Dopolnilno zdravstveno zavarovanje

Magistrsko diplomsko delo obravnava ureditev zdravstvenega zavarovanja v Sloveniji, s poudarkom na dopolnilnem zdravstvenem zavarovanju in njegovem izvoru, doplačilih. Cilj naloge je predstaviti problematiko trenutne ureditve obveznega zdravstvenega zavarovanja, ki se nanaša na neskladnost doplačil in dopolnilnega zdravstvenega zavarovanja z načeli enakosti, pravičnosti, solidarnosti in z načelom socialne države. Naš zdravstveni sistem je urejen po Bismarckovem modelu socialnega zavarovanja in deluje kot javni zdravstveni sistem, katerega temeljne značilnosti so, da temelji na načelu vzajemnosti med bolnimi in zdravimi ter na solidarnosti med revnejšimi in bogatejšimi. Dostop do ustreznega zdravstvenega varstva mora biti zagotovljen vsem, ki so v javni sistem vključeni. Ob nastanku nove države smo v Sloveniji ob bok obveznemu zdravstvenemu zavarovanju vpeljali doplačila v odstotku od vrednosti zdravstvenih storitev, ki najbolj prizadenejo oziroma bremenijo ekonomsko šibkejše posameznike. Zavarovana oseba se lahko neposrednemu plačilu doplačil izogne s sklenitvijo zasebnega prostovoljnega zavarovanja za doplačila oziroma t. i. dopolnilnega zdravstvenega zavarovanja. Dopolnilno zdravstveno zavarovanje je sicer nekoliko omililo krivičnost doplačil, kljub temu pa je tudi samo krivično, saj je premija za vse državljane enaka, kar za socialno šibkejše predstavlja precej večje finančno breme. Navedena ureditev ni v skladu z ustavnimi načeli enakosti, socialne varnosti, načelom socialne države ter ni solidarna in pravična. The master's thesis deals with the regulation of health insurance in Slovenia, with an emphasis on supplementary health insurance and its origins - co-payments. The aim of the thesis is to present the problems of the current regulation of mandatory health insurance, which lies in the incompatibility of co-payments and supplementary health insurance with the principles of equality, equity, solidarity, and the principle of the welfare state. Our health system is organised according to the Bismarckian model of social insurance and operates as a public health system, the fundamental characteristics of which are that it is based on the principle of solidarity between the sick and the healthy and between the poorer and the richer. Access to adequate health care must be guaranteed to all those who are included in the public system. When the new state was created, we introduced co-payments in Slovenia alongside mandatory health insurance, as a percentage of the value of the health services that most affect or burden the economically weaker individuals. The insured person can avoid paying the co-payments directly by taking out private voluntary insurance for the co-payments, known as supplementary health insurance. While supplementary health insurance has somewhat mitigated the unfairness of co-payments, it is also unfair, as the premium is the same for all citizens, which places a much greater financial burden on the socially weaker. The stated is not in line with the constitutional principles of equality, social security, the welfare state, solidarity, and is not equitable.