Health Insurance Fund deficit
Session: Fifteenth Riigikogu, sixth sitting, press briefing.
Date: 2025-09-17 16:00
Participating Politicians:
Total Speeches: 22
Membership: 15
Agenda Duration: 12m
AI Summaries: 22/22 Speeches (100.0%)
Analysis: Structured Analysis
Politicians Speaking Time
Politicians
Analysis
Summary
The Riigikogu discussed the question presented to Minister of Social Affairs Karmen Joller regarding the deepening financial deficit of the Health Insurance Fund (Tervisekassa), which was submitted by Riigikogu member Aleksei Jevgrafov. Jevgrafov highlighted Tervisekassa’s critical budget forecasts, which project growing deficits (a predicted minus of 254.2 million euros by 2028) and the depletion of retained earnings and reserves by the same year. He demanded a concrete action plan from the minister to resolve the critical situation and ensure the availability of healthcare services.
Minister Joller acknowledged the problem but emphasized that her priority was system restructuring, not simply pouring in more money, comparing the Tervisekassa budget to a leaky pot. She pointed out systemic inefficiencies, such as unjustified laboratory costs (approximately 20%) and patients seeing the wrong specialists (in about a third of cases), for which Tervisekassa still pays. Joller announced that Tervisekassa’s budget positions have changed, and according to the new forecast, over 200 million euros should remain in reserve by 2029. As solutions, she proposed increasing funding transparency, strengthening primary care provided by family doctors, and integrating the social and healthcare systems. In response to Jevgrafov’s follow-up question regarding treatment waiting lists, the minister replied that the main obstacle to accessibility is the shortage of doctors and nurses, not solely funding, and resolving this requires long-term training. Reili Rand further inquired whether the minister had requested additional resources during state budget strategy negotiations, questioning whether internal system savings could cover a shortfall amounting to hundreds of millions. Joller replied that there is no point in injecting additional funds before patching the systemic holes.
Decisions Made 1
Decisions were not made
Most Active Speaker
Aleksei Jevgrafov posed the initial question and the subsequent clarifying question, focusing on the financial crisis of the Health Insurance Fund (Tervisekassa) and the accessibility of medical care (miscellaneous).
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar announced that the fifth item on the agenda was a question being put forward by Riigikogu member Aleksei Jevgrafov to Minister of Social Affairs Karmen Joller concerning the Health Insurance Fund's deficit, and he then asked Jevgrafov to take the floor.
Esimees Lauri Hussar
AI Summary
Riigikogu member Aleksei Jevgrafov is posing his fifth question to Minister of Social Affairs Karmen Joller concerning the Tervisekassa (Health Insurance Fund) deficit.
Aleksei Jevgrafov
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Aleksei Jevgrafov highlighted the rapidly deepening financial crisis facing Tervisekassa (the Health Insurance Fund), whose projected deficit is expected to exceed 250 million euros by 2028, leading to the depletion of its reserves. He demanded a concrete plan from the responsible minister to resolve the situation and ensure the sustainability of healthcare services.
Aleksei Jevgrafov
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
The presentation points out the deepening deficit of the Health Insurance Fund, projected to continue until 2028. A question is then raised regarding the specific plan, measures, and timeline the responsible minister and the chairman of the Health Insurance Fund council will implement to ensure sustainable operations, guarantee the availability of healthcare services, and prevent deficits.
Sotsiaalminister Karmen Joller
AI Summary
Minister of Social Affairs Karmen Joller emphasizes that improving the budgetary position of the Health Insurance Fund requires not merely additional funding, but a fundamental overhaul of the entire system. This is necessary because the healthcare sector currently suffers from numerous unjustified expenses, such as inappropriate specialist referrals and overpriced laboratory services. As minister, she has prioritized transparency in financing and ensuring that costs are justified. Consequently, budget forecasts have improved, and current estimates project a reserve exceeding 200 million euros by the year 2029.
Sotsiaalminister Karmen Joller
AI Summary
Speaking about the funding of the Health Insurance Fund (Tervisekassa), Social Minister Karmen Joller pointed out that the funding must be transparent and costs justified, and the system needs to be streamlined to solve problems related to specialist referrals and laboratory service fees. She also promised to disclose the budget positions and discuss the 2029 forecast, which projects reserves exceeding 200 million euros, at the October board meeting.
