It will not be possible to achieve better results of the Slovak healthcare system without higher resources

On the occasion of the celebration of the 30th anniversary of the American Chamber of Commerce in the Slovak Republic, a unique Festival of the Future is being held, which provides insight into how emerging megatrends are shaping our sustainable future. The festival also included the Healthy Future conference, which was attended by over 200 participants from actors from the private sector, public administration and professional healthcare organizations or associations. From breakthrough green strategies and the latest sustainable economic models to the transformative power of space technology, our future depends on innovative solutions and new regulations. When it comes to the basic pillars of further development, sustainable healthcare cannot be left out.

According to the forecasts of the European Commission, the Slovak population is aging significantly. By 2030, the number of people aged 65+, who more often also have chronic diseases such as diabetes and high blood pressure, will increase significantly. At the same time, the number of people aged 20 to 64 will decrease. Most of the funding in the health sector comes from levies from these people. They are the workforce and many of them work as doctors and nurses. That’s why we need to think about how to set up long-term sustainable and multi-source financing of healthcare.

How are we prepared for new challenges?

Vladimír Baláž, chairman of the Committee of the National Assembly of the Slovak Republic for the health sector states that “among the biggest challenges that the Slovak healthcare system faces and will face is the aging of the population. This fact will cause pressures on financing, personnel resources and processes not only in the health sector, but also in the social field. If we want to influence the basic performance indicators of our healthcare system, it is necessary for us to focus on early diagnosis and treatment of serious diseases, with determination of the patient’s path in the system. These goals cannot be implemented without sufficient, transparent and predictable funding, and the fulfillment of these goals cannot be monitored without thorough digitalization of the healthcare system and analysis of collected data.”

Among the other challenges of the Slovak healthcare system, we can also include the availability of innovative medicines, where Slovakia has so far lagged behind. Ladislav Slobodník, State Secretary of the Ministry of Health of the Slovak Republic states that “Our vision is to bring breakthrough and innovative medicines that improve the quality of life of our patients, push the boundaries of medicine. Improve the accuracy of reported data also based on the implementation of new systems in e-Health. To ensure financial stability in drug policy as well as in medical devices.”

Michal Štofko, State Secretary of the Slovak Ministry of Health: “Covid-19 has shown us how unprepared the country can be for risks and pitfalls that can come at any time. We must learn from the pandemic and look at other countries whose results, unlike ours, were on the other side of the spectrum. Countries with the best healthcare differ from the others in several points. First of all, it is long-term and sufficient financing, while the long-term is a parameter that is regularly forgotten in today’s discussions. It is financing that can ensure an adequate and timely influx of innovations, which is characteristic of the best countries Healthcare expenditures should not be viewed as costs (e.g. doctors’ salaries), but as investments that, through many spill-over effects, will also bring us a positive long-term result from the point of view of the national economy – we can monitor this within the determinants of health across all countries. Eurozones According to the latest EU Aging report from this year, the increase in the share of health care expenditure in GDP by 2070 would be almost 3 times higher in the case of the sick population than in the case of the healthy population. This also clearly implies the need for a fundamental increase in emphasis on better prevention, whether we are talking about primary or secondary prevention. Of course, without increasing the health literacy of the population, any measures associated with better prevention are doomed to an extremely painful path and marginal impacts.

At the same time, it is necessary to focus on the gradual shift of competences within the medical and non-medical staff, as one of the most important tools for relieving the burden and gradually stabilizing today’s extremely overworked staff (almost all EU countries are struggling with this problem, which also significantly affects the increase in competition on the labor market between by individual countries – while even at the EU level there is a call for cooperation and coordination between countries rather than a competitive and “paying” fight). The last and extremely important factor is stable leadership, which is able to direct and maintain individual measures in the long term. The average “age of a minister” in Slovakia is approximately 1.5 years. In Norway it is 3 years, in the Netherlands more than 5 years and in Switzerland more than 6 years (taking into account the frequent changes of ministers during the pandemic).

It is clear that without a long-term direction to ensure a healthy population, which is supported by sufficient and long-term funding, strong support measures and a clear view of health spending as an investment, we will not be able to compete with the best countries in the future.”

