The President of the Republic, Nataša Pirc Musar, said after the forum on the future of health care that she would send the report to the Minister of Health Danijel Bešič Loredan, as she hopes that the minister will obtain information from it that will help him with health reform.
According to her, the preparation of the report is necessary, but if necessary, she will conduct another round of consultations, obtain certain information and forward it to the executive branch of government. She assured that in a few months she will meet with the minister and help with the ideas that the experts gave at the forum.
Pirc Musar also wanted, through the discussion at the forum, to recognize where there are still reserves in the existing system, which digitization can point to, she added. She believes that open data can contribute to high-quality analytics, shortening of waiting lines and the workload of doctors, where, according to her, there are certainly reserves.
After the forum, Minister of Health Bešič Loredan assessed that the discussion was extremely high-quality and fruitful, and that, in addition to trust and national consensus, cooperation is key. “First of all, we must find a common point in the health system and unite in the entire health system,” he said. He believes that politics must adapt to this as well, only then will they be able to carry out health reform.
At the same time, he assured that the report will be considered at the ministry when they receive it. He announced that he would meet with the president at least once a month and present, “what they have already done, what is possible and what can go through parliament“.
Anyone who wants to present their views, solutions or prepared proposals about the health care system can send them to the president’s office by the end of May.
Pirc Musar also pointed out that she is extremely satisfied that a large number of experts gathered at the forum.
The search for social and national consensus
In the morning, Pirc Musar opened her first health forum in Brdo pri Kranje, where experts in the field of health, politics and representatives of civil society spoke about the financing of the health system, efficient organization and management of health care, and rationalization.
In her opening address, she emphasized, among other things, that in areas that are related to strategically important topics for the future of Slovenia and that are almost impossible to arrange in one mandate, “seek social and national consensus”. “Well-designed policies and projects must be continued regardless of which political option is in power,” she emphasized and added that she will strive to create a consensus in the areas she considers to be key for the development and social cohesion of the country.
One of those areas is health care, where consensus needs to be reached,”how to ensure timely, high-quality and accessible healthcare for everyone in the public healthcare system”. “At the same time, I expect that the violation of the human rights of citizens who do not have regular access to healthcare services or a personal doctor will be resolved as soon as possible,” she warned, adding that she is aware that we need a comprehensive health reform, which she is involved in “many open questions”.
She asked the participants in the forum to indicate both short-term solutions that could be implemented immediately, and long-term solutions that first require consensus and then time for implementation. “Please also highlight the reserves in the system that could and should be activated immediately,” she added. She emphasized the quality and safety of patient treatment as one of the key areas: “This is an area where it is imperative to unify positions and start introducing all the measures that lead to greater safety for patients and greater quality of patient treatment. The Ministry of Health is a key factor here.”
“Rush without discussions and unification would not bring the expected results”
“We all agree that we need to ensure a strong public health system, supplemented by concessionaires and private individuals. We have been waiting for reforms for more than thirty years, so rushing without discussions and unification would not bring the expected results,” said the president at the opening of the forum, stressing the importance of cooperation, both in healthcare itself and with decision-makers.
She reminded that health reform is also necessary due to demographic indicators, “support in public opinion polls gives the preparers an additional incentive and at the same time is a great responsibility, because health is the value that we all place in one of the first places among the values that we value the most”.
Three thematic sections of the forum
The program of the forum was divided into three main thematic sections. In addition to the Minister of Health Danijela Bešič Loredan prominent experts in the field of healthcare, politics and representatives of civil society took part in the forum.
Professor from the Ljubljana Faculty of Economics Mitja Čok and Petra Došenović Bonča presented the financing of the health care system. Among other things, Čok emphasized that the population in Slovenia is aging, so additional funding sources will be needed in the coming years. Minister of Health Danijel Bešič Loredan said that everyone, including the best healthcare systems in the EU, is dealing with the issue of healthcare financing. That is why they want to organize a financial conference in June at the Ministry of Health and find sources of funding. If we do not find the right path, we will follow the countries further south, he warned.
The necessity of preventive medicine
In the second group, they are an immunologist Alojz Ihandirector of Celje Hospital Dragan Kovačić and president of the Slovenian Association of Patients with Lymphoma and Leukemia Kristina Modic talked about the efficient organization and management of healthcare. Among other things, Ihan warned that in the future some expensive therapies could become effective for common diseases, which would mean a problem for the health fund. That is why he emphasized the necessity of preventive medicine, which he says will be the only financially effective one in the future. The turn to preventive medicine is only possible if people trust medicine, he explained.
Kovačić proposed preferentially directing public money to public institutions and reducing payment for services outside of public healthcare, while at the same time increasing payment for the same services in public institutions. President of the board of the insurance company Vzajemna Ales Mikeln added to this the assessment that money will not solve all problems in healthcare.
The issue of data availability
In the last part, the participants discussed the possibilities of rationalizing healthcare for greater efficiency, including the issue of data availability. The initiator of the Tracker for covid-19 Luka Renko explained that the institutions in Slovenia should cooperate better and trust each other. Expert director of NIJZ Ivan Eržen he added that data is the property of people, not institutions, so it is important that it is available to everyone. Director General of the Institute for Health Insurance of Slovenia Tatjana Mlakar however, she emphasized that the information platform that connects all healthcare providers and stakeholders in Slovenia is not so bad, but it needs to be upgraded. Bešič Loredan emphasized that a consensus with “to medicine as a whole”. Therefore, he is still waiting for the entire medical profession to sign a document with proposals and their view on healthcare in the future. The President of the Medical Association of Slovenia, Bojana Beović, replied that the medical organizations had already prepared the document and forwarded it to the Ministry.
President of the Chamber of Health and Midwifery Care of Slovenia Monika Ažman at the same time, she pointed out that doctors are indeed the bearers of health care, but that health care is a team effort of many profiles.
The government is getting more and more complicated in the preparation and implementation of measures
Regulating and reforming Slovenian healthcare has also been set as a priority by the ruling policy, but the preparation and implementation of measures are getting more and more complicated, Radio Slovenija reported Snežana Ilijaš. The Ministry of Health has so far implemented two more important measures, clinics for the undefined to increase access to family doctors and unlimited payment for all services to reduce waiting times. But the results are not encouraging for now, warns an international consultant for health systems Dorjan Marušič: “We throw in money. And what happened? Waiting times have increased. And not only that…let’s do it all over again in a few years. We’re throwing money out the window.”
Marušič believes that “we are dealing with the wrong things” – first of all, in his opinion, it is necessary to reorganize the health network, which has been practically unchanged for almost 80 years, to maintain the primary level as the foundation of our system and to determine the basket of rights, and this before changing the sources of financing: “It doesn’t matter if we first determine the means and then the basket, that is, first determine the blanket, and then lie down and try to cover ourselves with it. Or if we first determine the basket and cover it with public funds. What we will determine , that it is a public priority, we must cover it with public funds.”
But public funds are already very limited. We do not have long-term sustainability, and expenses will increase even more due to demographic reasons, and we should be aware of this even when supplementary insurance is abolished, warned the economist on Monday in the Studio at 5:00 p.m. Dušan Mramor: “If you are in this position, as we are, you have to walk extremely carefully, with a feeling for every measure you take.”
And in such a situation, the salary reform does not open, Mramor points out: “When you start negotiating wages, it’s like a pressure cooker, when he lifts the lid – it’s just going to fly out.”