Web-economic-crisis-health-systems-and-health-web

392 Economic crisis, health systems and health in Europe: country experience
Changes to health coverage
Population (entitlement)
• People with a low income or who are uninsured will have free access
to treatment in designated public hospitals and to generic outpatient
prescription drugs from 2014 (2011).
The benefits package
• Reimbursement claims for hospital care must be submitted within two
months (2010).
• A national benefits package was established (2011).
• A positive list of drugs was reintroduced (abolished in 2006), with a focus
on generic drugs (2011).
• Some previously covered services were excluded (e.g. polymerase
chain reaction and thrombophilia tests) and cover restricted for others
(childbirth, air therapy, balneotherapy, thalassaemia, logotherapy and
nephropathy) mainly on the basis of their high cost (MoU 2012).
• A new negative list of medicines was created based on similar lists in
Spain and Italy; the list should be updated twice a year, shifting many
medicines to over-the-counter status (2012).
User charges
• Introduction of an exemption from user charges in public facilities for
people in vulnerable groups and the addition of people with diabetes and
people requiring organ transplants to the list of vulnerable groups (2011).
• User charges for outpatient visits in public hospitals and health centres
increased from €3 to €5 (2011).
• Introduction of a new co-payment of €25 per admission to a public
hospital (revoked in 2014) and an additional €1 per NHS prescription in
outpatient and inpatient settings from 2014 (2012).
• User charges for diagnostic tests in public hospitals abolished (2012).
• Co-insurance rates for drugs for specific diseases increased from 10%
to 25% (rheumatoid arthritis, psoriatic arthritis, lupus, vasculitis,
spondyloarthritis, scleroderma, chronic obstructive pulmonary disease,
pituitary adenomas, osteoporosis, Paget's disease, Crohn's disease,
cirrhosis), from 0% to 10% (Alzheimer's disease, dementia, epilepsy,
angiopathy) and from 0% to 25% (pulmonary hypertension); patients
requiring haemodialysis will no longer be exempt from all prescription
drug user charges, just from those related to their condition (2012).