Strategy of health sector reform OECD presentation

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Strategy of health sector reformOECD
presentation
Rudolf Zajac Minister of Health Peter
Paitný Advisor to the Minister of Health
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Content

• Fiscal position of Health sector
• Where is the beginning of the circle?
• Stabilisation measures
• System measures
• Network measures

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I. Fiscal position of Health Sector
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Gap is widening(Cumulative real growth of GDP,
1990100)
USA
EU 15
SR
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Deficit of Public Finances ( from GDP)
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Fiscal position of Health sector ( from GDP)
Expenditures
Resources
Deficit
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Coverage of the Deficit( from GDP)
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growing debts(in bln. Sk)
Annual change 2002 2003
VAT and deregulation 1,0
Providers 16,2 22,0
Health insurance funds 13,2 15,4
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Where is the Beginning of the Circle?
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Challenges and Reactions of the Reform
Challenges
Reactions

• Growing expectations of the citizens
• Increasing Costs
• Limited ability to pay

• Decreasing of expectations of the citizens
• Increasing of efficiency
• Mobilisation of Resources

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Position of Political Decisions

• How much Resources ?

Decreasing of high expectations of the citizens
Efficiency
How wide Treatment Act?
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Where is the Beginning of the Circle?
Health Care Act
Treatment Act
New Insurance Act
CONSTITUTION
Health Insurance Act
New Treatment Act
Health Care Surveillance Authority Act
Chambers Act
Health Care Occupations Act
Health Care Providers Act
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Schedule of reform steps
Network measures
New system
System measures
Stabilisation measures
2002
2003
2004
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III. Stabilisation measures
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Goals

• Stopping of debt growth
• Financial stabilisation of system

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Stabilisaton measures

• Modern definition of the Health Care
• Introduction of marginal co-payments
  for Providers
• New initiatives in Drug Policy

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1. Modern definition of the Health Care

• Health care

Related services Transport Food Accomodation
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2. Application of marginal co-payments for
Providers
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2. Vulnerable groups freed from co-payments

• People in material need
• Inconscious people
• People in health status, that odesnt allow the
  permission of agreement
• Mother with children (1 year)
• Blood donors
• Psychiatric patients

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2. Impact on patients
53 Sk monthly
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3. New initiatives in Drug policy

• New composition of categorization committee (11
  members, prevalence of economists over doctors)
• New concept of Appendix 2
• Fixing additional payments of patients in the
  case of partly reimbursed drugs

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stabilisation of debts (in bln.
Sk)
Annual change 2002 2003
VAT and deregulation 1,0
Total savings 2,5 - 3,8 bln. Sk
Providers 16,2 19,6
Health insurance funds 13,2 14,2
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IV. System measures
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Goals

• Decreasing of expectations of citizens
• Raising the efficiency of the system
• Mobilisation of Resources (particularly private)

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System measures

• NEW Treatment Act
• NEW Insurance Act
• NEW Health Care Surveillance Authority Act

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1. New Treatment Act
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1. New Treatment Act
Price
Onco Cardio Trauma Chronic
Frequency
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2. New Insurance Act
Voluntary insurance
Beyond scope of Treatment Act

• Compulsory
• insurance

Covering BBP in Treatment Act
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2. New Insurance Act
Voluntary insurance
Every licenced Insurance Fund

• Compulsory
• insurance

Licenced Health Insurance Fund
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3. Health Care Surveillance Authority

• Strong regulatory body, which monitors
• Licences
• Register of assured
• Index of risk
• Solvency of Health Insurance Funds
• Quality of Health Care
• Lege artis

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Goal Active role purchaser
Purchasing of goods
Drug policy

• Influencing the price

Purchasing of services
Provider
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V. Network measures
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Current conditions there is no feedback in the
system
Hospitals and LZZ
SKK
Health Insurance Fund
Patient
SKK
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Goals

• Increasing allocative and technical efficiency
• Increasing Quality
• Enhancement of effective access
• Reinforcement of competition
• Equality of chances

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Network measures

• NEW Chambers Act
• NEW Health Care Providers and Institutions Act
• NEW Health Care Occupations Act

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Goal Management of the patient in the future -
interaction
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Increasing of technical efficiency
Debt financing

• Decreasing of salary costs
• Increasing of productivity

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... ??? ...
We are lucky, the hole is not on our side
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Thank You for Your Attention

• We are looking forward to Your comments and for
  further information attend
• www.reformazdravotnictva.sk