Slovakia HiT (2016)

The Slovak health system is based on universal coverage, compulsory health insurance, a basic benefit package and a competitive insurance model with selective contracting of health care providers. However, 14 years after the introduction of a competitive insurance model, some health indicators, such as life expectancy, healthy life years and avoidable deaths, are troubling. This hints at persistent room for improvement in the delivery of care, especially primary and long-term care. Additionally, inequity in the distribution of health providers, resulting in lengthy travelling distances and waiting times for patients, needs to be addressed, especially as, given the ageing workforce, this trend is likely to continue.

Allocative efficiency also remains a challenge for the Slovak health system. For instance, the parallel systems of HICs, and the lack of data sharing capacity, promote repetitive testing and this contributes to the second highest spending on ancillary services in the EU in 2013.

On the one hand, there is a strong will to improve the Slovak health system, for example the current strategic documents and reform efforts by the Ministry of Health aim at a complete overhaul of enduring inefficiencies in the Slovak health system. On the other hand, health policy has been unstable over the last years and characterised by two rigid ideological positions. Key features of the 2002 reform are still the topic of heated debate and consequent modifications. For instance, user fees were introduced to make patients share the costs of health service provision, and, whilst set at a very low level, these were subsequently subject to several changes and will be abolished completely in the near future.

HiT health system reviews are country-based reports that provide a detailed description of a country's health system and of reform and policy initiatives in progress or under development. More up-to-date information on many countries can be found on our Health Systems and Policy Monitor (HSPM).