As far as funding is concerned, international comparisons show that the Slovak healthcare system has been significantly underfunded for a long time. Slovak healthcare has a long-term low budget, 400 euros per year less than the Czech Republic. This is manifested by debt in hospitals but also by increasing unofficial fees in doctor’s offices. According to a representative survey from 2023(1) these unofficial fees reached 64 euros per year per citizen only in doctor’s offices. In addition, there are additional payments for medicines and medical devices. For many citizens, these fees are stressful. As many as 23% of respondents in the survey declared that they postponed their visit to the doctor because they were worried about how much they would have to pay and whether they would be able to afford it. These fees are estimated to be 300 million. euro, i.e. roughly 25% of expenses for ambulatory health care. They could thus form the basis for multi-source financing. But it is necessary to put them in order and set them uniformly, transparently and at a level that is socially bearable even for the poorest. According to the survey, up to 73% of Slovaks support such a solution.

On the one hand, states, including Slovakia, face the need to consolidate public finances and cut spending. On the other hand, public health systems fulfill the role of universal coverage and accessibility for all, while the demand for health care will increase. Martin Vlachynský, INESS analyst states that “the traditional model of public health is starting to hit its limits. It will depend on the regulator whether it tries to look for synergies with emerging commercial responses to patient needs, or we end up with two separate worlds in healthcare.”

Members of the American Chamber of Commerce in the Slovak Republic repeatedly state that sufficient resources in the healthcare sector are an investment in health and economic growth. Henrieta Tulejová, partner of Advance Healthcare Management Institute adds: “We have already increased the levies, the state will add money here and there. But the number of economically active people, who pay taxes and levies and are also a workforce in the health sector, will decrease by 200,000 people in the next 5 years. The number of those most in need of affordable and high-quality health care will increase by approximately the same number. Therefore, we need to stabilize the involvement of private resources. The first step could be to bring order to unofficial fees and set them up in a socially acceptable way. Sufficient resources are as important a topic as their efficient use.’

The issue of sustainable financing is fundamental for health insurance companies. Martin Kultan, chairman of the board and general director of the health insurance company Dôvera states that “with the sustainability of the financing of the Slovak healthcare system, its functionality, or survival, is directly connected. It is no longer a question of whether the system is financially sustainable, but for how long. We all see and feel it – experts, patients, the whole society. Therefore, drastic and, unfortunately, unpopular steps are necessary on the part of politicians and competent authorities. The company should shut down and support these steps so that our healthcare system stops living and can develop for the benefit of the patient.”

The importance of cooperation and a comprehensive approach

In the complex world of information, actors, interests and possibilities, it is essential to create space for meaningful partnerships and inclusive, strategic and targeted cooperation. It is no different when building a modern, accessible, competitive and resilient healthcare ecosystem. Public and private spheres, scientific and academic institutions, we all have in our hands whether our society will progress or walk backwards.

Martina Žemberová, Chairwoman of the AmCham Committee for Healthcare, External Partnerships Lead, Roche Slovakia states: “At Roche, we care about contributing to prosperity in all the countries where we operate. Only an educated and healthy society has a chance to be successful, competitive and safe. Health care as a society-wide topic requires a partnership approach and systematic cooperation based on expertise and trust. This is exactly what we strive for within AmCham Slovakia, both with our members and with external partners. I am convinced that the project of a healthy future for us and the next generations has the potential to unite us and bring us closer to a common goal: modern, sustainable and reliable healthcare at the level of the 21st century, which patients across Slovakia deserve.”

Healthy Future Day at the AmCham Slovakia Festival of the Future was supported by Partners of the Future: Citi, Hurricane Event Production & Design, McDonald’s, Swiss Re; Premium Partners: DÔVERA zdravotná poisťovňa, PwC, Main Partners: Biogen, Čechová & Partners, GLOCCO, JOHNSON & JOHNSON, MEDTRONIC, Merck Sharp & Dohme (MSD Slovakia), NOVARTIS, ROCHE Slovakia, ZIMMER BIOMET, Partners: AbbVie, Amgen, Astra Zeneca, Dr. Max, PFIZER, Slovak Association of Manufacturers and Suppliers of “In Vitro” Diagnostic Medical Devices (SEDMA – IVD), Slovak Association of Medical Devices Suppliers (SK+MED), TAKEDA, VÁŠ LEKÁR

About the American Chamber of Commerce in Slovakia

The American Chamber of Commerce in Slovakia is an independent non-profit organization financed exclusively by the contributions of its members. It has been operating in Slovakia for 30 years with the aim of bringing positive change within the business environment in the Slovak Republic. The key pillars of the chamber’s activities include law enforcement, healthcare, education and regional development. The American Chamber of Commerce in Slovakia currently unites approximately 300 Slovak and foreign companies. Among them are the largest employers in the country, but also small and medium-sized enterprises, which are the key pillar of the economy of every country, as well as non-profit organizations and educational institutions. You can get more information about AmCham at and on social networks: LinkedIn, Instagram, Facebookor YouTube.