Healthcare in Slovenia

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Health care in Slovenia is organised primarily through the Health Insurance Institute of Slovenia.

In 2008 around 3 billion Euros, 8.10% of the Gross domestic product was allocated to health expenditures.[1] It was ranked 15th in the Euro health consumer index 2015 and second in the 2012 Euro Hepatitis Index,[2]

The Slovenian healthcare system is a conservative-health care model paid for through a mandatory insurance program called the Health Insurance Institute of Slovenia, HIIS (Zavod za zdravstveno zavarovanje Slovenije) that is paid by employers and employees. However, not all medical costs are covered from this insurance, with the exception of children's healthcare which is fully covered.[3] Almost all Slovenes thus pay voluntary insurance fees for additional coverage that also help support the system. Due to the amount of funds that is put into the system, Slovenian healthcare is comparable to many other advanced European nations'. The National Health Insurance Institute oversees all healthcare services. It is a right for all citizens to have equal access to healthcare, so long as they are Slovenian citizens or registered long-term residents.[4] In 2015, 8.10% of the gross domestic product went to healthcare expenditures.[5]

State healthcare[edit]

The National Health Insurance Institute is bound by law to give compulsory health insurance to all of its citizens. When a new employee is hired, the employers must register them with the institute. The combined contribution equates to 13.45%, 6.56% of which is paid for by the employer and 6.36% by the employee. The employer also pays another 0.53% fee for injuries at work and diseases.[4]

Dependent family members are covered by the employed family members. Self-employed people must pay a fixed proportion of their after-tax income. The unemployed, elderly, long-term sickness patients, or people on maternity leave pay a fixed amount of healthcare contributions that depends on their health status.[4]

The state fund does cover most medical services, such as treatments, prescription drugs, hospitalization, etc.[4] For additional things that are not covered, the Mutual Health Insurance organization (Vzajemna zdravstvena zavarovalnica) was established in 1999. It is owned and operated by the insured and operates as a non-profit and mutuality status. Other insurance companies are also able to offer voluntary insurance.[6]

Emergency care[edit]

All emergency services are provided for free, including the cost of the ambulance.[7] Emergency rooms are open all day, every day of the year. For people who are not Slovene citizens, emergency care may also be provided, usually free of charge. Once stabilized, the doctor or staff will ask for a proof of insurance, or else the patient may have to pay a small fee.

Dental care[edit]

Dentistry is seen as equally important as primary healthcare in Slovenian society. Co-payments are made for dental services. However, all people up to the age of 19 are given free access to dental care without co-payments. With the exception of emergency cases, co-payments for adults range anywhere between 10–60% depending on the definition of said procedure according to the Health Care and Health Insurance Act of 1992.[8]

Private practice[edit]

With the wave of rapid modernization in the early 1990s, Slovenia had tried to resolve much of the problems that plagued it before. This paved the way for the adoption of the Health Care and Health Insurance Act of 1992. One of the features that it included was the reintroduction of the private practices.

There is a higher level of satisfaction of those who are treated by a private practitioner than of those who went to a public physician (Toš et al. 2004).

From 1992 to 2009, there were 1,279 private practitioners in the country, out of a total of 8,191 physicians.[9] Private practitioners may also be registered with the HIIS. Only 190 were not registered by the end of 2006.[8] There seems to be a trend in people shifting towards private practitioners with the introduction of provision care in private practices. In fact, the highest proportion of all private practices comes from the dental field, where around 15% of all dentists are in a private practice.[8]

Problems[edit]

There are still problems that are facing the Slovene health system, mainly through the number of lines and wait times to see a doctor. This is especially seen through the wait times for dental services, as well as some specialized services as well.[8]

Since 2006, the unemployment of doctors has been low, but there is still a shortage of physicians, especially in many parts of the country where access to healthcare is limited. However, since the 1990s, there has been a steady increase in the number of physicians in Slovenia. This was mainly due to the fact that most medical schools increased their number of graduates and higher parts of migration to Slovenia from parts of the former Yugoslavia.[8]

There has been an upward trend for the number of dentists as well, but is slower than for physicians.

