Slovakia reintroduced a Bismarck model of health insurance in 1993. The Slovak National Health Insurance Fund was established in order to finance health insurance, sickness benefits and pensions. In 1994, the Act on Health Insurance was adopted, which enabled the establishment of other health insurance funds and legally defined SHI.
Health reform in 2002–2006, as part of a larger reform plan labelled as “Slovakia’s neo-liberal turn”, introduced hard budget constraints and aimed at effectively utilizing scarce resources and uncovering internal system reserves. The state significantly reduced its active involvement in favour of regulated market mechanisms.
The implementation of user fees in June 2003 was aimed at reducing the demand for health care. In result, the number of physician visits in primary care dropped by 10% in the second half of 2003 compared to the same period in 2002. Similar results were observed in first aid department visits (reduction of 13%). On the other hand, the changes to physician visits in secondary care (-2%) and hospitalizations (-2%) were not significant.
The government that came to power after the 2010 elections consists of four political parties, which have a conservative or liberal background. In health insurance, the government strives to support the development of voluntary complementary health insurance and to allow health insurance companies to make a profit. The government aims to reduce barriers for new entrants to the health insurance markets.