How patients are treated in Estonia. One of the best medical systems in Europe?

Free medical consultations, examinations, medicines and surgeries for everyone… Does it sound like a fantasy? But this is the reality of Estonian medicine. Here, state insurance covers almost everything. The only exceptions are plastic surgery, cosmetic procedures, and dentistry (partially). The country's budget allocates considerable funds for medicine, which makes it possible to combine affordable services with their high quality.

Is the Estonian medical system really one of the best in Europe? Inna Gordienko, a Ukrainian journalist who left for Estonia because of the war, told MEDplus about this from her own experience.

What do you need to know about government insurance in Estonia?

Every citizen of Estonia has state insurance. The policy is not purchased separately, the money is deducted automatically from the salary. 13% of social tax goes to healthcare. Pensioners, children, students, people with disabilities, and the unemployed receive state insurance without contributions.

Regardless of salary and contribution amounts, all Estonians in the hospital will receive the same medical care. Doctors will not put a patient in front of a choice of which medicines they want: more expensive or cheaper, or which materials for surgery they will choose. Everything is the best for the patient. Crossing the threshold of a hospital, a person does not worry about anything but his or her health. Neither for bills or medicines, nor for food. Everything will be provided by Haigekassa (Haigekassa is the Estonian hospital fund).

Ukrainians who came here because of the war were equated with Estonian citizens in terms of their rights to healthcare. «They receive this health insurance only when they have received a temporary protection certificate and registered in the city of residence», as Inna says.

If you don’t have insurance, you have to pay the bills yourself. The average cost of a visit to a private doctor is 50 euros per visit.

Do people in Estonia use private insurance policies?

Private insurance is also available in Estonia. Such insurance can be provided by Haigekassa, in this case it will cost about 180–200 euros per month. Other private insurance policies will be much more expensive. But they don’t have many advantages, except that the package includes plastic and cosmetic surgery and full payment for dental services.

How is dental treatment in Estonia covered?

The Haigekassa (let us remind you, this is a hospital fund) compensates just a small share of dental expenses — only 40 euros a year, and for a pensioner it is 30 euros more: 70 euros. But emergency medical care for acute toothache is free of charge.

Why is there a lack of family doctors?

As in other European countries, family doctors play a key role in Estonian medicine. Through them, patients already receive referrals for free tests, examinations and specialized care.

«There is a problem with family doctors, because there are not so many of them here. Estonia is a small country. Fewer people live here than in Kyiv alone, so there are not enough doctors. And a lot of people from Ukraine have come here, and everyone needs a family doctor. But the number of patients he can treat is limited», shared Inna.

But here, too, Ukrainians in Estonia were met with an exception to the rule: they were allowed to contact specialized specialists directly if necessary.

Has Estonia managed to solve the problem of waiting lists for specialists, which is typical for Europe?

The queue to visit a narrow specialist can be several months long. But even in public hospitals, you can bypass the queues by paying a fee to the cashier for urgency. This is officially about 30–50 euros. But in private medical institutions, there are almost no queues.

If it turns out that a patient requires an operation, they will be put back on the waiting list: if it is determined to be a planned operation, they will have to wait a few more months. Urgent cases are operated on immediately.

Emergency medicine hospitals

You can bypass the queues by going to an emergency hospital. As a rule, these are separate medical institutions that bring together specialists of all profiles under one roof and operate around the clock.

«You come, pay 5 euros, and they do everything the doctor considers necessary for your health at that moment», as Inna says.

However, you have to wait quite a long time at the emergency center.

How does the ambulance work in Estonia?

The Estonian ambulance system is fundamentally different from the services of other EU countries, and this resembles the Ukrainian one. People call it in case of high temperature, pressure, and other conditions that are not always life-threatening. And doctors come. Of course, they try to sort the calls, but most of the time they still respond.

What medicines can be purchased in pharmacies without a prescription from a family doctor?

Traditionally, in EU countries, it is impossible to buy anything other than nasal drops or sore throat lozenges without a prescription. However, there is an exception for Ukrainians: you can come to a pharmacy with a prescription issued in Ukraine.

Electronic medicine

Estonia is a leader in the digitalization of medicine in Europe. Here, all patient health information is stored electronically. This includes medical history, test results, and examinations. Even a pharmacist in a pharmacy can immediately see the prescription. At the same time, the data is carefully protected, with a special service monitoring that there is no abuse or interference with the patient’s privacy. A person can also independently check which doctor had access to his or her medical data and when, up to minutes when the system was logged in.

Let’s sum it up!

Let’s start with the disadvantages.

In Estonia, you sometimes have to wait months to get treatment from a narrow specialist. During this time, the disease can worsen. There is a shortage of medical personnel in the country, which has become even more acute with the influx of Ukrainians. Currently, it is difficult to conclude an agreement with a family doctor in Estonia, and without a referral, all treatment is paid.

The advantages of Estonian medicine include the following:

• quality medical services available to all;
• in an emergency hospital, you can undergo all the necessary tests and receive a diagnosis and prescription in a few hours;
• all patient data is stored in a single, secure database, which helps in making future diagnoses.