Table 4.
The 2008 financial reform measures
| Measure | Specific actions |
|---|---|
| Diversification of public revenue collection mechanisms through introduction of new mandatory health insurance (MHI) and complementary health insurance (CHI) contributions |
MHI contributions for the retired with pension under average salary paid from general taxation: rate 1% of gross pension
Retired with pension over average salary pay MHI contributions: rate 3% of gross pension
MHI contributions for the unemployed paid from general taxation: rate 5% of fixed sum
MHI contributions for pupils, students, war veterans, soldiers, asylum seekers, etc. paid in bulk from the state budget
Hypothecated cigarette taxation: 32% of excise duty
Tax on mandatory car insurance premiums: 7% (to cover the cost of health care provided due to traffic accidents)
CHI contributions for 100% disabled, organ donors, multiple blood donors, pupils, students, and all individuals with income per household member under the national poverty census threshold – paid from general taxation |
| Increased copayments |
Inpatient and outpatient hospital services: 20% of price (previously 15%-50%)
Dentistry: 20% of price (previously 15%-50%)
Primary care family medicine and gynecology: HRK 15 per visit deductible
Prescriptions – HRK 15 per prescription deductible
Price cap for all copayments: HRK 3000 per episode of illness |
| Reducing population exempted from copayments |
360 000 citizens became eligible for copayments (unemployed, war veterans, disabled with disability under 100%, etc.)
Exempted populations: children, pregnant women, patients with HIV, chronic psychiatry patients, transplant patients, dialysis and cancer patients, citizens living under the poverty level |
| Complementary health insurance |
Price increase from HRK 50 to 80 per month for the best of retired and HRK 80 to 130 for employed with large salaries |
| Financial discipline |
Stringent control of expenditure on all levels of the system |
| Resolution of accumulated arrears | Rationalization of expenditure Monitoring of debts and arrears Ban on increasing arrears |