Health system financing in Estonia: situation and challenges in 2005

In recent years, concern has grown about the sustainability of health system financing in Estonia. Nevertheless, no systematic overview of the health financing system has been available to serve as a basis for comprehensive discussions. This case study aims to fill this gap using a framework for country-level analysis of health care financing arrangements proposed by Kutzin (2001). The framework distinguished three subfunctions that all systems perform: • collecting revenue that is ultimately used to purchase health services; • pooling these funds: how the financial flows are organized; and • purchasing, which describes the interaction between the intermediaries who manage the prepaid and pooled funds and those who deliver the services. The executive summary gives an overview of the health financing system, underlines the challenges it faces and suggests possible way to move forward. The rest of the document is organized in three sections that describe in turn how each health financing function was organized in Estonia in early 2005. Address requests about publications of the WHO Regional Office to: • by e-mail [email protected] (for copies of publications) [email protected] (for permission to reproduce them) [email protected] (for permission to translate them) • by post Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark © World Health Organization 2005 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Where the designation “country or area” appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The views expressed by authors or editors do not necessarily represent the decisions or the stated policy of the World Health Organization.