How much does ‘free’ treatment cost?
Ksenia Niglas, Data Analyst at the Health Insurance Fund. Photo: private collection
Many people in Estonia are accustomed to seemingly free medical care. However, health care is not free and never will be, because it is funded by the taxes we all pay. In addition, the fact that the medical costs of Estonian people are largely covered by national health insurance, regardless of the amount of tax they pay, is pretty unique in the world.
In return for the contributions paid to health insurance, the Health Insurance Fund ensures payment for medical treatment in the event of illness, reimburses prescription medicines and medical equipment up to the prescribed amount, pays sick pay for sick leave, etc. Here are a few examples of the actual costs of treatment for common health problems, which are not billed to patients with health insurance in Estonia, i.e. they are instead paid by the Health Insurance Fund.
Bone fractures
Bone fractures are one of the most common injuries in Estonia, with 37,000 people a year suffering a fracture as a result of various accidents. Patients with fractures are most common in the 10–14 age group.
On average, it costs around 600 euros per patient to treat a fracture. That is the price of a plane ticket for an exotic trip.
Broken fingers or wrists (7,500 people a year) are the most common injuries. In this case, treatment is usually limited to X-rays and plaster casts and costs, on average, 115 euros per patient per year.
However, the most costly are femur fractures, which often require a long hospital stay or even a hip replacement. The treatment of femur fractures costs, on average, 4,200 euros per person.
Type 2 diabetes
In Estonia, 5,600 people are diagnosed with type 2 diabetes every year – in total, one in sixteen people is affected. The highest prevalence of type 2 diabetes is among people aged 70–79 years.
Type 2 diabetes is a lifestyle disease that is preventable through a healthy diet and exercise. There is no cure for diabetes, but it can be effectively controlled with medicines. On average, the Health Insurance Fund spends 136 euros per patient per year on treatment and nearly 350 euros per year on prescription medicines. This is equivalent to the price of a year’s membership of a training club.
Although there are many different medicines used to treat diabetes, the Health Insurance Fund spends the most money on semaglutide. More than 5,800 patients need it at a cost of more than 4.5 million euros a year.
In addition to medicines, people with diabetes need medical equipment, which costs 1.4 million euros a year – an average of 48 euros per patient. Most of the money is spent on glucometer test strips, which are used by almost 24,000 people.
Endoprostheses
Replacement of the hip or knee joint, or endoprosthesis, is one of the most common planned surgeries in Estonia. In Estonia, worn joints are replaced around 3,500 times a year, and this number is constantly rising. People aged between 60 and 69 are the most likely to need an endoprosthesis.
On average, joint replacement surgeries cost around 5,000 euros per patient. Pre- and post-operative treatment costs around 1,500 euros per person. For that money, you could buy a second-hand car in good working order.
The most expensive cases have cost the Health Insurance Fund more than 20,000 euros. Over the last five years, this has happened a dozen times.
COVID-19
Although COVID-19 is no longer an epidemic, more than 3,700 people have needed medical treatment over the past two years, at a cost of nearly 4,000 euros per patient. Elderly people aged 80–89 years are most affected by the coronavirus.
As we know, the course of the coronavirus can be very difficult, leading to long stays in the intensive care department and resulting in six-figure medical bills. Since the arrival of COVID-19, 38 patients have required extremely expensive treatment. In one case, it cost more than 428,000 euros to treat a patient with COVID-19 complications. That is equivalent to the price of a fancy house.
In addition to the cost of treatment, the Health Insurance Fund has reimbursed at least 1.5 million euros in prescription medicines to over 4,600 people and 14 million euros in certificates of incapacity for work related to COVID-19 to over 72,000 people. On average, the coronavirus costs 400 euros per person per year.
Want to know how much the Health Insurance Fund has paid for your treatment? Log in to the Health Portal.