Z (de)regulacijo do učinkovitega zdravstvenega sistema

Bizjak, Rok (author), Strban, Grega (mentor), Grilc, Peter (co-mentor)

V magistrski nalogi sem raziskal delovanje trenutnega zdravstvenega sistema v Sloveniji in njegove značilnosti. Naš sistem, podobno kot mnogi evropski, se sooča s problemom staranja prebivalstva. Ugotavljam, da smo vzpostavili kakovosten sistem primarnega zdravstvenega varstva. Poleg obveznega zdravstvenega zavarovanja se velik odstotek prebivalstva odloča za dopolnilno zdravstveno zavarovanje. V našem sistemu imamo poleg izvajalcev, katerih ustanovitelj je država ali lokalna skupnost, tudi zasebne izvajalce, ki so vključeni v javno mrežo kot koncesionarji. Ti so močno usmerjeni v delovanje v javni mreži, saj je zaradi pomanjkanja kapacitet v javnih zavodih veliko povpraševanje po njihovih storitvah. Dotaknil sem se tudi pravne ureditve izvajalcev in problematike povezane s tem ter izdatkov v zdravstvu. V povezavi z izvajalci v javni mreži sem raziskal tudi učinkovitost in kako je ta povezana z drugimi temeljnimi načeli. V tem delu sem pozornost posvetil tudi zasebnim zavarovalnicam in njihovemu poslovanju. Pomembno in najbolj aktualno poglavje se nanaša na izzive, ki nam jih je prinesla epidemija novega korona virusa. En od katerih bo zagotovo izredno velik primanjkljaj finančnih sredstev, ki bo klical po sistemskih spremembah financiranja. Magistrsko nalogo pa sem zaokrožil z izkušnjami iz tujine in smernicami za učinkovitejše delovanje.

• Language: Slovenian
• Keywords: zdravstvo, zdravstveni sistem, regulacija, financiranje, zavarovanje.
• Work type: Master's thesis/paper
• Organization: PF - Faculty of Law
• Year: 2021
• PID: 20.500.12556/RUL-127832
• COBISS.SI-ID: 69156611
• Publication date in RUL: 24.06.2021

Secondary language

• Language: English
• Title: Through (de)regulation to a more efficient healthcare system

Abstract

In my master's thesis I studied Slovenian healthcare system and its main characteristics. The main challenge it faces is the ongoing ageing of the population which is common across Europe. My finding is that the primary level system is well set up. The Slovenian system is based on Compulsory insurance and beside it a great percentage of the population chooses to participate in supplementary health insurance. The current system is mostly based on public health institutions. But some private institutions decide to take part in the public healthcare system through concession because of the lack of available capacities. I also studied different legal forms in which the healthcare providers can operate under and management of expenses the healthcare system has. Mostly regarding public healthcare providers a lot can be changed and achieved in terms of effectiveness and other basic principles. The functioning of providers is also determined by their relationship with private insurance companies. Current challenges we face as a society are a result of the new Coronavirus epidemic. It is going to be a significant venture to try to undo the health and economic consequences this epidemic caused. These are both present in the healthcare system and its ways of financing. To round it up I proposed a few guidelines for a more effective system and a few lessons we can learn from abroad.

• Keywords: healthcare, healthcare system, regulation, financing, insurance.