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DRAFT REVISION TO HEALTH INSURANCE ACT ANGERS INSURERS

Emotions in health care sector run high

THE RELATIONSHIP between Health Minister Ivan Valentovič and private health insurers operating on the Slovak market has been conflicted since the very beginning. The ruling Smer party has already produced its third revision to the Act on Health Insurers, which would prevent these companies from using their profit to pay dividends to their shareholders.

THE RELATIONSHIP between Health Minister Ivan Valentovič and private health insurers operating on the Slovak market has been conflicted since the very beginning. The ruling Smer party has already produced its third revision to the Act on Health Insurers, which would prevent these companies from using their profit to pay dividends to their shareholders.

The previous two drafts failed to make it to parliament and health insurers have said they want to make sure that the third version, which they have dubbed a tool for the "indirect expropriation" of insurance houses, is similarly short lived.

The revision cuts the cap on collected premiums that health insurers can use to cover administration costs from the current four percent to three percent while at the same time forcing the insurers to spend their entire profit on health care coverage.

The insurers claim that the draft is at odds with both the country's constitution and international agreements.

"The revision is unacceptable and unconstitutional," Eduard Kováč, executive director of the Association of Health Insurers, told The Slovak Spectator. "Legal analyses have shown that the revision might result in international lawsuits and have a negative financial impact on Slovakia."

The Association of Health Insurers, which shelters major private health insurers operating on the Slovak market, bases its claims on three independent legal analyses involving domestic and international legal experts, Kováč said.

The association also argues that Valentovič cannot clearly explain to the public on what kind of legal analysis he has based the drafts, which, according to legal experts, roughly intervenes in the economic performance of insurers.

The revision would also intervene in foreign investments into Slovak health insurance companies, a team of international legal experts, led by Czech lawyer Alexander Belohlávek, told the SITA newswire.

Constitutional lawyer Radoslav Procházka and the law firm Buzinger & Partners also said that the minister's draft is at odds with the constitution in the issue of protection of the right to ownership. The draft would intervene in health insurers' right to conduct business and to own and use their assets, Buzinger & Partners told SITA.

Health Ministry lawyers have said the draft fully complies with the constitution and the country's laws. The provisions that prevented the previous drafts from making it to parliament have now been removed, the Health Ministry claimed.

"The ministry considers the arguments of private health insurers and the association that represents them to be biased and their criticism unjustified," Silvia Balázsiková, the ministry's spokeswoman, told The Slovak Spectator.

The ministry rejected the legal analyses saying that only the Constitutional Court can rule on whether laws are in harmony with the constitution.

As long as the ministry does not have the definite ruling of the Constitutional Court, it would reject all polemics on the issue, said Balázsiková.

However, Kováč said that no compromises are possible if the current proposal goes to parliament. The association also keeps appealing on the ministry to publish the names of the experts who prepared the legal analysis for the draft.

Slovakia currently has six health insurance providers, two of which - Všeobecná Zdravotná Poisťovňa and Spoločná Zdravotná Poisťovňa - are owned by the state and the other four - Dôvera, Union, Apollo, and Európska Zdravotná Poisťovňa - are private.

Private health insurers turned a profit of approximately Sk1 billion (€30 million) last year, based on the estimates of the civil association Health Policy Institute, which, along with the Civil Conservative Party, the Conservative Institute of M. R. Štefánik and INESS Institute of Economic and Social Snalysis, has started collecting signatures for a mass protest to the draft.

Prime Minister Robert Fico's government has been trying to alter some of the reforms initiated by the previous health minister, Rudolf Zajac, claiming that the changes would bring the sector more in line with social-democrat ideals. Valentovič had hoped to see the state health insurance companies transformed from joint-stock companies into state-run institutions and all people whose insurance is paid by the state to be re-registered with state-owned insurers.

Meanwhile, Valentovič submitted a major report on the state of the health care sector in Slovakia, blaming the previous government for handing over the sector in what he calls "a terrible condition".

Making patients share the costs of some health procedures and the drugs and the transformation of public health insurance companies into joint stock companies has worsened the accessibility to health care overall and modified the whole system of public health insurance, said Valentovič.

"The aim of this change was to make it possible for business entities directly or indirectly related to financial groups, such as Penta or J&T, to benefit from public health insurance resources," Valentovič told SITA.

The Slovak cabinet approved Valentovič's report on June 6.

Former finance minister Ivan Mikloš of the opposition Slovak Democratic and Christian Union said the report was only submitted to divert attention away from the real problems. The report should have outlined plans to stop growing debts in the healthcare sector, he said.

The Association of Health Insurers said the minister's report on the state of healthcare was packed with incorrect data and misleading information.


Michaela Stanková
contributed to this report.

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