The sustainability of the health system has always been at the center of Estonia’s health policy. Although, with the latest financial crisis the sustainability of the health system has become one of the most important political questions not only in Estonia but all over the world. The study evaluates the functioning and sustainability of the Estonia’s health system. The funding system is analysed and new opportunities are offered to improve the efficiency of financing.
Estonia’s health system is mainly financed by the special purposed social tax. Approximately 2/3 of healthcare costs are covered by the social tax, 1/10 from other sources in the public budget and less than a quarter from the patients.
„Stability in the healthcare is mainly achieved primarily due to the special purposed social tax and the health insurance fund’s conservative budget policy“ – Andres Võrk
At the same time, the share of health care costs are quite small in relation to the total costs of the public sector. Offering healthcare services has many shortcomings and no central managing exists regarding capital investments. The overall healthcare costs are on the rise and they continue to increase as the population ages. Although, the aspects related to the health system influence the costs more than demographical developments. Inefficiency is created by governments weak control over capital investments and the lack of different stimuli to balance and coordinate the providing of treatment at different levels.
The study offers four possible opportunities to increase the efficiency of financing policy. It is recommended to increase the revenue base of the public sector, modidy the scope of insurance coverage, improve the management of budgetary resources and strengthen the strategic management of the health sector. The financial sustainability of the health system relies mainly on the political decisions on how much to invest into health and how to allocate resources.