Teisė į sveikatos priežiūros paslaugas kaip konstitucinė teisė
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The object of this work is official constitutional doctrine on Lithuanian healthcare system, mandatory health insurance, state guaranteed healthcare and requirements on the operation of the healthcare system. More specifically, the author of this paper tries to answer the questions what are the constitutional requirements for the delivery of state guaranteed healthcare and what are the constitutional implications of the state’s positive obligation to ensure healthcare. The issue of state guaranteed healthcare services is most troublesome in defining whether the respective medical services should be financed by the state budget or by supplementary public funds gathering instruments (e.g. mandatory health insurance, etc.). At the same time, the right of private healthcare providers to participate in provision of state guaranteed healthcare services is also an open question. Nevertheless, the issue addressed in the paper, however, is likely to raise further discussions in both scientific community and court practice. The author of this paper presents the thorough analysis of the Lithuanian constitutional court jurisprudence and identifies the criteria for separation of constitutional notions of state guaranteed health care and free of charge medical services. In addition, the author discusses the right of private healthcare providers to participate in provision of state guaranteed healthcare services and free of charge medical services by analysing the constitutional notion of state healthcare provider. Moreover, the constitutional principles governing the supplementary public funds gathering instruments designated for financing the state guaranteed healthcare services are addressed in the paper, as well. Generally, the author of this paper found out that it is likely that the notion of free of charge medical services is an independent constitutional notion and is separate from the notion of state guaranteed healthcare services. The dichotomy of the aforementioned constitutional notions implies a two tier health care services financing mechanism: free of charge medical services should be financed by the state budget and the state guaranteed healthcare services by supplementary public funds gathering instruments. Moreover, the analysis of constitutional doctrine implies a right for the state to choose the exact mechanism of supplementary public funds gathering instrument, as far as it corresponds to the constitutional requirements of solidarity and effectiveness. The author of this paper criticizes the constitutional doctrine of state institutions, as it pays not enough attention to the regulatory framework and restraints on the commercial activity of the private healthcare providers in comparison to a mere corporate control of the state healthcare providers.
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