How do OECD countries live? Challenges and insights

Last week, a delegation of the National Health Insurance Fund (NHIF) participated in the 12th annual meeting of the Organisation for Economic Co-operation and Development’s (OECD) Network of Budget and Health Professionals, held in Paris. What experiences did the representatives of the countries in attendance shared?        

Different countries - but similar challenges    

The meeting discussed how to balance the growing financing needs of health systems with the opportunities to ensure the sustainability and resilience of health systems to the challenges they face, the optimal sharing of the financing burden between the state and the population, how to deal with health budget overruns at all levels (state, regional, individual institutions), and how to shift from short-term solutions towards those that have a longer-term impact, notably through investment in prevention.  

Representatives from several OECD countries spoke on each of these issues, presenting their country experiences. It turned out that OECD countries with different health systems faced very similar challenges after the pandemic as Lithuania: increased queues, doctors moving to the private sector and others.

With increasing healthcare needs but limited capacity to increase health sector financing, many countries have discussed the need to increase the efficiency of public expenditure: optimising the hospital network, changing the structure of services (from inpatient to day and outpatient services), and actively introducing telemedicine services. According to the representative from Austria, if the decision to change the service structure is postponed today, the transformation will still have to take place at a later stage, but at a much higher cost and with insufficient financial resources.

More than one country also mentioned the need to stop the growth of the private part of the health sector, which prevents improvement in access to services and increases the direct costs for the population. This is also very relevant for Lithuania, where household spending on health constitutes about one third of total health expenditure, and where it ranks among the countries where the burden of financing the health system is too high for the population.

According to G. Kacevičius, Slovenia has announced that the country has removed, as of this year, the voluntary health insurance that was intended to reimburse the allowances that patients paid for most healthcare services. Slovenia justified its decision on the grounds that voluntary health insurance does not work on the basis of solidarity, that allowances are the same for everyone and are not related to solvency, and that it is insufficiently regulated. Austria supported this view, arguing that there is growing scientific evidence that private (supplementary, voluntary) health insurance does not reduce household health costs. 

Prevention in Lithuania is a priority

The Director of the NHIF presented the financing of preventive health care in Lithuania in a panel discussion.  


“Prevention in Lithuania has been funded by the Compulsory Health Insurance Fund since 2004, which is carried out in two ways. One is through payment for services under prevention programmes, of which there are currently five, with a sixth planned for lung cancer prevention. Another is the National Programme of Immunoprophylaxis, under which the National Health Insurance Fund has already purchased 22 different vaccines centrally”, – said the representative of Lithuania.  

According to G. Kacevičius, compared to other countries that have introduced prevention funding - Greece, Italy and Norway - Lithuania’s system seems to be simple and more efficiently managed.

During the discussion, the Director of the NHIF emphasised that in Lithuania, the financing of prevention through the Compulsory Health Insurance Fund has been a priority from the very beginning, and has been maintained throughout the crises. 

Referring to the future prospects, the NHIF representative said that Lithuania is not considering reforming the fairly successful model of financing prevention programmes, but that this area is being expanded and improved. For example, this year will mark the launch of two Early Diagnosis Coordination Centres for Oncology Diseases, which will be established by the Ministry of Health with funding from the European Union’s Structural Funds and will implement the principle of centralised invitation of the population to take part in preventive programmes.

The Health Insurance Funds point out that 36 countries are currently members of the OECD, but that the organisation also cooperates with more than 70 non-OECD countries. Lithuania became a member of the organisation in 2018.

The OECD works to strengthen economic growth, promote employment, improve living standards, maintain financial stability, help develop other economies and contribute to the development of world trade. 

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