Since patient visit fees increased last year, more and more people have been falling behind on payments to hospitals. Patients with outstanding debts can no longer see a specialist.
A year and a half ago, the cost of visiting a doctor quadrupled, with patient visit fees rising from €5 to €20 and daily hospital bed fees doubling from €2.50 to €5. Since then, the number of patients owing money to North Estonia Medical Center (PERH) has doubled, while the total amount owed has tripled.
"Daily hospital bed fees account for about 70 percent of the debt, while visit fees, mainly for emergency department visits, account for the remaining 30 percent," said Anneli Habicht, PERH's head of customer service.
According to Habicht, in about half of cases patients simply forget to pay, while the other half have no intention of paying. Before turning to a debt collection agency, the hospital spends a couple of months trying to recover the money itself.
"When we look at which groups are more likely to owe us money, it seems to be older people approaching retirement age, as well as very young adults. In terms of gender, men tend to be more likely to fall behind on payments," Habicht said.
Last year, nearly 2,200 people owed money to Narva Hospital. The amounts involved are generally small and are usually paid after a reminder.
"In the first nine months of this year, the number of debtors has increased by about 25 percent. At the same time, we haven't seen any behavior that would require us to take aggressive action through debt collection agencies or any signs that people are deliberately trying to avoid their obligations," said Narva Hospital CEO Üllar Lanno.
Tartu University Hospital has not experienced the same problems as its counterparts in northern Estonia.
"The hospital still receives most of its revenue for medical treatment through its contract with the Estonian Health Insurance Fund. Patients' out-of-pocket payments account for less than 3 percent of that. We have half a million outpatient visits a year and perhaps 200 to 400 patients need to be sent payment reminders," said Joel Starkopf, a member of Tartu University Hospital's management board.
According to debt collection agency Julianus Inkasso, the number of claims submitted by hospitals has increased by a few percentage points, although some medical institutions have submitted 10 percent more claims.
"When the visit fee was €5, it was a little easier to pay. If you're in a difficult financial situation, €20 is harder to afford. And if you forget to pay on time, finding that extra money later can be more difficult when you're working with a tight household budget," said Merle Laurimäe, CEO of Julianus Inkasso.
More than half of debtors settle their debts within a year of receiving a letter from the collection agency. However, they must also cover late-payment interest and collection fees of up to €30.
"I think the total could rise to around €55 at most, provided you act in time," Laurimäe said.
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