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

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

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18.06.2015 Views

Serbia Vukasin Radulovic Economic trends • Serbia's real GDP per capita contracted in 2009 by 4.1%. The deficit as a share of GDP has increased every year between 2007 and 2011. • Unemployment has been high relative to the European mean and increased between 2008 and 2011. • Public expenditure on health as a share of total government expenditure has remained relatively stable since 2008. (Serbia: Figs 1 and 2). Policy responses Changes to public funding for the health system • The SHI budget fell by about 10% between 2008 and 2012. Changes to health coverage Population (entitlement) • Simplification of statutory coverage procedures for vulnerable groups (2010). • Statutory coverage made more accessible for children whose parents were not covered because of job loss (2012). The benefits package • Creation of a positive list for drugs, generating savings that enabled 300 new drugs and 40 new groups from the Anatomical Therapeutic Chemical Classification to be added (2010–2012). • Creation of a positive list for drugs (2010–2012). • Creation of a special fund for treatment of rare diseases (2012). • Decisions about allocating resources for rare diseases moved to an independent national committee (2012). User charges • Although it was widely discussed, user charges for services and prescriptions were not increased.

476 Economic crisis, health systems and health in Europe: country experience % Serbia: Fig. 1 Economic and fiscal indicators 2000–2007 and 2008–2011 60 55 50 45 40 35 30 25 20 15 10 5 0 −5 −10 −15 −20 −25 −30 _ _ _ _ ● ● _ _ _ _ _ _ _ _ ● _ ● ● _ _ _ _ ● ● _ _ _ _ _ _ _ ● ● ● _ _ _ _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Year 2000−2007 2008 2009 2010 2011 _ _ _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Real GDP per capita growth Deficit/surplus (% GDP) Government spending (% GDP) Government health spending (% total government spending) Notes: Deficit/surplus: World Bank; Other indicators: WHO Health for All. 10−year bond rates Unemployment rate Serbia: Fig. 2 Trends in per capita spending on health, 2000–2011 Public spending per capita OOP spending per capita Non−OOP private spending per capita 600 Per capita spending $, PPP 400 200 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20 Growth % 0 −20 −40 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Public spending per capita growth OOP spending per capita growth Note: Spending calculated from WHO Health for All. Non−OOP private spending per capita growth

Serbia<br />

Vukasin Radulovic<br />

Economic trends<br />

• Serbia's real GDP per capita contracted in 2009 by 4.1%. The deficit as a<br />

share of GDP has increased every year between 2007 <strong>and</strong> 2011.<br />

• Unemployment has been high relative to the European mean <strong>and</strong><br />

increased between 2008 <strong>and</strong> 2011.<br />

• Public expenditure on <strong>health</strong> as a share of total government expenditure<br />

has remained relatively stable since 2008. (Serbia: Figs 1 <strong>and</strong> 2).<br />

Policy responses<br />

Changes to public funding for the <strong>health</strong> system<br />

• The SHI budget fell by about 10% between 2008 <strong>and</strong> 2012.<br />

Changes to <strong>health</strong> coverage<br />

Population (entitlement)<br />

• Simplification of statutory coverage procedures for vulnerable groups (2010).<br />

• Statutory coverage made more accessible for children whose parents were<br />

not covered because of job loss (2012).<br />

The benefits package<br />

• Creation of a positive list for drugs, generating savings that enabled<br />

300 new drugs <strong>and</strong> 40 new groups from the Anatomical Therapeutic<br />

Chemical Classification to be added (2010–2012).<br />

• Creation of a positive list for drugs (2010–2012).<br />

• Creation of a special fund for treatment of rare diseases (2012).<br />

• Decisions about allocating resources for rare diseases moved to an<br />

independent national committee (2012).<br />

User charges<br />

• Although it was widely discussed, user charges for services <strong>and</strong><br />

prescriptions were not increased.

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