Participation in Cost of Health Care from Compulsory Health Insurance

  • Viktor Gotovac Univeristy of Zagreb Faculty of Law
Keywords: health insurance, insured persons, participation in cost of health care from compulsory health insurance, complementary health insurance


Participation in cost of health care from compulsory health insurance is a legal concept which has been normatively provided in Croatian healthcare system for more than forty years, a concept that has seen its more significant application in the last twenty years as an additional source of funding of the public healthcare system, next to compulsory health insurance. Through personal, direct, coverage, as well as indirect coverage through complementary health insurance, of cost of health care from compulsory health insurance in part in which the insured persons are obliged to participate in cost of health care, this concept transfers a part of cost to the beneficiaries who are insured persons of the compulsory health insurance of healthcare, thus increasing the funding of the public health system and the services it provides. This participation may be executed in several manners, but the motivation behind all of them is the same - rationalization of the use of healthcare while increasing its income. There is a critical point in this approach - the risk of catastrophic financial loss caused by medical expenses - which is why this legal concept is usually associated with complementary health insurance replacing it. Taking into consideration the period of application of this concept, this paper shall try to outline its features in Croatia and compare it to the application in other European countries, while considering possibilities for the further development of this concept. The latter is the essential part of the paper, summarizing possible scenarios, from the petrification of the existing situation, through the possibility of parameter reform, to the cancellation of the concept. However, the directions and possible solutions themselves are not the most important - crucial is the awareness of questioning changes in society.