Symposium on the experiences in the implementation of healthcare reform in Croatia.

Th e symposium with international participation entitled Experiences in the Implementation of Healthcare Reform in the Republic of Croatia took place on October 27-29, 2009 at Plitvice Lakes. Th e Symposium was organized by the Ministry of Health and Social Welfare of the Republic of Croatia and Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, under the personal auspices of Jadranka Kosor, Prime Minister. Th e plan of implementation and results acquired to date in healthcare reform in the Republic of Croatia were presented at the conference, with special reference to the novel concept of healthcare fi nancing, the role and responsibilities of local government and self-government, reform of the primary and hospital healthcare system, reform of emergency medical service, and role of education and training of healthcare workers. In Croatia, healthcare reform that involves the overall healthcare system with all its segments has been in eff ect since 2008. Th e concept and objective set by Darko Milinović, MD, Minister of Health and Social Welfare, as the reform initiator and his team, is to bring the patient-insuree in the center of service, to improve the population health, the level of healthcare and healthcare indicators, and to upgrade the healthcare system. Th e fi nancial healthcare indicators recorded in mid-2008 made healthcare reform absolutely necessary. In his reform program, Minister of Health and Social Welfare describes the reform objectives as follows: to achieve fi xed healthcare allocations from the budget for the next three years; to ensure social sensitivity, accessibility and solidarity; to fi nd new fi nancing sources; to enable reduction in the rate of contribution for healthcare in order to stimulate the national economy competitiveness; to abolish the monopoly of the Croatian Institute of Health Insurance (CIHI); and to contribute to the reinforcement of individual responsibility, decentralization and fi ghting corruption. A considerable part of the Symposium program was dedicated to the reform of hospital healthcare, with the introductory lecture on this topic held by academician Zvonko Kusić as head of the Task Force for Monitoring Healthcare Reform in Hospital and Specialist-Consultation Healthcare (Task Force). Academician Zvonko Kusić is head of the University Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital in Zagreb and has great experience at leading positions in healthcare system as Director of Sestre milosrdnice University Hospital for several years, Vice-President of the National Health Council of the Republic of Croatia, and member or head of many commissions and councils. Besides academician Kusić, members of the Task Force were: Head Doctor Marcel Majsec, MD, MS; Professor Herman Haller, MD, PhD; Professor Vlado Jukić, MD, PhD; Velibor Drakulić, MD; Mirela Crničić, MBA; and Dario Nakić, MD. Th e Task Force held a number of sessions and was in charge of monitoring the course of reform in hospital healthcare. At the beginning of his presentation, academician Kusić gave a survey of diffi culties found in the healthcare system before the reform was launched. First of all, there were no multiple sources of healthcare system fi nancing, along with a very high level of payroll allocation of as much as 15 percent, which was the highest rate in Europe. In addition, a great deal of insurees did not pay their contribution for health insurance, thus the debt grew at a rate of 2 billion HRK per year. In the public, healthcare system was perceived as a corrupted setting, while being burdened with the lack of physicians (in part due to the decreased popularity of the profession and their drain to other, better paid services), lack of hospital standardization, inappropriate or nonexistent computerization, and unsound