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Government of Slovak Republic has again discussed the creation of one state-owned health insurance company. Information about the fulfilling of the timetable of its implementing, does not state when the Ministry of Health Care could introduce the transformation law. The law which should have already been in force since May has not even been officially introduced by the ministry. When this will happen is not certain. According to the minister of health care Zuzana Zvolenská the law is ready, however, the date of proposing it is not determined yet because first it is necessary to resolve the question if financing. The tender for an advisor has not been announced yet as well. It should have already been finished until April. Ministry has already introduced its conditions and it should be announced after the disclosure of the law.

The health insurance company will change since the next year almost 110 000 people. The most successful in the re-insuring campaign was state-owned General Health Insurance Company (VšZP). Whereas in the preceding years the insured in VšZP were plummeting, VšZP will gain insured since 2014. Conversely, private Union health insurance company after many years for the first time has recorded a decline in the number of insured. As further stems from the results of re-insuring which were made public by Health Care Surveillance Authority (Úrad pre dohľad nad zdravotnou starostlivosťou – ÚDZS) compared to previous year the most insured, almost 10 000, will lose Union health insurance company. On the other hand, more than 9 000 insured will gain VšZP and 807 people will gain private health insurance company Dôvera. 

Project eHealth is financed from the operational program Informatization of Society (OPIS) which is controlled by Ministry of Finance (MoF). MoF requires the Ministry of Health Care to return 3.9 million euros which is ten percent of the amount which the European Union (EU) gave on eHealth. The reason is the clause in the contracts with two software companies from 2011. This was agreed and approved by the Ministry of Finance under Ivan Mikloš and later under Peter Kažimír described as unacceptable and refused to repay. New administration of MoF evaluated commissioning of new software orders by a common clause as a infringing the rules by which are governed the EU funds. Current minister of health care Zuzana Zvolenská judges the case as a failure of previous minister of health care Ivan Uhliarik.

Governmental analysts have for the first time admitted that the debt of hospitals will this year again exceed the level at which the past governments have already given up and paid the debts of hospitals from the budget. Institute for Financial Policy which belongs under the Ministry of Finance assumes that till the end of the year will the public hospitals have liabilities after maturity in the amount of 330 mil. euros, which is approximately 0.4 percent of GDP. Health care facilities owed at the end of October on premium to Social Insurance Company more than 79.9 million euros. Since the end of the last year have their accounts receivables increased by 31.2 mil euros. Accounts receivables towards state-owned health care facilities attained at the end of October 50.4 million euros. That means they have risen within a month by more than 2.4 million euros.

German court did not prove right the Slovak opinion when it confirmed that the arbitrage court did not have the competence. Up till now it is in force that government has to pay for the damage stemming from the prohibition of paying out the profit of private insurance companies from the times of first Fico’s government. The highest court of Germany will not deal with the request of Slovakia about judging the competency of arbitrage court which decided about the reimbursement of the owner of private insurance company Union. Hence Slovakia is one step closer to paying 22 million euros as the damages and 3 million for the court costs to the owner of insurance company, Dutch corporation Achmea. According to the decision both sides now have one month to make a statement about it. 

State-owned General Health Insurance Company (VśZP) will in the coming months examine how many of the physicians – specialists are available for the patients. And not only from the point of view of geographical availability but also capacity availability. The result should be that specialists will get conditions which they have to fulfil in order to obtain a contract with the insurance company. General Health Insurance Company will focus on the physicians who run their private outpatients’ department only on part time. At first sight is the network of specialized outpatients’ departments oversized, however, in reality patients many times cannot get an appointment with the physician when they need it. Therefore the director of General Health Insurance Company has stated that they will not contract the number of physicians but the scope of opening hours.

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.