Can people afford to pay for health care? New evidence on financial protection in Slovenia

Overview

This review is part of a series of country-based studies generating new evidence on affordable access to health care (‎financial protection)‎ in health systems in Europe. Financial protection is central to universal health coverage and a core dimension of health system performance. Catastrophic health spending is lower in Slovenia than in most countries in Europe, but levels of unmet need are above the European Union average. Slovenia’s low incidence of catastrophic health spending reflects a relatively comprehensive publicly financed benefits package and (‎before 2024)‎ extensive protection from heavy user charges (‎co payments)‎ through carefully regulated complementary voluntary health insurance (‎VHI)‎. A major reform introduced in 2024 abolished most co-payments – an example of good practice to other countries in Europe and beyond – and replaced premiums for complementary VHI covering Health Insurance Institute of Slovenia co-payments with a new mandatory flat-rate contribution per person. The reform led to a large reduction in user charges, removed the need for complementary VHI covering co payments and lowered health system complexity and administrative and transaction costs – these are important gains. Several issues continue to require policy attention, however, including: a very heavy reliance on employment to finance the health system, which is a challenge in the context of population ageing; long waiting times; a lack of protection from remaining user charges; gaps in service coverage for medical products (‎corrective lenses and hearing aids)‎ and dental care for adults; the regressivity of the new mandatory flat-rate contribution; and a small but significant gap in population coverage.