The EU Commission explains that a system which is predominantly based on solidarity does not become economic in nature when operators have a small degree of discretion to compete on quality and to make profit from efficient provision of services (Spoločná zdravotná poisťovňa)

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Compulsory health insurance in Slovakia* Health insurance which is based on the principle of social solidarity is not economic in nature. Solidarity means that citizens have a right to the service in question and the quality of the service they obtain is not linked to the price they pay, if any. Health services which are provided privately for remuneration are economic in nature. Commission decision 2015/248 concerns the capitalisation of a health insurer in Slovakia [1]. In Slovakia health insurance is compulsory and offered by both state-owned and private companies. After several mergers, there are at present three main insurers: VZP (state owned), Dovera (private) and UHI (private). Health insurance companies can make profits. Their revenues are generated by contributions by

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