TFL Vsebine / Revija Pravnik

7

Dopolnilno zdravstveno zavarovanje je že več let predmet kritik in agend zakonodajalca, ki že skoraj desetletje obljublja strukturne reforme na področju financiranja zdravstvenega varstva. Kljub vsem obljubam in nameram pa na tem področju vse od novele Zakona o zdravstvenem varstvu in zdravstvenem zavarovanju (ZZVZZ-H) ni bilo večjih sprememb. Opozoriti je treba zgolj na dve: Zakon o uravnoteženju javnih financ (ZUJF) in novelo Zakona o zdravstvenem varstvu in zdravstvenem zavarovanju (ZZVZZ-M). ZUJF je leta 2012 odpravil določbo ZZVZZ, ki je določala predhodno pisno potrditev povišanja premije dopolnilnega zdravstvenega zavarovanja v času njegovega trajanja, novela ZZVZZ-M pa leto pozneje določbo ZZVZZ, ki izvajalcem dopolnilnega zdravstvenega zavarovanja nalaga, da polovico dobička iz dejavnosti dopolnilnega zdravstvenega zavarovanja namenijo za izvajanje te dejavnosti. Članek v luči pravnega reda Evropske unije (EU) analizira obe zakonodajni spremembi, ki sta posledici tožbe pred Sodiščem EU, ter razkriva pomisleke o primernosti slovenske obrambe pred Sodiščem EU in obeh zakonodajnih sprememb, s katerima je Slovenija določbi odpravila.

Complementary health insurance in the Republic of Slovenia has been subject of critiques for many years. In the same period it has also been on the agenda of the legislator which has been promising structural reforms in the field of financing of health care for almost a decade. Despite all the promises and intentions, since the Act Amending the Health Care and Health Insurance Act (HCHIA-H) there has not been any significant change in the field. Only two acts are worth mentioning: Fiscal Balance Act and Act Amending the Health Care and Health Insurance Act (HCHIA-M). In 2012, Fiscal Balance Act removed the provision of HCHIA laying down a prior written approval for raising the complementary health insurance premium in the period of its duration. One year later, the Act Amending the HCHIA-M removed the provision of HCHIA, which obliged the providers of complementary health insurance with a recovery of one half of the profit from complementary health insurance activity back to the management of this activity. In light of EU law, the article analyses both legislative amendments which are a consequence of a lawsuit before EU Court of Justice and raises concerns over the appropriateness of Slovenian defence and both legislative amendments by which Slovenia abolished the provisions.

Impact of Fiscal Balance Act and Act Amending the Health Care and Health Insurance Act on Financing of Complementary Health Insurance