On Wednesday, 14 September, Latvian Saeima’s Social and Employment Matters Committee supported the proposal submitted by the Ministry of Health on dropping the base health insurance basket, narrowing the range of recipients of state-funded healthcare.
According to Minister of Health Daniels Pavļuts, currently the Healthcare Financing Law details a two-basket healthcare insurance principle.
One of them is the healthcare minimum or the «base basket» for Latvian citizens, non-citizens, foreigners with permanent residence permits and others who are not socially insured. The other one – state mandatory healthcare insurance or the ‘full basket’ is for residents who pay state social insurance contributions within a general regime and persons who are less socially protected (children, pensioners and the unemployed).
According to Pavļuts, approval of this new system was postponed until the end of the year to give the government tie to come up with law amendments that would help establish in the law a single basket general health insurance principle financed by the state budget.
The minister believes it would be a good idea to narrow the range or people eligible to receive state-funded healthcare, because currently it is available to all.
At the same time, there are people in Latvia who do not actually live in the country, rather come back for vacation and use the state healthcare system.
For example, last year 1 100 people (citizens and non-citizens) who have residence registered outside of Latvia used its state-funded healthcare services.
«We have to clearly define which group of residents are and which are not eligible for state-funded healthcare. The solution is making it clear that healthcare in Latvia is financed for registered residents. It is important because registered residents are the tax residents, but we have no way to motivate people to re-register residence in Latvia,» said the minister.
At the same time, she added that emergency medical aid will be provided regardless of the alternative.
The other solution is setting up social contributions or health tax for groups of people who don’t pay relevant taxes. However, this would be in breach of the government’s commitment to not raise taxes, nor would this would be any different from the two-basket principle.
The Ministry of Health proposes dropping the base health insurance basket and introducing instead the principle under which healthcare in Latvia is provided to de facto declared population and specifically defined groups, from children to refugees.
The ministry provided the Saeima with multiple proposals regarding introduction of a comprehensive state mandatory health insurance system.
The ministry believes the «two-basket» system would discriminate and limit hundreds of thousands of Latvian residents’ access to healthcare.
The ministry notes that, despite how frequently this topic is brought up, no agreement has been reached with other ministries and coalition parties. The main objection the Ministry of Health receives is that there are people who have declared residence in Latvia but in actuality live elsewhere. According to the ministry, the issue of declared residence should be resolved using other means, not using medics.
Healthcare is not a controlling mechanism, it is meant to protect people’s health. This is why the ministry has decided to submit this initiative to the ruling coalition and the Saeima again by October.