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Table 3 Financing arrangements

From: State budget transfers to health insurance funds: extending universal health coverage in low- and middle-income countries of the WHO European Region

Country

Type of transfer logic

Calculation logic to determine state budget transfer amounts

Financing source of government revenue transfers

Social Security Funds as % of GGHE (2013) [15]

Albania

lump-sum [31, 44]

base for calculating government transfer is per capita health care expenditure during the previous year [41]

central government budget [31]

74.1

Bosnia & Herzegovina

Federation: per capita (for unemployed)

Republika Srpska: per capita [61]

Federation: n/a

Republika Srpska: contributions from the entity budget may not be less than the average per person contribution from the previous year [61]

unemployed entitled to benefits: Unemployment Fund

all other exempted: entity budget [61]

97.5

Bulgaria

per capita [38]

unemployed entitled to benefits: 8 % of the unemployment benefit (needs to be between the minimum and maximum income basis for insurance contributions),

others: 8 % of a predefined minimum income basis for insurance contributions [38]

unemployed entitled to benefits: Unemployment Fund

all other exempted: central government budget [38]

76.4

Georgia (MIP)

per capita [21]

contribution is determined through a tender process where insurance companies propose a contribution at which they would provide insurance covering a predefined benefit package; the insurance company with the lowest offer is selected [21]

central government budget two regions fund additional beneficiaries out of their regional government budgets [21]

68.8

Kyrgyzstan

per capita [63]

base for calculation is 1.5 times the minimum wage [63]

central government budget [63];

share of government transfers as of SHI revenues: 78 % (includes funding for the state guaranteed benefit package for all) [48]

64.1

Lithuania

per capita [75]

up to 36 % of the average gross monthly wage lagged by 2 years [76]

Counter-cyclical measures of compulsory health insurance contributions made by the state on behalf of the unemployed and economically inactive people

central government budget [77];

share of government transfers as of SHI revenues: 48 % (calculated by the authors based on data from [76]

85.1

Montenegro

per capita [68]

unemployed entitled to benefits: 7.5 % of the unemployment benefit

others: determined by law [61, 68]

unemployed entitled to benefits: unemployment fund:

all other exempted: central government budget [61, 67]

89.3

Republic of Moldova

lump-sum [26]

at least 12.1 % of the total government budget (annually) [26]

central government budget [26]

share of government transfers as of total SHI budget: 55 % [78]

85.0

Romania

women on maternity leave, people on sick leave, the unemployed, recipients of social assistance, prisoners: per capita [24]

others: n/a

woman on maternity leave, women on leave to take care of children < 2 years (<3 years if disabled), prisoners: 6.5 % of the sum representing the value of two national minimum gross wages

people on sick leave, unemployed, recipients of social assistance: 6.5 % of the sick leave, unemployment benefit or social assistance [24]

others: n/a

women on maternity leave, prisoners, persons in military service: central government budget;

people on sick leave: social security budget;

unemployed: unemployment fund;

recipients of social assistance: local government budget [24]

all other exempted: n/a

83.0

Russian Federation

lump- sum [27]

per-capita amount of transfers is not specified; decided by the government (budget contributions not enough to cover the costs of the exempted population considering that utilization is also much higher compared to the contributors) [19]

regional government budgets [27]

38.9

Serbia

per capita [61]

15.9 % of the average wage (the government not always gives adequate funding for the exempted) [61]

disabled people: Pension and Disability Fund;

all other exempted: central government budget [61, 72]

93.6

TFYR Macedonia

per capita [79]

unemployed entitled to benefits: 10 % of the benefit

recipients of social assistance, prisoners, war invalids, families of fallen soldiers: 10 % of half the average wage

all other exempted: 5.4 % of half the average wage [79]

the unemployed: unemployment fund

all other exempted: central government budget [79]

91.6

Turkey (Green Card Scheme)

lump-sum [23]

n/a

central government budget [23]

64.1