/nginx/o/2013/12/19/2702490t1h93d8.jpg)
On October 25th last year, the principle entered into force: no longer must our local patients see the doctor in Estonia, necessarily – rather, the step may be taken anywhere in EU. Health Insurance Fund will pay the bill, to the extent similar treatment would have cost in homeland.
In a couple of months, about two dozen inhabitants of Estonia have taken the opportunity; the first foreign bill landed at Health Insurance Fund just some days after the Directive entered into force. Relatively many people within a short period of time – revealing the opportunity to be cored abroad was missed, and longed for. That, in turn, poses a challenge to our local medical care providers.
Nothing wrong with Estonia’s hospitals or doctors; our treatment capability is easily competitive in the rest of EU. Rather, this is the issue of administration, determining the time it takes to see a medical specialist. Read: waiting lists. My mere statistical average, our «specialist lists» aren’t too long – nowhere is the average too much shorter. Even so, the lists differ in length, with varying specialists; should a patient find faster help elsewhere, he will go for that. Purse and guts allowing, of course. And going to Finland is a piece of cake, as one may well hit upon an Estonian doctor there.
For the first year, €8m has been allocated for compensating treatments abroad. That’s the money Estonian medical care system will not get. Meanwhile: this is just the first year of patients’ free movement. The size of the budget line proves to be, in years to come, largely depends on how well local hospital managers learn the lessons.
Last week, National Audit Office very severely tested functionality of e-health; among other things, the office pointed at unwillingness by hospitals to use e-registration at all. With a common system, it would be easy for a patient to spot the nearest possible time to see the needed specialist in Estonia. Right now, patients have no such option. Often, family doctors haven’t either.
There’s never enough money in health care; for a patient in trouble, the waiting list always looks unfairly long. This is a trust issue: how transparent, for the patient, is the administration of the waiting list? If, in Estonian, the list is long and opaque, but elsewhere short and transparent – the patients will choose their health i.e. treatment abroad.
While compensating foreign treatment bills, however, Health Insurance Fund will have less money left to buy services from local providers. Still, this could be prevented, if Estonia could manage to make its waiting lists more transparent. That will happen when hospitals start seeing themselves as part of Estonian health care, not competitors thereof.