{"id":987520983,"date":"2021-09-27T02:58:05","date_gmt":"2021-09-27T01:58:05","guid":{"rendered":"https:\/\/p4h.world\/news\/estonian-ministry-of-social-affairs-solicits-increased-health-financing-from-the-government\/"},"modified":"2023-03-02T10:01:06","modified_gmt":"2023-03-02T09:01:06","slug":"estonian-ministry-of-social-affairs-solicits-increased-health-financing-from-the-government","status":"publish","type":"news","link":"https:\/\/p4h.world\/en\/news\/estonian-ministry-of-social-affairs-solicits-increased-health-financing-from-the-government\/","title":{"rendered":"Estonian Ministry of Social Affairs solicits increased health financing from the Government"},"content":{"rendered":"<p><span><span><span><span lang=\"EN-US\">As reported by <\/span><a href=\"\/\/www.hspm.org\/countries\/estonia05112013')\" target=\"_blank\" rel=\"noopener\"><span lang=\"EN-US\"><span>Kaija Kasekamp<\/span><\/span><\/a><span lang=\"EN-US\"> at the platform of European Observatory on Health Systems and Policies, multiple analyses&nbsp;have&nbsp;indicated that the social tax-based health financing system in Estonia is not sustainable. Estonia&#8217;s working-age population is decreasing and therefore the number of&nbsp;non-contributing&nbsp;persons&nbsp;exceeds&nbsp;the number of contributing people. The situation is being rendered even more complicated by the increasing use of flexible forms of work. The number and share of employees working&nbsp;flexibly&nbsp;has doubled over the last ten years.&nbsp;As a result, the number of people who do not regularly contribute to the health insurance system&nbsp;is increasing&nbsp;and&nbsp;they&nbsp;do not have&nbsp;stable health insurance coverage. This has&nbsp;resulted in&nbsp;a situation where, since 2013,&nbsp;the Estonian Health Insurance Fund&nbsp;(EHIF)&nbsp;has needed&nbsp;additional state budget transfers to keep&nbsp;its solvency.&nbsp;The&nbsp;EHIF budget for 2021&nbsp;is&nbsp;725 million euros.&nbsp;<\/span><\/span><\/span><\/span><\/p>\n<p><span><span><span><span lang=\"EN-US\">The <strong>Ministry of Social Affairs&nbsp;(MoSA)<\/strong>&nbsp;has submitted to the Government&nbsp;four&nbsp;possible solutions&nbsp;to increase funding of&nbsp;EHIF:&nbsp;<\/span><\/span><\/span><\/span><\/p>\n<ol>\n<li><span><span><span><span><span lang=\"EN-US\"><span>Continue allocations from the state budget to cover the budget deficit of the EHIF. This option has been used during the COVID-19 pandemic to compensate for the loss in revenues due&nbsp;to&nbsp;declining&nbsp;social tax contributions.&nbsp;The amount of state transfers would be negotiable&nbsp;and applied from the state budget competing with other sectors.<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/span><\/li>\n<\/ol>\n<ol start=\"2\">\n<li><span><span><span><span><span lang=\"EN-US\"><span>Introduce&nbsp;a&nbsp;regulated&nbsp;formula-based&nbsp;state allocations to the EHIF for persons under 19 years of age. So far,&nbsp;the state contributes&nbsp;for certain vulnerable population groups and&nbsp;starting&nbsp;from&nbsp;2018,&nbsp;due to&nbsp;the&nbsp;EHIF longstanding deficit,&nbsp;on behalf of&nbsp;non-working&nbsp;pensioners.&nbsp;If&nbsp;the state would contribute on behalf of under&nbsp;19-year-olds&nbsp;based on&nbsp;a&nbsp;social tax&nbsp;calculated against the&nbsp;minimum wage,&nbsp;the&nbsp;EHIF&nbsp;annual&nbsp;budget would increase&nbsp;by&nbsp;250 million euros.<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/span><\/li>\n<\/ol>\n<ol start=\"3\">\n<li><span><span><span><span><span lang=\"EN-US\"><span>Broaden the&nbsp;social&nbsp;tax base&nbsp;to&nbsp;all declared&nbsp;income, such as&nbsp;rent, dividends&nbsp;etc.,&nbsp;which are&nbsp;currently not subject to social tax in Estonia.&nbsp;The ministry proposes that&nbsp;this change may increase funding&nbsp;by&nbsp;about 200 million euros annually.&nbsp;This regulation&nbsp;would&nbsp;guarantee funding without annual negotiations.<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/span><\/li>\n<\/ol>\n<ol start=\"4\">\n<li><span><span><span><span><span lang=\"EN-US\"><span>Excluding the sickness benefits from the EHIF&#8217;s budget and assigning it to the Estonian Unemployment Insurance Fund.