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Government approved the draft of terms of the public procurement for the counsellor for the introduction of a unitary system of public health insurance. The counsellor should appreciate for example the value of private health insurance companies. As can be seen from the material, conditions are set so that participate on procurement can only firms with experience. More concrete, they must have had at least three contracts in the last three years, for which received at least half a million. The condition of high rewards is not liked by more lawyers. Reward for counsellor may vary at three million. The Ministry of Health justified the price by the fact that such large and complex transactions require the participation of a qualified counsellor with human and technical capacities, and sufficient expertise. Counsellor should be known in August. Contracting authority is Company for introduction of unitary system of public health insurance.

Medical facilities owed to Social Insurance Company at the end of April 2013 on unpaid premium over € 61.5 million. Since the end of last year is it an increase of more than 12.8 million euros. Receivables of state medical facilities have reached the end of April more than € 35.9 mil.; i.e. 58.4 per cent of the total receivables. Compared with the previous month it increased by 4.5 million. Despite the fact, their debts were paid by State at the end of 2011. Transformed health care facilities owed  to Social Insurance Company more than € 25.5 million. Compared with the previous month, debts increased by 1.4 million. Spokeswoman of Ministry said that the Ministry of Health monitors the development of the debt in Social Insurance Company. 

Association of Hospital in Slovakia (AHS) has recommended to hospitals which associate to not sign the contracts with health insurance company Union. Association attitude will change only if the smallest private health insurance company Union raises payments to hospitals for five to ten per cent. This condition is based on the attitude of the state General Health Insurance Company (Všeobecná zdravotná poisťovňa – VšZP), which stated that if the amount of the payments by competitor will not be the same, the company will withdraw contracts with hospitals. Lower payments to hospitals currently give only health insurance company Union. General Health Insurance Company (GHIC) submits a proposal for new terms and conditions to AHS. In it is included the condition that if hospital will have a contract with an insurance company competitive with lower prices for finished hospitalization than is paid by General Health Insurance Company, GHIC will pays only the price of competition. 

By June 1, 2013 is it 10 years after the introduction of "20 and 50 crown" fees in health care, so-called „zajacovky“. Anniversary commemorated at a press conference former members of the reform team of Minister Rudolf Zajac, who now operate in Health Policy Institute (HPI). According to Director of HPI Peter Pažitný, the main reasons for introducing of fees a decade ago were: to limit excessive demand for health care, to increase patient co-responsibility for own health, to reduce corruption. Although the objectives of the introduction of fees were fulfilled, unpopularity made them the subject of political struggle. After elections in 2006, the government runs down the most of the fees. If the fees were reintroduced at the same rate today, it could bring overall more than € 115 million per year into the health care sector. Nowadays, outpatient doctors who charges fees, do not use cash registers and how much they earn by fees no one knows.

Government approved the proposal that guarantees next stage of increasing the salaries of doctors. The proposal of amendment to the Act on Health Insurance, which modify the salaries, is based on an agreement between the Minister of Health and Medical Trade Unions association. Salaries of doctors will rise two times. Necessary funds for increasing of salaries must find hospitals by themselves, whereas for this purpose are not allocated any special resources. Small and medium-sized hospitals associated under the Association of Hospitals of Slovakia (AHS) do not have money for further increasing the salaries. AHS therefore wants to initiate negotiations with insurance companies to raise funds for small and medium-sized hospitals. Since January 2014, salaries should increase on 1.25-fold of the average national wage for the doctors without attestation and 2.1-fold for the doctors with attestation.

Nurses are increasingly demanding higher wages, but so far without success. While the doctors’ salaries have increased twice already and further increase will continue next year, nurses are rewarded as before. The current law, which guaranteed them a wage increasing, was suspended last year by the Constitutional Court. Nurses again plan to solve the wage issue directly with the Minister of Health Zuzana Zvolenská. Slovak Chamber of Nurses and Midwives wants to reach her this week. The Ministry of Health states that nurses’ salaries have been increased last year. In the words of her spokesman, the state hospitals fully respected the requirements of nurses.

Slovak Medical Chamber do not like the proposed legislative changes which tighten the integrity of health workers and bring the threat of prison, fines or loss of licence for those who during the state of emergency will not come to work. The proposed changes considered the chamber as unjustifiable interference with the fundamental rights of health workers to practice their profession. The head of the Slovak Medical Chamber Marian Kollar said that the parliamentary proposal to revise the Criminal Code is not intended to ensure the performance of work during the crisis, but is only "a baton for health professionals“. Chairman of Medical Trade Unions Peter Visolajský argues that laws containing the threat of imprisonment, fines and loss of licence are only the impetus for doctors to go abroad, what can harm the patients. Spokeswoman of Ministry of Health said that there is no criminalization of doctors, but if doctor during the crisis intentionally harm the patient, he must take the appropriate sanctions. 

If and when will be the one state insurance company, is uncertain. Since the beginning of May should came into force Act, which is necessary for its implementation. However, Ministry of Health has not yet given the Act to the commentary proceeding. "It will be soon," claims Minister of Health Zuzana Zvolenska for several weeks. According to the original schedule, approved by the Government, this Act should have already become effective from 1st May. From December to April the state should chose a consultant who can valuate the insurance companies. The choosing process even did not begin. Why is it so, the Ministry does not say. Although Zvolenska plan is late, she promises that the Act will be not accepted by accelerated procedure. Dates are according to the spokeswoman only preliminary and final date of introduction of one state insurance company will be right on time.

Debt in health care (measured as overdue liabilities) reached at the end of last year € 213 million. Liabilities of state facilities amounted 141.7 million euros, representing an increase of 72.3 million. The largest part of the debt and generate teaching and university hospitals, with the exception of hospital in Nitra. Health care facilities transformed into joint stock companies, which do not show any overdue liabilities. According to estimation by Health Policy Institute (HPI), at the end of the year 2013 may debt exceed amount of 300 million. €. From previous experience, HPI consider this limit from the view of suppliers’ patience as critical. Therefore HPI assume that in 2014 will be needed another debt elimination of hospitals.

Pokus