Slovakia’s new fiscal deficit measures hit health coverage, staff levels [Advocacy Lab Content]

Slovakia’s Prime Minister Robert Fico, has announced a new wave of proposed cost-saving measures aimed at deficit reduction, but they risk impacting Slovakia’s health service and health insurance provision.

Fico has been visiting ministries during the so-called ‘control days’. After visiting the ministries of health and finance, additional measures were communicated as the Slovak government targets a deficit reduction of 1% of GDP.

“We need €1.4 billion, however, in the process of consolidation, we cannot go against the people’s social standards. We will not reduce social benefits, unemployment support, maternity benefits, child allowances, or the 13th pensions,” PM Fico said at a press conference.

Instead, PM Fico noted that every contract and agreement at the state health insurance company should be audited and re-evaluated while also warning that some ministries have unjustifiably high employment rates.

“Perhaps now I’ll scare the employees of the state administration, but I believe that a 30 per cent reduction would not be noticeable,” he continued.

MP Dr Tomáš Szalay (SaS/ECR), at a press conference, welcomed, despite being in the opposition party, the much-needed audit and agreed that the Ministry of Health is currently struggling with overly high employment rates.

Further proposed measures include taxation on nicotine products and sugary drinks and scrapping a dental benefit.

Since January, to bolster funding for healthcare, the health insurance contributions for self-employed people and self-payers rose from 14 to 15 per cent. For employers, the contribution increased from 10 to 11 percent. This increased fee will be in place at least until 2027. 

New taxation

Starting next year, a new taxation on non-alcoholic sweetened beverages, electronic cigarettes, nicotine pouches, and other nicotine-containing products will be introduced.

“We expect higher revenues for the state budget with the increase of taxes related to tobacco products. The second product, which has also been approved by our coalition partners, will be all beverages containing sugar and sweeteners, which will become more expensive,” added PM Fico.

This will include all sweetened beverages, liquid and solid concentrates, as well as energy drinks with added sugar or artificial sweeteners. The ‘sugar tax’ will not apply to pure fruit juices and honey.

The expected revenue from e-cigarettes and other nicotine and tobacco products is €15 million in 2025 and €126 million in 2026. Taxing sweetened non-alcoholic beverages is expected to bring to the state budget an extra €85 million in 2025 and €117 million in 2026.

A successful health benefit to be cut

Health insurance companies offer so-called ‘health benefits’, reimbursements or access to more examinations under certain conditions while also maintaining competition among insurers.

A popular benefit was the ‘dental benefit’ – citizens could ask for partial reimbursement for their dental examination. However, to improve prevention and check-up rates, the reimbursement was conditioned on a check-up with a general practitioner.

According to the Health Care Surveillance Authority, in 2023, the health insurance companies covered benefits for their policyholders in a total amount of 60.8 million euros.

All health insurance companies collectively spent a total of €45.8 million solely on dental treatments and dental hygiene, which accounted for 75% of the total expenditure on benefits for the year 2023.

Now, the dental benefit is coming to an end at the end of April.

Attendance at check-ups to take a blow

“The educational potential of increasing preventive check-ups through dental benefits has been exhausted; it is necessary to reassess it and find new versions of benefits that will focus on prevention,” Health Minister Zuzana Dolinková said in a press release.

The announced cancellation was met with surprise and general dissatisfaction.

“It is very important and right that insurance companies were doing it this way. Since 2019, they have provided these benefits to two million patients, and the number of preventive check-ups has increased by 12%. That is 427,000 preventive check-ups that otherwise would not have occurred – which is a tremendous benefit,” MP Jana Bittó Cigániková (SaS/ECR) said at a press conference.

She added that the preventive check-ups with GPs in adults rose by 40%, a statistic that has long been a challenge to improve. MP Szalay warns that the cancellation of benefits will likely lead to a decrease in attendance at check-ups.

All three health insurance companies confirmed to Euractiv the cancellation of the benefit at the end of the month. They also validated that the benefits have led to increased attendance at preventive check-ups while adding that no more cuts are currently planned.

“No health insurance company is pleased with the news of the reassessment of benefits by the Ministries of Health and Finance, but we respect the decision,” executive director of the Association of Health Insurance Companies, Dr. Dajana Petríková, told Euractiv.

Health insurance companies advocate that support for prevention plays an irreplaceable role in improving the quality of life for policyholders.

“I can assure you that each health insurance company is working on preparing their new useful benefits for their policyholders. In my opinion, it would be prosperous for the newly developed benefits to focus, for example, on the prevention of the most serious diseases in the areas of oncology, cardiovascular system, and neurology. However, everything depends on the creativity of individual health insurance companies,” she added.

Health insurance companies did not share with Euractiv any new planned health benefits or whether the dental benefit might be reintroduced in the future.

[By Filip Áč, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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