Concerning the decision of the Government of the Republic of Kosovo to postpone the beginning of the collection of premiums for Health Insurance.

PRIZREN 30.06.2017

The Association of Patients’ Rights in Kosovo – PRAK thanks the Government of Kosovo that it has taken into consideration its recommendations and other interest groups that the health insurance scheme is not yet ready to be launched.

We consider a reasonable decision to postpone the date for starting the collection of health insurance premiums based on some analyzes we have made on this process. We also want to point out that this postponement does not enjoy us at all, but as we have mentioned in the public letter we sent to the Prime Minister, a beginning of the health insurance scheme without proper preparation, we consider only an additional tax citizens but not improve the state of health.

Our attitude is based on the fact that:

  • The Law on Health Insurance has a series of deficiencies and is in the process of change;
  • A series of sub-legal acts necessary for the functioning of the Fund have not yet been adopted;
  • The Fund has an extremely low number of staff and there is no facility for staff accommodation;
  • The integrated health information system is not yet functional;
  • The list of basic health services with pricelist and co-payment is not harmonized;
  • Communicating with the public about this issue is at zero point;

The postponement of the beginning of the collection of health insurance premiums should not imply the suspension of these activities. On the contrary, the Ministry of Health and other stakeholders involved in this process should work hard to:

  1. Establish the Fund before the collection of premiums begins, as the health financing agency can not collect premiums;
  2. To respect the World Bank’s recommendation that “payment of 7% premiums should be reduced to 5% (in order to have a broader range of positive response to the payment of contributions);
  3. The amount of co-payments from the price list of services (pocket payments) under the WHO criterion does not exceed 15% of total health expenditure.
  4. Considering transparency as vital, be published on the Fund’s web site:

4.1. All Fund Regulations,

4.2. Contracts with all contracted service providers,

4.3. Lists with services covered by the Prize Fund and co-payment,

4.4. Lists with medicines reimbursed by the Fund with pricing and co-payment,

4.5. All financial movements on a monthly basis.

Within 6 months:

  1. Implement the Integrated Health Information System throughout Kosovo;
  2. Adopt all regulations and other acts necessary for the work of the Fund;
  3. To contract the primary health institutions on the basis of the capitulation;
  4. Determine contract criteria and contract pharmacies;
  5. Make special contracts with secondary and tertiary health institutions;
  6. From the beginning of the purchase of services, besides the reimbursement of out-of-hospital medicines, hospital services are supplied with medicines and medical material at 100%. No single drug is required to be bought by the patient himself.

If these necessary requirements are not met within this period, it is considered that the necessary preparations have not been made and it is impossible to start collecting the premiums.

We remind you that PRAK has sent a public letter to the Prime Minister of the Republic of Kosovo a day ago with an analysis of the health insurance scheme that was summarized in 10 conclusions and some recommendations. Find the attached public paper link:


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