The Minister of Health and Labour Jevgeni Ossinovski replied to the interpellation concerning the changing of the management of the Estonian Health Insurance Fund (No. 375), submitted by members of the Riigikogu Monika Haukanõmm, Artur Talvik, Andres Herkel, Krista Aru, Külliki Kübarsepp, Andres Ammas, Jüri Adams and Ain Lutsepp on 26 September.
The interpellators highlighted the fact that the Estonian Health Insurance Fund was an important organisation from the point of view of every person, and the decisions made there influenced every person living in Estonia. The Supervisory Board of the Health Insurance Fund adopts and makes these strategic decisions. The interpellators wished to be informed of the changes to the management of the Health Insurance Fund and the underlying principles therefor.
Ossinovski gave a brief overview of the current situation. “The Supervisory Board of the Health Insurance Fund has been established first of all based on the principle of social partnership which means that representatives of employers, representatives of the insured and representatives of the state are represented in it on a parity basis,” the minister said.
Ossinovski said that, besides the management board, a two-tier system was proposed for the management of the Health Insurance Fund whereby committees would be established at the supervisory board. They would actually conduct proceedings on the most important document, the list of health services, which is approved by the Government of the Republic but which receives the substantive input from the management board of the Health Insurance Fund at present. “It would receive the substantive input from health care specialists through such a committee then. An analogy could be drawn here with the Committee for Medicinal Products who, exactly in the same way, makes considered proposals as to which medicinal products should be included in the list of compensated medicinal products and which should not. Based on that, the supervisory board sees if the decisions are in accordance with the strategic objectives and if they are budgetable, and then it submits the relevant proposals to the Ministry of Social Affairs for approval,” Ossinovski said in justification. In his opinion it is important that we wish continue to adhere to the principle of social partnership.
“Our initial idea or plan was to establish a supervisory board along the lines of the logic of the supervisory board of the Unemployment Insurance Fund. As we know, the supervisory board of the Unemployment Insurance Fund works on the principle of 2-2-2, that is, two employers, two trade union representatives and two representatives of the state. The Government considered it important that a representative of the opposition would also continue to be represented in the Health Insurance Fund besides two ministers on the part of the state – the Minister of Finance and the Minister of Health. Consequently we have proposed, in today’s stage, to include a third person on the part of the state who would be a representative of the opposition by virtue of his or her office, that is, the Chairman of the State Budget Control Committee, in our vision,” Ossinovski explained.
Ossinovski pointed out in which way health care specialists could actually give their input. “We have negotiated with the parties and we are also ready to fix more precisely at the level of Act that this is not simply an advisory body where the Medical Association, the Nurses’ Union and the Primary Care Association come together and can present their proposals,” the minister said. “We actually see that this could be the place where a consensus weighted by specialists would be reached as to which new procedures, new medical devices or other things to include in our lists,” the minister said.
Substitute member Karin Tammemägi took her oath of office before the Riigikogu. She assumed membership of the Riigikogu in connection with Andrei Novikov becoming the Assistant Mayor of Tallinn.
Video recordings of the sittings of the Riigikogu can be viewed at https://www.youtube.com/riigikogu
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