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S toga svako neispunjenje ili delimično ispunjenje utvrđenih
finansijskih obaveza prema ovom Zavodu od strane države,
pravnih ili fizičkih lica, ima za posledicu otežano ispunjenje
obaveza Zavoda u pogledu obezbeđenja obima i sadržaja
zdravstvene zaštite garantovane državljanima Srbije i ostalim
navedenim licima.
S obzirom da su pravo na zdravstvenu zaštitu, kao i obim
i sadržina iste, Zakonom garantovane državljanima Srbije, to
je Vlada dužna da planira sredstva za ostvarivanje ovih prava
u Budžetu Republike shodno realnim potrebama, kao i da
sprovodi druge mere iz njene nadležnosti kako bi se u Zavodu
obezbedila dovoljna količina sredstava, što Vlada godinama
unazad ne čini.
U 2004 g. Vlada je iz budžeta izdvojila svega 2, 6 milijardi
din. za finansiranje navedenog broja neosiguranih, izbeglih i
prognanih lica, što je svega 2.170,00 din. po jednom licu, dok
su osigurana lica na ime doprinosa izdvojila 80 milijardi dinara,
odnosno 12.300,00 din. po jednom licu. S obzirom na to da i
jedna i druga kategorija lica ima isti obim prava na zdravstvenu
zaštitu, to je očigledno da uprkos zakonskim propisima
zdravstvenu zaštitu neosiguranih, izbeglih i prognanih lica
finansiraju osigurana lica, kroz prelivanje doprinosa
Godinama unazad Vlada sprovodi mere koje ne samo da
pogoršavaju materijalni položaj Zavoda, pa time i ukupnog
zdravstvenog sistema, već i ozbiljno dovode u pitanje
funkcionisanje Zavoda kao organizacije za zdravstveno
osiguranje, kroz uvođenje zakonskih rešenja koja su primerenija
sistemu budžetskog finansiranja zdravstva nego sistemu
osiguranja:
- Kontinuirano smanjenje stope doprinosa za zdravstveno
osiguranje, uprkos rastućim potrebama
1994-1996 20,2 % (PIO 20,2%)
1996-1998 16,2 %
1999-2001 19,4 %
2001-2004 11,9 %
2004 12,3% (PIO 20,2%)
- Donošenje Zakona o budžetu, kojim se budžetski način
finansiranja primenjuje i na Zavod, suprotno odredbama
Zakona o zdravstvenom osiguranju i samoj suštini
osiguranja.
- Donošenje zakona o jedinstvenoj stopi doprinosa, kojim
se sve ingerencije prenose sa Upravnog odbora Zavoda
na Ministarstvo finansija, smanjuju osnovice za obračun
doprinosa, predviđaju razna oslobađanja od obaveze
plaćanja doprinosa.
- Donošenje Zakona o poreskom postupku i poreskoj
administraciji, kojim su sve ingerencije oko naplate
i kontrole naplate doprinosa prešle sa Zavoda na
Ministarstvo finansija-poresku upravu.
- Neadekvatna naplata i kontrola naplate doprinosa
od strane poreske uprave (trenutno nenaplaćeni
doprinosi samo od obveznika samostalnih zanimanja i
zemljoradnika iznose blizu 10 milijardi dinara).
- Donošenje Odluke o odlaganju plaćanja dela dospelih
obaveza po osnovu javnih prihoda, koju je donela Vlada
13. 2. 2004., a kojom je, suprotno odredbi člana 108p
stav 3. Zakona o zdravstvenom osiguranju utvrđen
otpis 50% doprinosa za zdravstveno osiguranje (koji
je definisan kao sporedno poresko davanje) utvrđenog
na dan 31. 12. 2003. godine, preduzećima koja se
nalaze u procesu restruktuiranja (62); na tenderu (14);
aukciji (39); koja su sa većinskim državnim paketom
akcija (6) i iz nadležnosti Akcijskog fonda (5), što čini
ukupno 125 privrednih subjekata. Pri tome po navedenoj
Kosovo and Metohia.
For this reason, any failure to fulfill, or partial fulfillment
of established financial obligations to the Administration by the
state, by legal or natural persons, results in a difficulty to fulfill
the obligation of the Administration pertaining to the scope and
content of health care guaranteed to citizens of Serbia and other
listed persons.
Since the right to health care, as well as its scope and content
are guaranteed to citizens of Serbia by the Law, the Government
is obliged to plan funds for the realization of these rights in the
Budget of the Republic in accordance with actual needs, as well
as to implement other measures within its scope of competences,
in order to provide to the Administration sufficient funds, which
is something the Government has not done for years.
In 2004, the Government set aside in the Budget only 2.6
billion dinars for financing the above mentioned number of
uninsured persons, while insured persons contributed 80 billion
dinars, i.e. 12,300.00 dinars per person. Since both categories
have the same scope of rights to health care, it is apparent that,
regardless pf legal regulatives, the health care of uninsured
persons, refugees, and exiled persons is financed by insured
persons, by transfer of contributions.
For years, the Government has undertaken measures that not
only worsen the financial position of the Administration, and
thus of the entire health care system, but also seriously threaten
the functioning of the Administration as the organization for
health insurance, by introducing legal solutions more adapted
to a system of budget financing of health care than to a system
of insurance:
- Continuous decrease of the level of contributions for
health care insurance, regardless of growing needs
1994-1996 - 20.2% (Pension and Invalidity Insurance 20.2%)
1996-1998 - 16.2%
1999-2001 - 19.4%
2001-2004 - 11.9%
2004 - 12.3% (Pension and Invalidity Insurance 20.2%)
- The passing of the Law on the Budget, which applies
budget financing also to the Administration, contrary to
provisions of the Law on Health Insurance, and to the
very essence of insurance.
- The passing of the Law on Unified Level of
Contributions, which transfers all competences from
the Management Board of the Administration to the
Ministry of Finance, decreases the base for calculation
of contributions, envisages various exemptions from
payment of contributions.
- The passing of the Law on Taxation Procedure and
Tax Administration, which transfers all competences
pertaining to collection and control of collection of
contributions from the Administration to the Ministry of
Finance – Tax Administration.
- Inadequate collection and control of collection of
contributions by the Tax Administration (presently,
uncollected contributions, only from payers engaged in
individual activities and farmers amount to almost 10
billion dinars).
- The passing of the Decision to postpone payment of part
of obligations in arrears from public income, passed by the
Government on 13 February 2004, establishing, contrary
to the provision of Article 108p, Paragraph 3 of the Law
on Health Insurance, a write-off of 50% of contributions
for health insurance (which are defined as an auxiliary
tax) established on 31 December 2003, for companies in
the process of restructuring (62); in tender procedure (14);
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