In Slovakia, public funding, including government and social health insurance expenditures, accounted for about 89% of total health expenditure in 2000, well above the OECD average of 72%. Out-of-pocket expenditure is the only source of private financing, as private health insurance is virtually non-existent, and includes considerable unmeasured informal payments. The extent to which a private health insurance market in Slovakia might develop is uncertain, given the lack of a history of private cover and population distrust into third-party purchasers of health services. A clear-cut definition of services to be insured by mandatory and voluntary health insurance, the establishment of rules of access to care to minimize treatment differentials between those with and without private health insurance, particularly in the case of coverage of faster access to care, and the legal separation of entities furnishing mandatory and voluntary health insurance are needed.
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