Sotsiaalminister Karmen Joller
AI Summary
Minister of Social Affairs Karmen Joller emphasizes that solving the budget problems of the Health Insurance Fund (Tervisekassa) requires more than just additional funding; instead, the system needs streamlining, cost transparency, and a reduction in unjustified expenditures (e.g., unnecessary specialist visits and inflated laboratory prices). Consequently, reforms have been initiated that have improved the budget position and are projected to result in a reserve exceeding 200 million euros by 2029.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar thanks the previous speaker and asks Aleksei Jevgrafov to pose a clarifying question.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar thanked the previous speaker and subsequently gave the floor to Aleksei Yevgrafov to pose a clarifying question.
Aleksei Jevgrafov
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Aleksei Jevgrafov sharply criticized the Estonian healthcare system, highlighting specialist care waiting lists that are among the longest in the OECD, the shortage of family doctors, and the deepening deficit of the Health Insurance Fund (Tervisekassa). He demanded concrete measures from the minister to ensure that additional funds are directed toward improving services that genuinely reach patients, and not just patching up holes in the system.
Aleksei Jevgrafov
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
The report highlights that Estonia has some of the longest specialist medical care waiting lists in the OECD, there is a shortage of family doctors (GPs), and the Health Insurance Fund's budget is running a deficit. Furthermore, the forecast for the coming years predicts that the number of doctors will drop by about a thousand. It then raises the question of what specific measures are planned to shorten these waiting lists and how it will be ensured that the additional funding reaches patients, rather than simply being used to patch up the system.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller underscored that when assessing the accessibility of medical care, the length of the waiting list is not the sole indicator; quality is also essential. She confirmed that, against the backdrop of the Health Insurance Fund's (Tervisekassa) deficit, the focus will be placed on strengthening primary healthcare, which is also the main objective of the development plan set to be finalized by the end of the year, in addition to the reform aimed at integrating the social and healthcare systems, in order to achieve cost savings and better health outcomes.
Sotsiaalminister Karmen Joller
AI Summary
Speaking as a member of the Riigikogu, Minister of Social Affairs Karmen Joller stated that strengthening primary care and integrating the social and healthcare systems are the key steps for reducing the deficit and improving public health. Waiting lists must not be the sole indicator, and reforms will be implemented based on feedback, with financing also being addressed.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar thanked the previous speaker and then gave the floor to colleague Reili Rand so that she could ask a supplementary question.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar offers his thanks and announces that his colleague, Reili Rand, will be asking a follow-up question.
Reili Rand
Profiling Sotsiaaldemokraatliku Erakonna fraktsioonAI Summary
Reili Rand points out that the "pot of money" found during the state budget strategy negotiations was only a one-time revenue, and demands an answer from the minister as to whether additional funds have been planned for the Health Insurance Fund (Tervisekassa) to ensure people can access a doctor faster, stressing that internal systemic savings cannot cover the hundreds of millions that are lacking and are necessary to improve the availability of medical care.
Reili Rand
Profiling Sotsiaaldemokraatliku Erakonna fraktsioonAI Summary
During the state budget strategy negotiations, Reili Rand asked whether additional funds would be allocated to the Health Insurance Fund (Tervisekassa) to speed up access to a doctor, emphasizing that although the discussions only mention savings in the tens of millions, the deficit amounts to hundreds of millions, and the required sums should be significantly higher.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller dismisses the notion that healthcare problems can be solved simply by throwing more money at them. She emphasizes that the budget of the Health Insurance Fund (Tervisekassa) is like a leaky bucket, meaning systemic issues and the shortage of doctors and nurses must be addressed before any additional funding is provided. This is because resolving the workforce crisis demands lengthy training and systemic reforms, not a quick cash injection, which will ultimately fail to improve access to medical care.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller emphasized that simply increasing healthcare funding will not solve the problems. She stressed that the priority must be to first patch up the budget holes, assess the role of private funding, and focus on alleviating the shortage of doctors and nurses through training and better engagement of family physicians. She added that any additional money needs to be precisely targeted and may not necessarily shorten waiting lists.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller refutes the notion that the Health Insurance Fund’s budget problems can be solved simply by pouring in more money, comparing the system to a leaky pot. She stresses that structural problems must be addressed before directing additional funds, especially the shortage of doctors and nurses, because adding money alone will not improve the availability of medical care and requires a thorough analysis beforehand by the Foresight Centre.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar thanked the audience and announced that the consideration of today's fifth question had concluded.
Esimees Lauri Hussar
AI Summary
The Chairman thanks the participants and concludes the consideration of today's fifth matter.