Prishtina, December 15, 2016 – Law on Health Insurance has been characterized with delays in implementation since its adoption in April 2014. These delays in implementation are a result of a wrongful approach in the early stages of drafting and fast-track approval, without a detailed structuring and consultation with the key stakeholders, including the private sector. In addition, a recent information session organized by the American Chamber of Commerce has rendered has shed light on numerous flaws, which hinder the implementation of the law and confirm lack of dialogue with stakeholders.
Many important provisions of the law are deficiently specified or are not specified at all, thus giving the impression that the purpose of having such law is collection of additional revenues for country’s budget and not improvement of health indicators and provision of financial safeguards from poverty because of high expenditures for health care, which is thought to be the purpose of this law.
AmCham emphasizes that collecting premiums before all stipulated preconditions are met is actually a violation of the law, and in such circumstances premiums cannot be charged or collected. Also, payment of premiums for services which are not provided both by public and private institutions is in violation of the market economy principles.
AmCham is concerned over the fact that Ministry of Health has public announced that all services will be contracted by public healthcare institutions only, and that private healthcare institutions will be contracted only for those services which may not be provided by public sector. Pursuant to the Law on Health, equal treatment of public and private sector is a key principle of the healthcare system in Kosovo.
The American Chamber of Commerce in Kosovo believes that the implementation of this law should not be conceived as an experiment and as a testing period, because the universal access to quality healthcare services is a basic right for all the citizens of Republic of Kosovo, whereas the equal treatment of public and private sector is a right guaranteed with country’s constitution and legislation which promotes fair competition and non-discriminatory treatment. Contrary to this, the Law on Health Insurance, jeopardizes this right.
AmCham voices its concern over the calculation of health premiums as a percentage of gross revenues for the individual. While understanding the principle of solidarity promoted by the law, as to ensure equal access to healthcare services for the entire population, AmCham suggests the matter of contribution to be further regulated, in terms of having a ceiling for the contribution of employees, similarly to the case of self-employed persons. On the contrary, the current legislation may result in encouraging informality in employment, a phenomenon which should necessarily be fought.
Based on this, the American Chamber of Commerce in Kosovo calls on the Government of Kosovo to suspend the initiation of collection of premiums, set to begin on January 1, 2016, until further clarification of the primary and secondary legislation, and elimination of all flaws, including the discrimination of private healthcare institutions. At the same time, AmCham calls on the Ministry of Health and Government to lead a comprehensive consultation process with all the interest organizations in Republic of Kosovo.
Main concerns of the professional healthcare community regarding the law are as follows:
- Incomplete detailing of the list of services, list of medicaments and pricelist which are a pre-condition before the beginning of collection of healthcare premiums;
- Non-fulfillment of criteria stipulated in the Article 37, paragraph 10 of the Law on Health Insurance as necessary criteria for initiation of collection of premiums. Furthermore, there are no information on the status of the process of fulfillment of these criteria;
- Delays and uncertainties in the contracting of private healthcare institutions licensed for provision of basic healthcare services; and
- Non-initiation of process for development of a heal insurance management software and equipment of employees with health insurance cards, being one of main priorities stipulated in the transitional provisions of the law.
AmCham’s call for suspension of the implementation of the law is also based on the slow dynamics and continuous delays of Kosovo’s institutions in many regards, from drafting of various secondary legislation up to completion of the boards of independent agencies.