IntoBalance 09/2008 (english)

Svet zdravia continues with organization changes in its ten hospitals. Company Svet zdravia owned by investment group Penta, after operational changes and centralization of management of hospitals in Košice, is planning to change their medical focus. In approximately half of the year could be created new specialized operational centers for ophthalmology, oncology, neurology and neonatology in the eastern part of Slovakia. Since the takeover of hospitals by Svet zdravia the many directors of hospitals were changed. Penta is also negotiating the takeover of hospitals in neighbouring countries and hopes that in Slovakia will be more acquisitions in the near future. 

Agreement between physicians and management of Hospital of Žilina is threatened. Doctors currently claims that they will terminate an agreement, if Hospital release more than seven doctors per year; if someone submits a complaint to the doctor who fought for his rights; if the director due to organizational changes will close or concatenate departments without the adjustment of trade unions and if director will prohibit employees to publicly express an opinion on the operation of the hospital. According to Minister of Health Zuzana Zvolenska, making another and new conditions for the implementation of the agreement is wrong and she believes that this is just some misunderstanding.

The second attempt to get a report on Arbitration by the opposition party SDKÚ failed. SDKÚ required submission of report on a lost arbitration with shareholders of Union health insurance company to Parliament. For proposal of SDKÚ party leader Pavol Frešo voted only 59 of 142 attending members. The first request for a report did not pass the on Tuesday. For the second attempt Frešo has decided in the light of new information that Slovakia may lose in arbitration up to € 750 million. According to Chairman of SDKU Frešo, Government have to inform the public through the members of Parliament about the real state of Arbitration.

Willem van Duin, chief of Achmea, thinks that for Slovakia would be most reasonable to pay for lose Arbitrage as soon as possible, because every month of delay must pay a penalty of 50-thousand euros. Slovakia, according to W. van Duin, could challenge only serious procedural violation, however, it has already tried to and did not succeed. Arbitral tribunal itself was chosen strictly by international rules Uncitral: one arbitrator was chosen by Slovakia, the second by Achmea and both of them chose the president of the court. As said van Duin, the decision was unanimous and he cannot imagine that Slovakia, as the rule of law and a member of EU, refused to pay.

According to the statement of Minister of Health Zuzana Zvolenska, government will not get healthcare into debt by creating a single health insurance company. To purchase or expropriate private health insurance companies will not use money intended for providers and patients. She has responded to the former Minister of Health Ivan Uhliarik (KDH), who said that any government has no right to debt the healthcare for decades. Zvolenská advocates creation of a unitary health system by argument that new system will provide greater satisfaction with healthcare. Plurality system, according to her, brought only chaos. Zvolenska also stated that in case of creating a one health insurance company is not worried of arbitration.

Analysis of Institute for Financial Policy (IFP) on the effectiveness of Slovak healthcare, according to Association of Health Insurance Companies, confirmed that a unitary system of public health insurance will not save the system Association of Health Insurance Companies appreciated that state brought to debate technical arguments. President of Association Katarína Kafková said that until now it was only about political statements and enjoy that Ministry of Finance admits that the announced expropriation will not solve the problems of Slovak health care. As she noted, the analysis could not clearly identify the reasons why the increasing of resources in health care did not manifest in better health. She also pointed out that the analysis also proved greater efficiency of private health insurance companies.

The problem of Slovak health care is not about whether there is one or are more insurance companies, but its effectiveness and in defining of legal rights of policyholders on what they have covered by public health insurance. It is a politically sensitive issue, said in a discussion former Minister of Health Rudolf Zajac. According to Zajac, we can expect the nationalization or creating a state monopoly of distribution companies and also the state monopoly on pharmacies because the drug policy creates far more profits than health insurance companies. As he also noted, we can also be witness of the nationalization of private doctors and private hospitals, because of they are making profit.

For surgery are waiting at the end of the year more patients of General Health Insurance Company than in September. And despite of a public promise that gave the director of insurance company Marcel Forai in September that insurance company will reimburse to hospitals all costs of medical care to ensure that on waiting list will be any patient by the end of this year. In September 2012, there were 6.706 policyholders on waiting list; today it is around seven thousand.

According to the survey by the Institute for Public Affairs and Agency Focus, cancellation of plurality health insurance system and introduction of one insurance company considered as right 41% of Slovaks and 46% wrong. Did not kwon 13% of respondents. Approval of the introduction of a unitary system of public health insurance is supported by less educated people; workers in unskilled manual professions and people older than 65. Significantly more critical are people with higher education, performing skilled professions, such as students and businessmen, and residents of big cities. With unitary system agree mainly supporters of political party Smer-SD and disagree mainly supporters of political parties SDKÚ and SaS.

According to daily Hospodárske noviny, State paid only for lawyers in a dispute with the Achmea, Dutch owner of health insurance company Union, more than 13 million euros. Conversely, Dutch paid to lawyer for the ten million euros less and result is that state should pay around 25 million euros to Union health insurance company, including the court costs. Over generous spending on legal services are surprised as an international legal journal Global arbitration review, as well as some domestic experts. Law firm KŠD Šťovíček have been chosen by Ministry of Finance led by Ján Počiatek.