Hospital leaders, doctors reject Joller’s health budget plan

Health Minister Karmen Joller says Estonia’s Health Insurance Fund can close a budget gap of nearly 90 million euros within a few years, but hospital leaders and doctors told ERR that the plan is unrealistic.

The fund has spent more on treating people than it has received in tax revenue for years. Joller said higher social tax revenue and postponing a planned healthcare workers’ pay rise could help bring income and expenditure into balance.

The pay rise, originally due next April, would be postponed until 2028. “We can choose whether to cut services or slow down wage growth,” Joller said, adding that the Health Insurance Fund does not decide doctors’ and nurses’ salaries. Those are negotiated by employees and employers, she said, while the fund has decided to postpone the increase in the minimum-wage component included in its healthcare service prices by nine months.

Agris Peedu, head of North Estonia Medical Centre, said it was unrealistic to promise that the deficit could be halved next year. He also dismissed the idea that significant savings could be achieved quickly through digital and artificial intelligence-based solutions.

“Hospitals have not even been shown examples of such solutions. If the aim is to achieve savings with them as early as 2027, they should already be being piloted by the larger healthcare providers. They are not,” Peedu said.

Peedu also criticised postponing the pay rise, noting that wages increased by nearly 5 percent in 2025 but by only 1.5 percent this year.

“It seems that the goal of the Health Insurance Fund and the social minister is to balance the fund’s budget, rather than ensure medical care for people,” said Katrin Rehemaa, secretary general of the Doctors’ Association. She said doctors, nurses and other specialists were responsible for treating patients, and that excluding their pay from the budget sent a clear message that their work was not valued and that they were not needed in the state healthcare system.

Doctors who previously moved to Finland for higher salaries are now moving to private clinics, Rehemaa said.

Eero Merilind, a family doctor, member of parliament and Joller’s party colleague, said it was possible to make the figures work before elections. He warned, however, that the same questions would arise again in 2028 when the postponed pay rise takes effect.

One cost-cutting option discussed by the Health Insurance Fund’s supervisory board is raising the daily fee paid by hospital patients.