Juozas Galdikas
 APPOINTMENTS

Founder of the Conservative Party of Lithuania (L.C.) - 01. 05. 1993;
Founder and chairman of the Health Care Committee of the L.C. (1993-1998);
Member - Seimas (Parliament) of the Republic of Lithuania (1996-2000);
Appointed to Minister of Health Care at the VIII'th Government of the Republic of Lithuania (1996 - 1998);
Chairman - Community Health Council of Lazdijai municipality (1998-2000);
Member - National Health Council (1998-2000);
Member - Budget & Finance Committee at the Seimas of the Republic of Lithuania (1998-2000);
Chairman of the Health care department of Vilnius municipality (1995-1996);

THE COMPULSARY HEALTH INSURANCE

At the time of being the Minister of Health care was introduced in practice the Compulsory health Insurance with the main principles:
1. The state insurance budget is based on the principle of solidarity, that is the size of personal contributions varies dependingly not on the risk level, related to a particular person, but on his or her financial state.
2. The law on Health Insurance provides for the use of health insurance means for the financing of services delivered by both state and private health are institutions (favourable conditions are assured for the development of private practice).
3. The provisions in the law allow persons to take up supplementary (voluntary) health insurance and to receive reimbursement for the services mentioned in the insurance policy. It is expected that in the future some 10% of the population will use the services of supplementary health insurance.
4. The compulsory health insurance budget is separated from the state budget and is composed of:
  • 3% of the salary contributions paid for every employed person;
  • no less than 30% of the natural person income tax paid for all the persons, who receive income related to their employment;
  • contributions from the state budget for the person, ensured by the state (children under 18 years of age, students, pensioners, etc.). The size of the contributions from the state budget is the same; in the case of all the insured by the state;
  • compulsory health insurance contributions paid voluntarily by the persons who do not pay natural person income tax, are not employed in agriculture and do not belong to the category of the insured by the state.
    5. A centralised system of patient funds with one State Patient Fund and ten territorial patient funds (one in each district) has been established.
    6. The Law of Health Insurance has conditioned the distribution of financial responsibility between the responsible state institutions and the health insurance system.
    7. The national health insurance budget shall be formed annually and shall be approved by the Government. The compulsory health insurance fund is managed by the Insurance Board.
    8. The sustainable financing of the population is assured by distributing the compulsory health insurance means to the territorial patient funds according to the number of the population and the scope o health care service delivery in every particular district.
    9. The distribution of financing among different service groups is as follows:
  • individual health care - 77%; including:
    20% for primary health care;
    10% for secondary and tertiary out - patient health care;
    70% for in - patient services;
  • resort treatment - 7%;
  • reimbursement for drugs for out - patient treatment - 13%;
  • centralised procurement of medication, medical means and prosthesis - 3%.
    10. The patient funds will also ensure the covering of the ordinary expenditure on out - patient and in - patient health care on the basis of the contracts concluded between the territorial patient funds and the health care institutions and relying on the scope of service provision stated by the latter.
    11. The basic price per service has been set. It is a highly aggregated price, which complies with the set norm of expenditure. The same set basic prices will be applied all over the country, therefore, the real costs will be payed in the case of health care institutions with high intensity of service delivery and relatively low delivery costs. The basic price is set in points; thus the value of a point might vary depending on size of health insurance budget.
    12. The compulsory health insurance will assure 70-80% of the health care financing. The remaining part (public health care, investment, state and municipal programmes),thus, will be financed from the state and municipal budget.
    13. The financing of primary personal health care services is performed on the basis of the number of population, registered with the institution in question, and the basic price of primary health care services set per person. Secondary and tertiary out - patient services are financed per specialist consultation.
    14. In - patient health care institutions are financed per treated patient. In - patient services financed based on the basic prices set according to the disease treatment profile per day and the normative length of stay.
    15. Main goal of primary health care reform:
  • major attention should be paid to disease prophylaxis and health maintenance instead of disease treatment, i. e. the scope of in - patient services should be decreased by transferring the major part of service delivery to the out - patient health care level;
  • episodic treatment should be replaced by personal and family health care; health care service delivery should not be the responsibility of independantly practising specialists but rather of a team of medical personnel, where doctors and nursing personnel work together;
  • professional domination should be replaced by interdepartmental co-operation, community participation and responsibility;
    16. Characteristic features of a successful primary health care model:
  • accessible to everybody;
  • effective and efficient;
  • in harmony with other health - related services and programmes;
  • administered by the local government and established on the basis of existing local needs;
  • accountable to the society;
  • using the skills of health care workers to the optimum;
  • improving the role of disease prevention and health education and putting a special emphasis on disease prevention;
  • enhancing participation of the society, consumers and the community in setting the needs, service planning, administration and delivery;
  • using effective medical technologies. Implementation of primary health care (PHC) is performed by strengthening the institution of general practitioner (GP) and the rest of PHC personnel Components of a successful primary health care implementation.
    17. The Lithuanian health insurance system cannot and will never be a copy of the health insurance systems functioning in the West European countries. The transition to the new market economy is based on Lithuania's cultural, political and economic traditions.

    CV | POLITICS | INTERESTS