By increasing the co-payment for hospital treatment from nine to 25 marks per day, as well as by correcting the prices of certain health services such as laboratory diagnostics, hospitals in Srpska are trying to mitigate the rising labor costs, while citizens warn that higher expenses will further burden their budgets and affect the decision of some whether to accept hospital care at all.
The RS Health Insurance Fund announced that the co-payments in the compulsory health insurance system have not changed since 2011, although the costs of health services have increased significantly in the meantime due to the increase in the price of medical and non-medical materials, medicines, energy sources, maintenance of medical equipment and labor costs.
According to the Fund, the amendments to the Rulebook on the amount and method of payment of co-payments, which have been applied since the beginning of the year, and at the request of health institutions, are focused primarily on secondary and tertiary health care, as well as on the use of emergency services in non-emergency situations, while clear protection mechanisms for the insured have been introduced.
– More than 50 percent of insured persons do not pay the co-payment for some reason. Children up to 18 years of age, persons over 65 years of age, pregnant women and women in labor, blind persons, patients with rare and serious diseases, voluntary blood donors, pensioners with the lowest pension, war invalids, as well as other sensitive categories are completely exempt from payment – the announcement reads.
As stated, patients who are being treated for malignant diseases, diabetes, hemophilia, epilepsy, multiple sclerosis and other serious diseases, both in the treatment of the underlying disease and complications, do not pay the participation fee.
The new rulebook specifies that co-payment for hospital treatment is paid for a maximum of 14 days and amounts to 25 KM per day, or 12 days in the University Clinical Center of the RS and is paid for 30 KM per day. Regardless of the length of hospital treatment and the actual costs of the health service, the maximum amount of participation, the FZO pointed out, cannot exceed 370 KM.
They remind that participation is the income of health institutions, not the Fund, and that it continues to finance the most modern and expensive health services without additional burden for the insured, from the installation of a cochlear implant, heart surgery and the installation of a pacemaker, to complex oncological procedures, which cost tens of thousands of marks per patient. They also point out that certain illogicalities in the system have been corrected with the changes, so it no longer happens that insured persons pay a higher co-payment for certain outpatient or diagnostic services than for hospital treatment.
The President of Active Directors of Public Health Institutions and Director of the Zvornik Hospital, Ivan Popović, told “Voice” that the increase in co-payments was inevitable, because the prices of health services have not changed for years, although in the meantime all the operating costs of health institutions have increased significantly.
– Participation for hospital treatment was nine marks per day and has not changed for decades, while in the meantime the prices of medicines, consumables, energy sources and everything necessary for the functioning of hospitals have risen. This increase applies exclusively to those who pay the co-payment, and there are very few of them. Also, there was a correction of the prices of certain services, such as the laboratory and the like – pointed out Popović.
The director of the “Srbija” Hospital from East Sarajevo, Nebojša Šešlija, stated that the participation so far was not enough to cover even the basic costs of the patients’ stay.
– Only the costs of food and hygiene are much higher – said Šešlija.
The director of the Trebinje Hospital, Nedeljko Lambeta, assessed that this increase will mean that health institutions will be able to cover the costs of medicines and consumables.
On the other hand, the president of the consumer association “ToPeer” from Doboj, Snežana Šešlija, believes that the increase in participation is only one in a series since the beginning of the year.
– Although at first glance it doesn’t seem big, in the conditions of the citizens’ difficult standard, this can influence their decision to avoid hospital treatment – said Šešlija.
EMERGENCY
The Fund points out that co-payment was also introduced in emergency services for non-emergency situations in order to prevent misuse and provide greater availability of emergency medical assistance to those who really need it, with a clear demarcation of emergency and non-emergency cases through IZIS. They stated that the Fund has been taking on a significant burden of healthcare financing for years, even though Republika Srpska has one of the lowest contribution rates, and that since 2020 allocations for health centers and hospitals have been significantly increased.
