ZAGREB, 12 June 2022 - The measures proposed by Health Minister Vili Beroš to reform the health system have been welcomed by the heads of two Zagreb hospitals, who say that introducing a model of payment to hospitals based on efficiency would be a major change in the operation of hospitals, burdened by debts.

The announced reform measures, such as the establishment of excellence centres, hospital accreditation and payments based on efficiency would change the operation of hospitals which are given billions of kuna from the budget every year to settle their debts, the head of Zagreb's Sisters of Charity Hospital, Davor Vagić, said at a panel on the hospital system, held as part of the MedMed 2022 conference in Grožnjan on Saturday and organised by reporters covering the health system and health-related topics.

Croatia has 62 hospitals, including hospital centres, clinical and general hospitals and special and private hospitals.

Medical workers attending the panel were agreed that the number of hospitals should not be reduced but that they should be repurposed and accredited and excellence centres established, noting that changes should be made to the model of payment to hospitals.

Hospitals operate with a programmed loss and despite budget rescue aid in the amount of HRK 6.3 billion in 2021 and HRK 3.5 billion in 2022, their due debt currently amounts to HRK 2.5 billion, warned Dražen Jurković, director of the Association of Health Sector Employers.

Hospital directors attending the panel expressed support to the proposed changes to the model of payment to hospitals, their computerisation and monitoring treatment outcomes.

Vagić said that if the reform was launched by the end of the year, its results would be visible only after three years and that the situation could be better in five years' time.

The head of Zagreb's KB Dubrava hospital, Ivica Lukšić, said that each new health administration annulled decisions taken by the previous one, which was the reason why the reform, called for by almost every government, had never been implemented.

Lukšić said that with the existing limits, hospitals could not operate in the black, which was why better organisation and a single system of procurement were necessary.

A representative of the association of family doctors, Vikica Krolo, welcomed the proposed reform measures related to primary health care, such as the merging of community medical centres, which in the future should also offer specialist examinations.

Vagić noted that specialists working in hospitals would have to be motivated to work in community medical centres and that they could not be assigned to work there by decree.

He said that he would always advocate the right to work in the private sector for hospital doctors who regularly meet their obligations in the public sector but that he agreed with the minister's position that order should be made in that regard.

Commenting on announced changes restricting the work of public sector doctors in the private sector, Croatian Medical Chamber head Krešimir Luetić said that the chamber considered as satisfactory the existing rules, under which a public hospital doctor wishing to take on a second job in the private sector has to regularly and professionally perform their duties under their employment contract, continue their own professional development, respect work organisation and does not have a criminal, misdemeanor or disciplinary decision issued against them.

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ZAGREB, 4 May 2022 - Finance Minister Zdravko Marić said on Wednesday that employers' proposal to further reduce the tax burden on labour are taken into account in principle but that additional discussions and analyses are required, while reducing contributions requires structural reforms in the health and pensions systems.

The Croatian Employers Association (HUP) said on Tuesday that attracting and keeping quality labour required a more significant reduction of overall labour costs so that employers could pay higher salaries to workers, proposing short-term proposals for an increase in net wages, which should happen relatively soon.

"It is necessary to significantly reduce the total cost of labour, including by increasing non-taxable income to HRK 5,000, reducing the lower income tax rate by 5 pp, from 20% to 15%, and keeping the higher income tax rate at 30% but raising the threshold for its application, from the current HRK 30,000 to 50,000", HUP said.

As for contributions, HUP called for reducing the contribution to the first pension pillar by 2 pp, from 15 to 13%, reducing the health insurance contribution by 1.5 pp, from 16.5 to 15%, and limiting the highest amount of payments for pensions and health insurance to four average monthly wages.

HUP also proposed a further increase in non-taxable payments to workers, notably considering that that does not mean additional costs for the state while creating more room for employers to compensate workers.

HUP advocates increasing the non-taxable amount for rewards from HRK 3,000 to HRK 6,000 and rewards for work performance from HRK 5,000 to HRK 12,000. It also advocates the introduction of non-taxable income for work from home, increasing the non-taxable amount for severance pay and retirement from HRK 8,000 to HRK 15,000 as well as increasing the allowance for the use of private vehicles for business purposes from HRK 2 to HRK 3 per kilometre.

Marić said that at present, at least two-thirds of taxpayers did not pay income tax since in previous rounds of tax reform tax breaks were introduced and basic tax relief was increased.

The principle of proportionality of taxation could be further discussed, he said, recalling other tax changes, including the exemption of young people from income tax, which this year will result in 146,000 young workers receiving HRK 640 million in tax return.

He said that he government had worked a lot on income tax, noting that the scope of nontaxable income had been expanded.

"Further reducing the tax burden, of which I am in favour, requires, among other things, paying special attention to health and pension insurance contributions," Marić said but noted that due to the situation in the health and pension sectors, creating preconditions for further reducing the tax burden on labour would require structural changes in the two sectors.

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ZAGREB, 13 April 2022 - The fight against the COVID-19 epidemic has cost the Croatian Health Insurance Fund (HZZO) HRK 5 billion (€666.6m) over the last two years and two months, Jutarnji List newspaper said on Wednesday.

The cost only includes testing, treatment, sick leave and vaccination, but not other economic costs, the cost of equipment or the cost of conversion of hospitals and other facilities used for the treatment of COVID patients.

As for the costs covered by the HZZO, treatment cost around HRK 1.9 billion (€253.3m),  testing HRK 1.7 billion (€226.6m), sick leave HRK 290 million (€38.6m) and vaccination HRK 1 billion (€133.3m).

The newspaper said that the amount spent by the HZZO would be enough to cover the debts of the health care system.

In addition to the cost of health care, by far the most expensive measure was the government's job retention scheme, which cost HRK 18 billion (€2.4bn).

In total, at least HRK 23 billion (€3.06bn) has been spent on combating the coronavirus epidemic since the first case was confirmed in Croatia on 25 February 2020, according to Jutarnji List.

(€1 = HRK 7.5)

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ZAGREB, 31 Oct. 2021 - The Croatian Association of Hospital Doctors (HUBOL) warned on Sunday that the situation in hospitals treating COVID-19 patients was difficult as more and more arrive every day because, it said, the virus is allowed to spread and those in charge are doing nothing about it, shirking responsibility.

The healthcare system is disappearing, HUBOL said in a press release.

The system does not exist when COVID-19 patients wait for hours to be admitted because there is no room, it does not exist when we don't have enough anesthesiologists, infectious disease specialists and internists who know how to treat people with destroyed lungs, it does not exist when you need a connection to get a bed supplied with oxygen as soon as possible, HUBOL said.

The system does not exist when patients will be treated for complications by a surgeon, gynecologist or other such doctor, and when those who decide if the system is overloaded get services with one call to the hospital administration, HUBOL said. "They and their relatives, friends and acquaintances don't wait in lines."

While those in charge "are doing nothing... the increasingly tired people who make up the healthcare system will soon have to stop with operations and examinations for other diseases because they are on COVID wards," HUBOL said.

They are there "because the virus is being allowed to spread," and in those wards "one will soon have to decide which patient to put in a bed with oxygen or a ventilator."

"The virus is spreading as much as we allow it to, the president of the epidemiological society said recently. Those whose responsibility it is to stop the virus from spreading among the population, with all the procedures and measures necessary (as in Denmark, for instance), inform us every day in a sedating voice about the increasing numbers of hospitalisations and deaths, washing their hands of their responsibility and reason for existing," HUBOL said.

"After all, only people in the Balkans, not some 'stupid' Danes, can allow such spreading of the virus and numbers of hospitalisations and deaths."

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