Pharmaceutical companies spend annually around 40 million euros on the promotion and marketing. This money is used to sponsor doctors and pharmacists. The Ministry of Finance plans to tax these promotional activities. For example, if the company has paid doctors for participation in the Congress, than has to pay 19 per cent tax from the amount company spent on it. Companies and practitioners disagree with this tax. Currently, sponsorship is in the declaration of taxes listed by doctors. Ministry of Finance, however, seem suspicious amounts they admitted. Pharmaceutical companies have reported that they spent more than 41 million on the promotional activities, but doctors according to the Ministry taxed only tens of thousands of euros.
According to Health Policy Institute, debt of state-owned health care facilities will be 400 million euros by the end of the year. Ministry of Finance is not counting with this fact. According to the Ministry of Health, hospitals would not create new debt, and thus should be able to start to pay the old liabilities. At the end of last year, hospitals have 365 million debts. This year it may reach tens of millions of euros more. Such a scenario could be problematic for the state budget. That´s why hospitals tend to be annually known as one of its largest landmines. With what kind of debts of medical facilities Ministry of Finance is counting, Ministry did not said. According to experts, debt will continue to grow.
Debt of healthcare facilities to the Social insurance company grows even further this year. The end of January facilities owed on premiums € 89.7 million. Monthly their claims increased by more than 3.3 million. Accounts receivables of state-owned medical facilities have reached at the end of January this year more than 58 million euros. It is a monthly increase by nearly 2.7 million euros. Debt of transformed medical facilities was more than 31.6 million euros. Per month it increased by € 673,000. Social Insurance company register 21 healthcare facilities with the claims. Of these, five are state-owned and 16 are transformed healthcare facilities.
Ministry of health care has announced a tender on 74 licenses for operation of ambulance cars. The reason is that the current licenses are expiring. Last year the first two rounds took place. We are still waiting for the results of the second round. Because of the first round the chief of the resort Zuzana Zvolenská had to face an attempt for removal from the office by the parliament. The new licenses, for which the applicants can ask till 17th of March, should according to new legislation be in force for six years instead of current four years. Amended law about the providers of health care at the same time brought the obligation to submit together with the request for the issuing the permission also the statement about personal ensuring of operation of ambulance and the project of strategy and development of ambulances.
Medical facilities owed at the end of December 2013 on the social contributions to Social insurance company more than 86.3 million euros. That represents an increase of accounts receivables by more than 37.6 million euros. Accounts receivables to state-owned medical facilities reached at the end of December the level of almost 55.4 million euros. It is a monthly increase by more than 4.3 million euros. A rise of accounts receivables because of not paying is registered in a hospital in Banská Bystrica, also in hospitals in Bratislava, National transfusion service and Psychiatric hospital in Hronovce. According to minister of health Zuzana Zvolenská, the problematic are hospitals in Bratislava and Banská Bystrica. The debts of transformed facilities constituted 30.9 million euros.
Since the next year the state will pay less for its insured. It will be historically the lowest contribution, which will be at the level of 4 % out of the average wage from 2 years ago. The insured of the state are the most expensive patients. Among insured of the state are children, retirees, unemployed or mothers on the maternity leave. Together they compose more than 3 million people. The contributions of the state for its insured are declining from year to year. Whereas in 2010 it was 4.78 % out of average wage, this year it was only 4.25 %. It was monthly per one insured 33.44 euros, from the new year the state will pay 32.20 euros.
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.
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.
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.
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.