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(Re)organizacija obveznega zdravstvenega zavarovanja
ID Andoljšek, Anja (Author), ID Mišič, Luka (Mentor) More about this mentor... This link opens in a new window

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Abstract
Magistrsko diplomsko delo obravnava (re)organizacijo obveznega zdravstvenega zavarovanja v Sloveniji. Primerjalno pravno obravnavo sistemov zdravstvenega zavarovanja puščam ob strani in se poglabljam v aktualni zakonodajni okvir ter razpravljam o problematiki in možnih izboljšavah področja na sistemski, vsebinski in organizacijski ravni. Obvezno zdravstveno zavarovanje, kot je uveljavljeno od leta 1992, je v tridesetletni zgodovini doživelo nekaj korenitih sprememb, ki so deloma izraz spremenjenih družbenih okoliščin, političnih pritiskov in naknadno izkazanih pomanjkljivosti ureditve. Slovenija ima uveljavljen javni zdravstveni sistem po Bismarckovem modelu, katerega temeljna značilnost je skladnost z načelom solidarnosti med revnejšimi in bogatejšimi ter načelom horizontalne solidarnosti oziroma vzajemnosti med bolnimi in zdravimi. Ena od pomembnejših sprememb je nastopila po več kot dveh desetletjih javne razprave, in sicer ukinitev instituta dopolnilnega zdravstvenega zavarovanja in uvedba obveznega zdravstvenega prispevka. Še vedno aktualno vprašanje ureditve prispevka za obvezno zdravstveno zavarovanje in (trenutno aktualnega) obveznega zdravstvenega prispevka odpira vrsto drugih dilem v zvezi z načinom določitve teh prispevkov, organizacijo in delovanjem Zavoda za zdravstveno zavarovanje ter dostopnosti zdravstvenih storitev in dajatev v kontekstu razmejitve med javnim in zasebnim sistemom zdravstvenega varstva, ki so problematizirane v nalogi. Na področju socialnega tveganja odvisnosti od oskrbe drugega je bil sprejet Zakon o dolgotrajni oskrbi, ki na enem mestu ureja pravice do dolgotrajne oskrbe in tako deloma rešuje problematiko razpršenosti in nedoločenosti pravic, ki izhajajo iz tega socialnega tveganja.

Language:Slovenian
Keywords:obvezno zdravstveno zavarovanje, obvezni zdravstveni prispevek, dolgotrajna oskrba, slovenski zdravstveni sistem, (re)organizacija
Work type:Master's thesis/paper
Typology:2.09 - Master's Thesis
Organization:PF - Faculty of Law
Publication status:Published
Publication version:Version of Record
Year:2025
PID:20.500.12556/RUL-174402 This link opens in a new window
COBISS.SI-ID:257516035 This link opens in a new window
Publication date in RUL:02.10.2025
Views:680
Downloads:184
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Secondary language

Language:English
Title:(Re)organization of compulsory health insurance in Slovenia
Abstract:
The master's thesis explores the (re)organization of compulsory health insurance in Slovenia. It leaves asidecomparative legal analysis of health insurance systems and focuses on the current legislative framework, discussing key issues and potential improvements at the systemic, substantive, and organizational levels. Since its establishment in 1992, the system of compulsory health insurance in Slovenia has undergone several significant reforms, reflecting changing social conditions, political pressures, and the subsequent revelation of regulatory shortcomings. Slovenia operates a public health system based on the Bismarck model, characterized primarily by the principles of solidarity between the wealthy and the poor, and reciprocity between the healthy and the sick. One of the most significant reforms occurred after more than two decades of public debate: the abolition of supplementary health insurance and the introduction of a mandatory health contribution. The ongoing challenges surrounding the regulation of contributions for compulsory health insurance—specifically, the currently applicable mandatory health contribution—raise several other dilemmas. These include the method of determining contributions, the organization and functioning of the Health Insurance Institute, and the accessibility of healthcare services and benefits, particularly in the context of the division between public and private healthcare systems. These topics are critically examined in the thesis. Furthermore, in relation to the social risk of dependence on long-term care, the adoption of the Long-Term Care Act has brought some resolution by consolidating the rights arising from this risk within a single legislative framework, thereby addressing the previous fragmentation and legal uncertainty.

Keywords:compulsory health insurance, compulsory health contribution, long-term care, Slovenian health care system, (re)organization

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