The Minister of Health and Labour Jevgeni Ossinovski replied to the interpellation concerning the validity of the principles of insurance medicine (No. 420), submitted by members of the Riigikogu Raivo Põldaru, Martin Helme, Henn Põlluaas, Mart Helme, Uno Kaskpeit, Jaak Madison and Arno Sild on 5 March.
In the opinion of the interpellators, the principle of insurance medicine, according to which the funding of health services proceeds from the interests of the insured, is violated in Estonia. Rather, despite the current price list of health services, in “state hospitals” the health insurance money is used for disproportionately large investments, and therefore the final goal – up-to-date treatment and diagnostics – remains unattainable to patients in Põlva as well as in Hiiumaa, but also to residents of Tallinn and Tartu at the end of the year, due to large debts of medical institutions.
The interpellators wished to know how the scarcity of funds, including the high loan burden, had affected the provision of diagnostic and health services in hospitals in December 2017. They asked for the minister’s comment on the situation where construction is ongoing, but treatment is not provided.
Ossinovski admitted that, on the whole, the scarcity of funds in the health care system was definitely an objective concern. Therefore he had set as his political priority to ensure that additional funds would be found for health care. The relevant Act came into force at the beginning of this year, which means that the Health Insurance Fund will receive additional funds.
“The Health Insurance Fund does not allocate funds for constructing hospitals; it allocates funds for the treatment of people. These funds also include a component that concerns the maintenance and improvement of the infrastructure,” the minister said. He explained that hospitals could make decisions concerning the updating of their infrastructure which was also definitely necessary from time to time.
Ossinovski admitted that the interpellators drew attention to a serious problem. “Indeed, funds are scarce, and not because of whether construction is ongoing or not, or loans are being paid or not, but because, over the years, the contract of the Health Insurance Fund has been insufficient to service all people,” the minister noted. He referred to the situations where procedures and consultations planned for December are postponed to the following year because there is no contract for that month. “This does not happen because of construction, but because the Health Insurance Fund does not have enough money to fund health services in that month,” Ossinovski stated. He reiterated that underfunding in health care was a serious problem of supervision, but gradually, with decisions on additional funding being made, that situation would begin to be alleviated in the coming years.
According to Ossinovski’s explanations, it is intended that the Health Insurance Fund actually also calculates infrastructure costs according to its pricing methodology. “That is, the covering of the costs of infrastructure as a vital precondition for the provision of the health care service has also been planned into the health insurance money from the outset. This is still the case, and will remain so also in the future,” the minister said.
The Minister of the Interior Andres Anvelt replied to the interpellation concerning the risk of interruption of the provision of rescue services in the near future (No. 425), and the interpellation concerning the situation in drug policy (No. 428).
The Minister of Education and Research Mailis Reps replied to four interpellations. They were the interpellation concerning the establishment of a state upper secondary school in the city of Narva, and experiments in the organisation of the education of children whose native language is Russian (No. 421); the interpellation concerning the developments in higher education in Estonia (No. 427); the interpellation concerning the internationalisation of Estonian institutions of higher education, and higher education in Estonian (No. 429), and the interpellation concerning learning and teaching in preschool education (No. 430).
The sitting ended at 8.28 p.m.
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