The future of Estonian healthcare

Join us by brainstorming and contributing your ideas to this platform in order to collectively find new and cross-sectoral solutions to the funding challenges facing the Estonian healthcare system

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1+1=3, or how private healthcare and solidary healthcare could support each other

The idea has two parts.

Firstly, employers could contribute to their employees’ health tax-free, increasing the annual amount from the current €400 to €1,000. I dare to say that many employers who currently invest €400 per year in their employees’ health would do so to a much greater extent if they didn’t have to pay fringe benefit tax on it. This would bring additional funds into the healthcare system.

Secondly, the Health Insurance Fund could promote patient treatment in private healthcare on a larger scale. Here’s an example: a patient receives a referral from their family doctor to see a cardiologist, and the waiting time for a Health Insurance Fund appointment is two months. The patient has a choice—either wait for two months or go to a private clinic where they can get an appointment, say, within two weeks. The patient pays for the private clinic visit and then, when the Health Insurance Fund’s turn for the patient would have arrived—approximately two months later—they receive a reimbursement from the Health Insurance Fund based on its price list for part of the cost of the private visit. This way, a) the patient gets an appointment faster, b) resources in the public system are freed up, and c) even patients who don’t want to go to a private clinic would get an appointment sooner due to the freed-up resources.

Therefore, public-private sector cooperation shouldn’t be viewed in a black-and-white manner, i.e., whether to have a solidarity system or not. These systems could successfully complement each other.

M
Mart Healthcare

Additional suggestions

KP
Kadri Puna
Erakliinikud tõmbasid tööjõudu ära avalikust sektorist jube enne seda kui eraravikindlustus turule saabus. Ehk et see, kes lõpuks teenuse eest erasektoris tasub, ei ole põhjuseks. Palju olulisem on see, et riik ei üritagi (vähemalt ei ole mina leidnud) analüüsida, kuidas erakindlustuse rahavoog aitaks kaasa elanikkonna tervishoiu omaosaluse määra vähendamusele. Avalikest poliitikute väljaütlemistest kangastub mingi kujutelm rikaste pärusmaast. Meie riigi tervishoiu kulude omaosalus täna on 23%, eesmärk on 2030 jõuda 15%ni aga Riigikontrolli aruande järgi see hoopis kahekordistub(!) kui miskit ei muutu. Poliitikute põhiline vastuargument, miks eraraha ei tohi juurde lasta, on uskumus, et eriarstabi kättesaadavus halveneb, samas kui fakt on, et inimeste endi poolt tasutud eriarstidega seotud kulud moodustavad kõigest 10% (!) kodaniku tervishoikulude omaosalusest. Tervishoikuludeks makstud raha läheb inimestel suures osas aga hoopis hambaravi, ravimite, prillide, taastusravi, õenduse jms peale. Ehk et ENAMUS need teenused, mida tegelikult saab katta erarsvikindlustusega ja kuhu tegelikult erakindlustuse raha ka läheb. Ja mis kōige tähtsam: hirm et erakindlustusest ei saavad osa vaid rikkad, on eriti põhjendamatu, lausa alusetu. Eraravikindlustus on täna ettevõtetele aga see on suunatud ettevõtete tavalistele töötajatele, sh KÕIKIDEL erialadel (müüjad, tislerid, põllumehed, juuksurid, insenerid, jne). Minul on ettepanek, et riik telliks siiski reaalse analüüsi uurimaks, milliste leibkondade rahakotti eraravikindlustus tegelikult aitab ja milline on eraravikindlustuse mõju riigi tervishoikulude kõrge omaosaluse maandamisel (mis enamjaolt hoopis koosneb hambaravist, ravimitest, meditsiinitarvikutest, taastusravist ja hooldusravist).
AT
Anu Toots
See mudel töötaks oludes, kus tööjõudu on piisavalt nii era kui avaliku tervishoiu jaoks. Meil tõmbavad erakliinikud tööjõudu ära avalikust sektorist. Tulemus on ikka pikad järjekorras ja suurem tervise ebavõrdsus.
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