The follow-up analysis "Responding to the challenge of financial sustainability in Estonia's health system: one year on" is ready

4.10 2011

Today on October 4, the Estonian Health Insurance Fund, Estonian Ministry of Social Affairs, and World Health Organisation (WHO) will present an analysis that provides an overview of whether and how the proposals made in the analysis “Responding to the challenge of financial sustainability in Estonia’s health system” for the previous year have been taken into account when organising Estonia's health system over the past year. The analysis sums up the developments since 2009, and highlights the areas of concern, covering the topics of health insurance, state-financed services as well as the extent of cost-sharing by people.

The new short report titled “Responding to the challenge of financial sustainability in Estonia’s health system: one year on” addresses the main changes in the health system financing since April 2009.

The analysis shows that during the period under review the utilisation of the available financial resources has somewhat improved in the health sector. For example, the prescription and issue of active ingredient based medicines has been gaining more and more ground, the reputation of generic medicines has improved both in the eyes of the public as well as medical staff, the role of family doctors as coordinators has been expanded for patients with chronic diseases, the development of day care has been promoted and the use of health technology assessment, clinical practice guidelines and quality indicators has been continuously encouraged.

On the other hand, the population’s financial protection has somewhat lessened due to the financial cuts made in the meantime. The cuts have led to longer waiting lists, abolition of dental care benefits universal for all population groups, lower rates of sickness benefits and the cap on reimbursement of cost-effective medicines in the 50% category has not been lifted. As of today, the public sector’s revenue base has not been broadened and no action has been taken to implement the development program of the hospital network to the full extent.

Jarno Habicht, head of the office of WHO in Estonia and the representative of WHO in the Republic of Moldova, said: “Over the past year, Estonia’s health system has gone through several changes that rely on the strengths of the existing system and have helped the system do well under the conditions of the global financial crisis. First and foremost, I would like to acknowledge the efforts made in promoting the rational use of medicines and more intensive application of principles of evidence-based medicine through the renewal of the system for assessment of health technologies and preparation of clinical practice guidelines. However, decisions concerning long-term sustainability and broadening of the revenue base for health insurance have not received due attention.”

The analysis to be presented today is a follow-up to the analysis of long-term sustainability of Estonia’s health sector financing, published last year and titled “Responding to the challenge of financial sustainability in Estonia’s health system”, that assessed the organisation of the health system financing against the backdrop of the national financial and budget policy.

Both analyses are available on the homepage of the Estonian Health Insurance Fund.


Evelin Koppel
Public relations manager
Estonian Health Insurance Fund
Lembitu 10, 10114 Tallinn, Estonia
Telephone: +372 620 8439; +372 53 478 949
E-mail: evelin.koppel [at]