We disregarded the fact that each of the inhabitants of Slovenia must pay a tax intended for health insurance fund in the form of compulsory health insurance, and therefore in reality the market price of the services – providing one has a doctor's referral – is never paid by the patient. Excluded are, of course, the occurrences when an individual avoids waiting in a queue by paying for the service from his/her own wallet.
Different prices for different institutions
The Health Insurance Institute of Slovenia (ZZZS) calculations for payments to the performers of the services is based on two different prices. The first is intended for the services performed at the Maribor or Ljubljana University Medical Centre, and the second for the services provided by general hospitals. Each service has a factor which is consequently multiplied by a fixed amount, i.e. 1,682.01 euros (for services performed by one of the University Medical Centres) or 1,156.84 euros (for services performed by a general hospital).
Delivery is the most frequent service
Last year the most frequently performed medical service was a vaginal delivery (14,234). For each the Health Insurance Institute of Slovenia pays 1,530 euros to a University Medical Centre, and 1,052 euros to a general hospital.
On the list of ten most frequent procedures (4,989) can be found knee surgeries, and each of them cost the state 1,328 or 913 euros, depending on the performer. On the list of fifteen most frequent procedures can be found abortions (3,458 last year), costing the health insurance fund 622 or 428 euros; the majority of abortions was performed by both Universal Medical Centres (71.4%).
Expertise allowance
The logical question was why the difference in price for the same service. The Health Insurance Institute pays 45% higher price to both University Medical Centres compared to the price paid to general hospitals. The answer we received was that the agreement on that subject – defined by the government – is signed annually.

Therefore for the procedures performed in one of the two University Medical Centres an additional amount is added, for tertiary activity. »This allowance is intended for the highest expert level of medical care, research, development, and introduction of new knowledge from the field of national pathology, and transfer of knowledge and abilities to health care workers and co-workers regardless of the level, and setting directions for the entire state, or an important part of it," they wrote.
The largest part of a price are work costs, i.e. approximately 54 percent of all the expenses (according to unofficial information we received mostly for auxiliary staff), while material cost, and amortisation amount to approximately 46%.
The Health Insurance Institute of Slovenia last year had almost 2.4 billion euros expenses, the largest part of the money, in total 1.8 billion euros, for specialist ambulatory and hospital medical treatment, basic health care, and for medicines and medicinal products. The last item cost the Institute more than 383 million euros. The health insurance fund disbursed 230 million euros for funeral allowances, absence compensation, reimbursement to socially challenged individuals …