Reform[edit]

Since the economic crisis of 2008 occurred, Slovenia was one of the many nations that experienced hardship. Like many other nations, the amount of health spending went negative in real terms of 2010.[10] While health spending has gone up in recent years, the amount is less than 1% per year. However, the amount they spend on healthcare expenditures has also been challenged. In 2012, Slovenia paid 9.3% of its GDP on healthcare and long-term care, the same as the OECD average.[10] However, this is higher than the average amount of GDP spent for nations with similar GDP's per capita.[11] There have also been complaints of higher costs for the voluntary insurance.

Like many other OECD nations, spending on pharmaceuticals has decreased in recent years, with Slovenia decreasing spending by less than 1% in 2011, but increasing 2.6% in 2012. In 2009, there were reforms to control the spending growth on pharmaceuticals. These reforms included lists of drugs that would be reimbursed by the national health insurance fund, as well as price reductions that was negotiated between both the government and pharmaceutical companies.[10]

There have also been growing calls for economic and social spending reform. Slovenia spends close to 50% of its GDP on public expenditures; this makes it among the highest in nations with similar levels of economic development. Slovenia spends close to 20% of its GDP on social transfers and benefits, higher than Nordic nations as well as Central and East European nations. While this does show signs for a preference of well-developed welfare state, the nation has been plagued with poor expenditure spending.[12] An aging population is also increasing spending. Slovenia is generally ranked low in terms of economic inequality. Therefore, many nations, primarily in the OECD are pushing for Slovenia to restructure their welfare state as to save on spending and put it towards other programs, since they believe this wouldn't make their equality level vulnerable. Many analysts believe that healthcare would be improved by enhancing cost-effective primary care, as well as a reform with long-term care to help contain the spending on the aging population.[13] The retirement age has risen in both 2014 and 2015 but is still relatively low compared to other nations.[14]

Hospitals[edit]

See List of hospitals in Slovenia

References[edit]

  1. ^ "Health in Slovenia". European Commission. Retrieved 31 January 2016.
  2. ^ "Outcomes in EHCI 2015" (PDF). Health Consumer Powerhouse. 26 January 2016. Retrieved 27 January 2016.
  3. ^ "The Healthcare System In Slovenia". www.treatmentabroad.com. Retrieved 2016-11-27.
  4. ^ a b c d "Healthcare in Slovenia | Europe-Cities". www.europe-cities.com. Retrieved 2016-11-27.
  5. ^ "Health in Slovenia - International Cooperation and Development - European Commission". International Cooperation and Development. Retrieved 2016-12-03.
  6. ^ "The healthcare system in Slovenia | Medical Tourism DMC". www.medicaltourism-dmc.com. Retrieved 2016-11-27.
  7. ^ Choices, NHS. "Healthcare in Slovenia - Healthcare abroad - NHS Choices". www.nhs.uk. Retrieved 2016-11-27.
  8. ^ a b c d e Albreht, Tit (2009). "Slovenia Health System Review" (PDF). www.euro.who.int. World Health Organization. Retrieved November 26, 2016.
  9. ^ "Slovenia Medical Chamber". legeforeningen.no. European Forum of Medical Associations. 2009. Retrieved November 26, 2016.
  10. ^ a b c "OECD Health Statistics in 2014" (PDF). OECD. OECD. 2014. Retrieved November 28, 2016.
  11. ^ "REFORMING HEALTH AND LONG-TERM CARE TO ENSURE FISCAL SUSTAINABILITY AND IMPROVE SERVICE DELIVERY" (PDF). OECD. OECD. May 2015. Retrieved November 28, 2016.
  12. ^ "Restructuring Welfare Spending in Slovenia | OECD READ edition". OECD iLibrary. Retrieved 2016-11-28.
  13. ^ Kierzenkowski, Rafal (2013). "Restructuring Welfare Spending in Slovenia" (PDF). OECD. OECD. Retrieved November 28, 2016.
  14. ^ "Retirement Age Increasing, Still Relatively Low". www.sloveniatimes.com. Retrieved 2016-11-28.