1. Health Care In Latvia Current Situation And Challenges In the Future Ingrīda Circene Minister for Health of the Republic of Latvia Riga, 2012.10.17.

2. General Facts Area: 64, 589 km2 Density: 34.2/km2 Population: 2,067,887 GDP per capita: US $11,620 (World Bank, 2010) Natural growth of population: -3.7 1 2015.09.20. 2 1 Data source : Central Statistical Bureau http://www.csb.gov.lv/statistikas-temas/iedzivotaji-galvenie-raditaji-30260.html

3. Population (2011) Population: 2,067,887 Males: 45.8% Females: 54.2% 2015.09.20. 3 Data source : Central Statistical Bureau http://www.csb.gov.lv/statistikas-temas/iedzivotaji-galvenie-raditaji- 30260.html

4. The Most Common Causes of Mortality (per 100 000 inhab.) 2015.09.20. 4

5. Allocation of Health Care Resources  Law on State budget – determines scale of subsidy for health care (public financing through general taxation)  Payments for health care services are determined by the Regulations of the Cabinet of Ministers  Incomes of medical institutions are formed from payments for provided health care services; paid by states budget, patients’ fee and incomes from paid services 2015.09.20. Sagatavots Veselības ministrijā 5

6. Health Care Budget 2003 – 2013 in Comparison With GDP 2015.09.20. 6

7. Public Expenditure for Health Care 2005-2011 (LVL per capita) 2015.09.20. Sagatavots Veselības ministrijā 7

8. Parliament Government Ministry of Health Health Inspectorate Centre for Diseases Prevention and Control National Health Service Administration of financial resources, contracts with medical institutions on provision of health care services paid by the state; organization of cancer screening organization. Public health analysis, surveys, statistics, epidemiological safety, preventing diseases including infectious and rare diseases Supervision and control (medical care, environmental hygiene, drinking water, noise, cosmetics, chemicals, drugs etc.) Legislation Policy planning 2015.09.20. Sagatavots Veselības ministrijā 8

9. Health Care Organization  At present health care system is based on the residence principle  Negative list of benefits – the state pays for all services except those that are excluded from the scope  Health care benefits are available at the state, municipal level and at private inpatient and outpatient health care institutions Sagatavots Veselības ministrijā 2015.09.20. 9

10. Main Challenges in the Future  to improve accessibility to the primary health care;  to develop out-patient health care services;  public health as the priority, especially healthy aging;  to sustain availability of reimbursed medicines;  to develop new health financing model;  to facilitate medical tourism  to introduce well timed treatment in order to decrease the time of illness or prevent from forecasted (predictable) disability 2015.09.20. Sagatavots Veselības ministrijā 10

11.  To enlarge a GPs’ team by providing additional nurse for general practitioners  To increase accessibility of GPs  To promote active involvement of the GPs in disease prevention  To ensure more effective management of patients with chronic diseases  To tackle the spread of infectious diseases  To motivate GPs to provide broad range of health care services to patients Measures to Improve Accessibility of Primary Health Care Services 2015.09.20. Sagatavots Veselības ministrijā

12. Development of the Out-patient Health Care Services  Home care shall be provided at home if patient needs a regular (permanent) out-patient treatment  Promote day hospitals  Set up observation beds in emergency hospitals  Evaluate pre-hospital emergency care team and their localization points in rural areas 2015.09.20. Sagatavots Veselības ministrijā 12

13. Healthy Aging 2015.09.20. 13  Health and life expectancy are still linked to socio-economic circumstances  Tackling health inequalities requires comprehensive collaboration of the government and actions in all policy fields  Our aim is to maintain, improve and restore the health of the population of Latvia, to prolong life expectancy (incl., the reduction of the differences in life expectancy between men and women), and make the lived years of life as healthy as possible.

14. Other Priorities  Maternal and child health care;  Health promotion and prevention (according to the Public Health Strategy for 2011-2017) health education in schools; programme for prevention and treatment of diseases of heart and circulatory system; programme for prevention of diabetes; development of the mental health care; promotion of the cancer screening 2015.09.20. Sagatavots Veselības ministrijā 14

15. New Model of Health Care Financing  The concept of new model of health care financing - to link eligibility to receive health services to the payment of an earmarked income tax (or other)  Main objectives: to motivate people to pay taxes; to attract additional financial resources to the health sector and to improve accessibility; to develop a sustainable health care financing system  Increased financial resources are foreseen to be directed to the improvement of accessibility of out-patient health care services reimbursable medicinal products and to raise the salaries of medicinal professionals 2015.09.20. Sagatavots Veselības ministrijā 15

16. New Model of Health Care Financing II  Acording to the proposed model there will be provided a minimum health care services for all citizens (tax payers and non-payers) - emergency medical assistance, diagnostics, treatment of particular diagnosis and compensation of 100% reimbursed medicines  Planned health care services paid by state will be provided to tax payers, persons insured by state and persons who will make the particular contributions to the state budget 2015.09.20. Sagatavots Veselības ministrijā 16

17. Medical Tourism  Products and services of health tourism in Latvia have a high added value and good exporting potential;  Development of this sector would contribute to the country’s economic growth as well as the improvement of the public welfare  Ministry of Health has contributed into the Latvia’s Tourism Marketing Strategy for 2010 to 2015 and has taken the neccessary measures to promote medical tourism in Latvia 2015.09.20. Sagatavots Veselības ministrijā 17

18. Thank you! Questions? Contribution into the health sector is a breakthrough in the economic development!