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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.
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.
In the centre of Bratislava begins construction of a new building of Hospital of St. Michael, which belongs under the Ministry of Interior. Work on the hospital was officially opened by tapping on the foundation stone by Minister of Interior Robert Kaliňák, Minister of Health Zuzana Zvolenska and hospital director Marian Križko. The project, according to preliminary estimates, will require 49.7 million euros. Two thirds of this amount is earmarked for the construction of the building, the rest should be used for equipment. According to Kaliňák, the construction of a hospital will finance hospital by itself, seeing that the money for this purpose has already got more than five years from the state-owned assets.
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.
The first round of the tender for licenses for emergency ambulance did not end successfully for several regional hospitals. They have been replaced by private or state companies. Emergency ambulances (EMTs) are considered one of the most profitable areas in the health sector, so hospitals will probably miss the sources. Licences will be re redistributed after six years. As is clear from the published results of the tender, the licenses to operate 76 ambulances ground emergency medical services are reallocate among the LSE-Life Star Emergency, Falck Záchranná, Záchranná a dopravná zdravotnícka služba Bratislava and Záchranná služba Košice. Conversely, the licenses lost hospitals in Trstená, Čadca, Bojnice, Spišská Nová Ves, Myjava, Partizánske, Námestovo and Poprad. Regional Hospitals wish to appeal against the results of the first round of the tender for EMTs.
Together 16 universities, teaching hospitals and several institutes whose directors are appointed by the Ministry of Health cancel the contract with Union health insurance company. According to Union, cancellation from them came in late June at a same time. With three of them agreed new contracts later. Contracts with 13 facilities are still valid, but expire 30 September. This is the last day, when people can exchange health insurance company. Union argues that the large hospital get together against it. Therefore wants to turn at the Antimonopoly Office. Office should investigate if hospitals are not abusing market position. The insurance company is according to law compulsory to conclude the contract with state hospitals and institutions. They are part of a terminal network, so insurance companies have to conclude contracts with them.
Health insurance companies submitted for the first half of this year nearly 140-thousand proposals to conduct enforcement on premium payers. At the end of June, they managed to recover 64.8 million euros together. The General Health Insurance Company (VšZP) registered at the end of June this year 314.675 defaulters who unpaid the premiums of over two hundred million euros. Compared to the same period last year, the number of defaulters fell by 13 per cent. In the health insurance Dôvera is the list of debtors for the first half of 2013 nearly 60-thousand clients. Unpaid premiums reached 15.3 million.
The biggest public health facilities also face executions of nearly 600 thousand euros.
Health care facilities owed the end of July the insurance Social Insurance over 70 million. Since last year their assets increased by € 21.3 million. Claims on state medical facilities have reached the end of July € 43.02 mil. Per month assets increased by more than 4.4 million euros.
The Ministry of Health has been delayed three quarters of the year with the adoption of legislation, which is a condition to implement the new payment mechanism for hospitals, the so-called DRG (Diagnoses Related Groups) system. Originally, the ministry should have approved a decree which provides a list of medical procedures necessary for the further progress of the project in October last year. The term could not be observed, because the list of performances has not been finished. In February, the Healthcare Surveillance Authority, which covers the process of introducing DRG, announced that the list is ready. However, the Ministry has not approved the decree till today. According to Authority, the decree is prepared and its estimated force was established on October this year.
Two-thirds of competitions that make Slovak hospitals are with only one candidate. In the Czech Republic there are more. While in tenders in our hospitals are on average two bidders, in the Czech Republic are three. In public procurement for medical supplies have Slovak hospitals an average of 1.4 candidates, while Czech hospitals have up to 4.2 candidates. Slovakia on comparison with the Czech is also worse in comparing the top ten procurers. Just in one hospital was the average number of bids in the tender more than two. In contrast, in the ten largest hospital procurers in Czech Republic have on averages per one procurement more than two offers.