The act would introduce a number of changes: it would abolish additional health insurance, cap the sick leave compensation, widen the contribution scheme from health insurance and implement progressive taxation instead of a fixed price of additional health insurance.

The proposed act would not shrink the scope of services included in the obligatory health insurance. According to Kolar Celarc, the services will be offered without co-payments and include preventive, primary, dental, specialist and hospital health services, treatment abroad, medical rehabilitation, palliative care, medication, sick leave compensation etc.

The proposal lists 17 medical services that would not be covered by obligatory insurance, including aesthetic procedures that are not performed due to functional damage repair, alternative treatments that would not be approved by the health ministry, surgical treatment of obesity (except certain cases), the right to a second opinion and wage compensation for donating blood.

If the bill is passed, there will certainly be a discussion regarding how to tackle the provision that requires the patients to pay for treatments of medical complications arising from health services performed by private health care facilities, for treatment of illnesses caused by declining compulsory vaccinations, and for extra health services demanded by patients despite the doctor’s estimation that they are not necessary considering the patient’s health condition.

Lower co-payments for dental care?
The coverage of health services is also relevant in terms of dental care, which currently requires co-payments or full self-funding by patients from almost all services.

The proposal grants patients the right to a yearly dental examination, treatment, fillings, upgrades and an X-ray exam. This includes oral and maxillofacial surgeries, dental prosthetics and a few other services. Dental prosthetics comprises coating, super structuring, fillings, bridges, partial and total false teeth. Only minors, under the age of 18, will receive free orthopaedic treatment. A detailed list and standards were determined by the Health Insurance Institute of Slovenia in cooperation with the health ministry.

Andrej Čebokli, MMC; translated by K. Z.