&nbsp;This would free up about 85 million euros&nbsp;every year, but would&nbsp;need to be combined with other solutions to increase sustainability of funding.<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/span><\/li>\n<\/ol>\n<p><span><span><span><span lang=\"EN-US\"><span>The&nbsp;MoSA&nbsp;also proposed two policy scenarios to expand insurance coverage&nbsp;for the 5-6% of population not covered&nbsp;yet:<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/p>\n<ol>\n<li><span><span><span><span><span lang=\"EN-US\"><span>Expand insurance coverage to the total population,&nbsp;delinking contributions from&nbsp;entitlements;<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/span><\/li>\n<\/ol>\n<ol start=\"2\">\n<li><span><span><span><span><span lang=\"EN-US\"><span>Expand&nbsp;insurance coverage to&nbsp;the&nbsp;population who pays income tax in the country,&nbsp;keeping the link&nbsp;between&nbsp;contributions and entitlement.&nbsp;This would expand insurance coverage for approximately 45 thousand persons.<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/span><\/li>\n<\/ol>\n<p><span><span><span><span lang=\"EN-US\"><span>The Government has not made any&nbsp;decisions&nbsp;on&nbsp;next steps. Nevertheless, the&nbsp;MoSA&nbsp;proposal triggered public debate on&nbsp;the&nbsp;general tax system in Estonia.<\/span><\/span>&nbsp;<\/span><\/span><\/span><\/p>\n<p><span><span><span><span lang=\"EN-US\"><span>Sources: <\/span><\/span><\/span><\/span><\/span><\/p>\n<p><span><span><span><a href=\"https:\/\/www.hspm.org\/_layouts\/livinghit\/customforms\/dispupdate.aspx?id=39&amp;site=https:\/\/www.hspm.org\/countries\/estonia05112013&amp;isdlg=1\"><span lang=\"EN-US\"><span>https:\/\/www.hspm.org\/_layouts\/livinghit\/customforms\/dispupdate.aspx?id=39&amp;site=https:\/\/www.hspm.org\/countries\/estonia05112013&amp;isdlg=1<\/span><\/span><\/a><\/span><\/span><\/span><\/p>\n<p><span><span><span><a href=\"https:\/\/www.sm.ee\/sites\/default\/files\/content-editors\/Tervishoid\/tervishoiu_rahastamise_analuus.pdf\"><span lang=\"EN-US\"><span>https:\/\/www.sm.ee\/sites\/default\/files\/content-editors\/Tervishoid\/tervishoiu_rahastamise_analuus.pdf<\/span><\/span><\/a><\/span><\/span><\/span><\/p>\n<p><span><span><span><a href=\"https:\/\/www.hspm.org\/countries\/estonia05112013\/countrypage.aspx\"><span lang=\"EN-US\"><span>https:\/\/www.hspm.org\/countries\/estonia05112013\/countrypage.aspx<\/span><\/span><\/a> <\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>As reported by Kaija Kasekamp at the platform of European Observatory on Health Systems and Policies, multiple analyses&nbsp;have&nbsp;indicated that the social tax-based health financing system in Estonia is not sustainable. Estonia&#8217;s working-age population is decreasing and therefore the number of&nbsp;non-contributing&nbsp;persons&nbsp;exceeds&nbsp;the number of contributing people. The situation is being rendered even more complicated by the increasing&#8230;<\/p>\n","protected":false},"author":137,"featured_media":987529141,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":""},"categories":[],"tags":[128,133],"acf":[],"_links":{"self":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987520983"}],"collection":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news"}],"about":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/types\/news"}],"author":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/users\/137"}],"replies":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/comments?post=987520983"}],"version-history":[{"count":0,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987520983\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media\/987529141"}],"wp:attachment":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media?parent=987520983"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/categories?post=987520983"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/tags?post=987520983"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}