Forty Lithuanian organizations—uniting patients, doctors, citizens, and businesses—have addressed the leaders and members of the Seimas (Parliament). They urge the Parliament to reject proposed legislation that would ban additional co-payments for state-funded healthcare services.

There is a growing concern that the law is being rushed through without sufficient consideration of input from social partners, their proposals, or constitutional concerns. The proposed changes raise alarm because they may have long-term harmful consequences not only for the healthcare sector but also for the national economy and public well-being.

Freedom of Choice Is Being Restricted

Today, the private healthcare sector is an integral part of the healthcare system and helps ensure timely and quality care for patients. However, the proposed restrictions may lead to a decline in service quality and choice, as well as a reduction in innovation.

If the law is passed, patients will be forced to choose between basic state services and paying the full price for treatment. This would severely limit freedom of choice, making it entirely dependent on individual financial means or state capacity.

However, state resources are not limitless—especially since other vital sectors, such as defense, also require funding. For many citizens, lacking access to higher-quality services will only increase dissatisfaction and distrust in the healthcare system. New social and economic challenges loom as access to superior care becomes a privilege for the wealthy.

It is publicly stated that the removal of private sector funding will force doctors back into the public sector. Yet doctors warn that cuts in healthcare financing will drive many physicians abroad. Fewer doctors mean longer wait times. And with reduced access to care, unethical practices—such as under-the-table payments—may resurface, practices we had hoped to leave behind.

A Threat to Competitiveness

Banning co-payments would deliver a serious blow to businesses operating in the healthcare sector. It would halt investments in new technologies, medical innovations, and the recruitment of highly qualified specialists. This would hinder the development of the healthcare system.

Lawmakers point out that Lithuanian households currently spend nearly 32% of all healthcare expenditure from their own pockets—well above the EU average of 14.27%. In France, such out-of-pocket expenses amount to just 9%.

However, in France, co-payments are used to encourage awareness of healthcare costs and service needs. Moreover, France has a robust supplementary health insurance system—unlike Lithuania, where there are now efforts to restrict its use.

High household spending on healthcare is also seen in Bulgaria (35%), Greece (33.5%), Latvia (30.7%), Malta (30%), and Portugal (29.65%). In these countries, as in Lithuania, supplementary insurance systems are weak or non-existent. Therefore, we should be focusing on encouraging such insurance rather than imposing new limitations.

The Goal Should Be Partnership

In many advanced countries, such as Sweden, Finland, and Germany, patient co-payments are standard practice. Patients can choose services based on their needs and resources, while the state ensures basic access for all. The private sector is allowed to operate as a partner that fosters healthy competition.

For Lithuania to remain competitive and attractive to investors, it should pursue a more progressive path—one that emphasizes partnership between the public and private sectors, not rigid restrictions. We can build a better healthcare system—one that is both high-quality and accessible to all.

But for that, patients must be allowed to choose services they can afford, and we must ensure competition and innovation in healthcare institutions. When making decisions, it’s crucial to pursue not only legal compliance but also to carefully assess the real impact on patients and society as a whole.

Commentary by Vytautas Šilinskas, Director of the Investors’ Forum