Privatisation of health care in Slovenia in the period 1992-2008

Objectives To discuss the background, nature and facilitating and hindering factors of the privatisation process in health care in Slovenia.Methods Descriptive analyses of legal and policy documents mapping the situation in Slovenia against an internationally established taxonomy and typology. Description of the scope and volume of the different types of privatisation.Results Determined by the political will, privatisation in health care in Slovenia has been a gradual process. In 2008, it applies to 30% of the primary care providers (GPs, paediatricians and school medicine doctors), almost 60% of providers in dentistry and about 20% of providers of outpatient specialist care. In the hospital setting, privatisation remained limited and there have not been significant private investments in health infrastructure. Privatisation of health insurance (including insurance to cover co-payments) has steeply risen to 15% of the total health expenditure (THE), while out-of-pocket payments reached 12% of the THE.Conclusions Slovenia's privatisation in health care is focused on primary health care and on health expenditures. Controversies over its extent kept privatisation contained and controlled. Today's share of private provision of health services remains at the conservative end of the European Union. Private expenditures for health services increased considerably, while privatisation of health infrastructure and management has so far been limited. Concerns about the future course of privatisation relate to the issues of equity, fairness and solidarity.