the National Registry of healthcare workers (NR HW), at the end of 2010 the 3.704 of more than 18 thousand doctors in Slovakia have had total working time employment in the medical profession "doctor and dentist" greater than 1.0. This means that almost one fifth of Slovak doctors can do medical work for other employers alongside overtimes and emergency services in their main job. Most full-time jobs in the medical profession doctor and dentist had at the end of 2010 doctor with 3.5 full-time jobs. He would have to work 28 hours a day. Most labour relations had doctor who has been registered to 7 active legal relationships with various employers. NR HW listed more than one employment relationship by 4.074 doctors, what represents 21.7%. In these numbers are not included working time employments outside the medical profession, such teaching activities at the university, scientific and research activities for pharmaceutical companies and various business activities.
Government has approved the proposal of Act on National Health Information System (NHIS) made by the Ministry of Health. As can be seen from the material, policyholders should get a health insurance card with an electronic chip until the end of 2015. Electronization of Health care should cost this year 1.2 million euros. Money should be used to cover the operator's license of eHealth, support of legislative team and operating costs for the NHIS. Operation of the NHIS will require addition € 3.9 million this year. In the next year it will be 9.3 million and in 2015 and 2016 it should be € 9.5 million.
Ministry of Health Zuzana Zvolenska said that they want to re-examine whether it is possible to somehow combine the issue of identity cards with an electronic chip and access to eHealth. ID cards could be merging with health insurance cards in the future. About this option should negotiate ministries of Health, Finance and Interior.
