The paradox of the voluntary health insurance in the Republic of Macedonia

Abstract

This working paper explores the position of the voluntary health insurance within the scope of the mandatory health insurance as a main tier of health insurance in the Republic of Macedonia. The main subject of research is the legislation regulating this issue (Law on voluntary health insurance), the application and functionality of its provisions; and also the accomplished results considering the fact that this law has been in force almost 4 years. For this purpose an analysis will be made of the statistical data on the number of insured persons under the voluntary health insurance. A brief comparison with several Balkan countries will be made in terms of the legal solutions for voluntary health insurance and also in the development of the voluntary health insurance through the statistical data of the insured persons under the voluntary health insurance scheme. This paper will also address some of the positive experiences in the countries in which the voluntary health insurance functions appropriately and simultaneously with the mandatory health insurance. The goal of this working paper is to point out the shortcomings of the voluntary health insurance system in Macedonia and to provide some ideas for improvement, to develop better, cheaper and more accessible health services for the Macedonian citizens. This goal can be accomplished with deregulation and liberalization of the health insurance sector, through amendments to the Law on health insurance aimed at balancing the basic and additional package of health care services and amendments to the Law on voluntary health insurance aimed at providing a greater freedom for all market participants in the health insurance system. Also, the idea of this paper is to examine the possibility to allow some citizens that would fulfill the necessary conditions, to abandon the mandatory health insurance system and join the voluntary health insurance system.