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AmCham Business Breakfast, Tuesday, 9 December 2014, Hotel Slon, Ljubljana

Guests at the Business breakfast:

Arne Björnberg, Ph.D., Chairman and COO, Health Consumer Powerhouse, monitors and compares healthcare systems in 35 countries.

Full prof. Mitja Čok, Ph.D.,
examined the financial sustainability of the public healthcare system and possible sources of founding.

Full prof. Alojz Ihan, M.D. Ph.D.,
medical doctor, professor, researcher and an active observer of the healthcare system.

Dorjan Marušič, M.D., Ph.D., former Minister of Health of the Republic of Slovenia.

Andrej Možina, M.D., Ph.D., Surgeon and President of the Medical Chamber of Slovenia.

AmCham Health Committee, which was the initiator of the debate, consists of 37 experts from 25 companies and seeks, through the prism of Slovenian and foreign business, professional and entrepreneurial practices, to contribute to implementing a complete, transparent and just healthcare reform in Slovenia. The debate was led by one of the members of AmCham healthcare Commission, Jadranka Jezeršek Turnes.

The keynote guest, Dr. Arne Björnberg, pointed out in his opening remarks how in a small country even a limited number of qualified and dedicated individuals can make a big difference. Compared to others in Europe, the Slovenian (healthcare) system is reasonably solid, Björnberg believes, but it lacks stability.

The healthcare system in Slovenia needs an upgrade

Jadranka Jezeršek Turnes challenged her counterparts by claiming that “interest groups have high expectations and citizens expect a comprehensive, transparent and an innovative system. The Ministry should have enough courage to implement reforms, which would be derived through a coherent public debate.”

Marušič warned: “Let’s avoid the word reform. A better term would be an upgrade-we need to upgrade the system. What the system needs above all is continuity. My main concern is that the process of change has been slowed down.”

“The Medical Chamber should be an important part of the reform, a strategic partner. Unfortunately, that is not the case. It is difficult to say why but I personally believe the main reason is ideological. With regards to the legislation, nothing has changed in the last twenty-five years. The Ministers have, however, changed frequently, which makes it difficult to communicate. We are supposed to be proud of our system, but the system does not show potential. Hospital margins are in negative numbers, we are not following innovations. We want a dialogue, efficiency and stability. Therefore we demand the leadership tools to be in the hands of healthcare managers and we demand competitiveness in the global and European markets.” Emphasized Možina.

Alojz Ihan added:It is very difficult to introduce a new system in Slovenia, because we grew up with a national healthcare system. The problem is in collecting/raising the money and managing the healthcare system. Moreover, the healthcare system providers are corporations doing business like any other corporation and therefore operate under the same principles as other businesses. I regret that 20 years ago, we didn’t introduce the Austrian or German hospital models as an example of how hospitals can serve patients. I believe this is a model according to which our hospitals should be guided.”

The Netherlands can be a role model

Björnberg presented the case of the Dutch healthcare system upgrade. “The Netherlands had a bad healthcare system. Their main reform focus was removing politicians from the decision-making process. If intelligent, competent people are kept and made to communicate with the users, you have a recipe for success. The Netherlands is the only country that allows its citizens to search for medical care anywhere in Europe. They realized that people in fact do not really want to travel to receive medical services.”

Marušič added that the process of introducing changes is of great importance: “The healthcare system must become one of the first three priorities in Slovenia, because this has not been the case for a long time. Considering the Netherlands, I would draw one thing from its experience, namely the length of the reform process, which took as many as 10 years. We cannot literally copy the Dutch solution, but we can copy the process. Another problem here is the frequent changes in dialogue, viewpoints and visions which change with each healthcare minister.”

Prof. Čok highlighted: »What we need are long-term changes in the system, starting with a change in the pension system with regards to healthcare. This will solve many problems.”

The key is in efficient management – queues are an indicator of the state of the healthcare system

Björnberg: »Healthcare is an ideal industry. Its users are willing to pay for the services; other industries would do a lot to achieve this. It does not matter whether a hospital is private or public, the importance lies in its management. Healthcare institutions should be financed according to their results, not merely because they exist.”

Čok highlighted the problem of queues: “Queues in fact eliminate people from the system, a private system with the possibility of visiting various hospitals would be better, we currently have the most unjust healthcare system.”

Marušič emphasized the correlation between queue lengths and the efficiency of a healthcare system: “Queues are an indicator of the state of the healthcare system; the longer the queue, the lower the organizational level and effectiveness. Similarly, long queues reduce the safety of our citizens, therefore reorganization is important.”

“Hospitals should become independent institutions, we must get rid of the queues. Hospitals are afraid of accepting foreigners because of queues at home – it would look controversial if anyone jumped them” further added prof. Ihan.

Be brave and innovative – a message to the government

At the end, participants also gave their recommendations to the government. Former Health minister Marušič bets on courage and innovation: “Design solutions that go beyond your mandate. Do not forget that you are leading a system, which requires systemic solutions and touches every single citizen. In doing so, be brave and innovative.”

Björnberg once again highlighted the financing method: “Financing of healthcare services has to be organized on the basis of efficiency and results. Furthermore, professional management of institutions is crucial. The healthcare system can do much more than what it is doing today.”

Možina wants above all a better communication with the government. “Better communication and greater respect are needed. Healthcare managers should be given more tools.”

AmCham Health Committee will continue to promote discussions on upgrading the healthcare system in Slovenia, by focusing on three key areas:

· financing of the system and cost-effectiveness,

· management and organization of the healthcare system,

· system of evaluating healthcare innovations

Pictures of AmCham Business Breakfast are available on our Facebook page.