History of the Health Insurance in Lithuania

On October 28, 1928, the first patients’ fund was established in Kaunas, and, in a while, six more patients’ funds were founded in different counties (Kaunas, Siauliai, Mariampole, Panevezys, Ukmerge and Vilkaviskis. By the end of 1931, these funds became county-dependent. In 1931, new patient funds were established in Telsiai, Taurage and Alytus. Some patients’ funds were departmental.

The beginning of the Patients’ Funds was difficult, financial status – unenviable. But in 1935 – 1940, the activities by the patients’ funds were stabilized and situation started improving: the funds used to establish their own heath care and disease prevention institutions, propagated healthy lifestyles. Unfortunately, after the soviet invasion, patients’ funds were liquidated and the health care system financed in a centralized way, from the State budget, was introduced and functioning during the entire soviet period.

After Lithuania has regained its independence, our medical community has started looking for effective ways to improve the health care system and quality of provided services.

On October 31, 1991, the Lithuanian Republic Seimas adopted the National Health Care Concept of Lithuania, where the health care policy was formulated and priorities in the field were set, including the development of primary health care, introduction of the family doctor’s institution and foreseeing the structure of institutions within the health care system, according to the primary, secondary and thirdly medical service provision level. The aforementioned concept has become a basis for the Lithuanian Health Policy formation.

In 1992, the State Patients’ Fund was incorporated under subordination of the Health Ministry. Initially, the Fund was given a function of methodical management, but since 1993 already, the State Patients’ Fund has started making contracts with national health care institutions for compensation of simple costs for medical services to Lithuanian residents. This period lasted up to 1997, when a major part of functions for financing medical institutions was undertaken by the territorial patients’ funds founded on the basis of the Law on Health Insurance.

The Law on the Health Care System passed in July 1994 has given a legal grounds for the health care policy, defined the roles of the Government, municipalities and counties in administration of health care.

In 1996, the Laws on Health Insurance and Health Care Institutions were passed. The first law regulates that financing of public health care institutions would be made though the State Patients’ Fund (SPF).

On September 16, 1996, the SPF was moved under the Government’s subordination. The regulations of the Compulsory Health Insurance Council at the Government of the Republic of Lithuania were approved and established the membership of the Council. 10 territorial patients’ funds were founded in Vilnius, Kaunas, Klaipeda, Siauliai, Panevezys, Alytus, Utena, Telsiai, Taurage and Mariampole.

In January 2003, the SPF came under the Health Ministry’s subordination, territorial patients’ funds were reorganized, five territorial funds of Vilnius, Kaunas, Panevezys, Siauliai and Klaipeda established in replacement of previous ten territorial patients’ funds.