The Paradox of the Health System in Bosnia and Herzegovina

If you need swaddling after a surgery, and you happen to be not in your municipality of residence but in the neighboring one, you will pay the costs, regardless of the fact that you have properly regulated health insurance. The same practice is present in case you need such an intervention in a canton other than your own. Such a practice, it seems, will last a long time, because the complicated political, and thus the health system, has broken every problem down to the smallest detail.

Maja Memic testifies to another paradox of this country. Her permanent place of residence is in Una-Sana Canton. However, due to business obligations, she often stays in Sarajevo Canton. In addition to several health problems that she constantly struggles with, she also has to think about whether at a certain moment he has enough money with him to pay for medical expenses when she stays in Sarajevo. Considering that she comes from USK, she is only entitled to free emergency medical assistance in Canton Sarajevo.

“If you need some additional swaddling services, anything, absolutely everything is paid for. And I emphasize that again, you have to pay at that moment, otherwise no one will accept you. Only great urgency is taken into account right away, and then after that you struggle with the bureaucratic system on how you will repay, whether you will repay”, says Maja.

The Federal Ministry of Health states that the cantons are obliged to provide health care to persons who are not their insured persons and do not have a permanent residence address in those cantons. However, the law precisely defines which persons it refers to:

“Insured persons who temporarily reside in the area of cantonal health insurance institutes where they use health care for schooling, studying, professional training. Insured persons who need emergency medical assistance. Insured persons who, in accordance with the general act of the cantonal institution of which they are insured, are referred for the use of health care.”

As our interlocutor does not fall into any of the mentioned categories, she bears the costs of health services herself. True, he has the right to reimbursement of expenses, but only if they amount to 300 BAM, or if it is an emergency medical intervention.

The interlocutors believe that it is high time to change the law.

“It is incomprehensible to me why this is so since it is FBiH, so it is logical that we all have equal access to health insurance and the system,” says Maja.

“There have been many initiatives to improve legal regulations, but for now, these are exclusively legal regulations,” points out Haris Dučić, spokesman for the Health Insurance Institute of CS.

There are currently no initiatives by the competent authorities to change the law. Not even in indications. Because of this, patients in the Federation of Bosnia and Herzegovina suffer the most. Interestingly, in another part of the country the situation is completely different. A health insured person, a patient – realizes his full right to health services in any city of the Republika Srpska, regardless of his place of residence.

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