natgillin/translations-raw huggingface dataset:
Nogle ordninger kombinerer træk fra begge kategorier (solidaritetsbaserede ordninger og ordninger af økonomisk karakter) [52].
On the basis of that provision, the State aid rules only apply where the beneficiary of the measure is an ‘undertaking’.
I sådanne tilfælde skal Kommissionen for at afgøre, hvorvidt en bestemt ordning er økonomisk eller ikkeøkonomisk, undersøge tilstedeværelsen af de forskellige aspekter i de to foregående betragtninger og afveje deres respektive betydning i den pågældende ordning [53].
The case-law of the Court of Justice of the European Union (‘CJEU’) defines an undertaking for the purposes of Article 107(1) of the Treaty as any entity engaged in an economic activity, regardless of its legal status or the way in which it is financed [37].
Den endelige bestemmelse af, hvorvidt levering af obligatoriske sygesikringsydelser i Den Slovakiske Republik er en økonomisk eller ikkeøkonomisk aktivitet, kræver en dybdegående analyse af netop den måde, som aktiviteten er organiseret og gennemført på i den pågældende medlemsstat, og bestemmelsen er derfor specifik for det obligatoriske sygesikringssystem i Slovakiet.
The classification of a particular entity as an undertaking thus depends entirely on the economic or non-economic nature of its activities.
Kommissionen vil på grundlag af disse generelle bemærkninger vurdere, hvorvidt de anfægtede foranstaltninger, der påstås gennemført til fordel for SZP/VZP, kan anses for statsstøtte på linje med foranstaltninger gennemført til fordel for en virksomhed i henhold til artikel 107, stk. 1, i traktaten.
As explained in the opening decision, the question whether the measures granted in favour of SZP/VZP constitute State aid therefore depends in the first instance on whether and to what extent SZP/VZP, when they operate within the Slovak compulsory health insurance system, act as undertakings because they could be considered to be engaged in an economic activity as defined by the case-law.
En række indikatorer peger på, at det slovakiske sundhedsforsikringssystem er ikkeøkonomisk, især dets sociale funktioner og formål, som indtager en vigtig plads i driften af systemet, og det forhold, at solidaritetsprincippet er systemets omdrejningspunkt.
According to the CJEU, an economic activity is any activity consisting in offering goods and/or services on a given market [38].
For det første er det et lovkrav, at størstedelen af den slovakiske befolkning deltager i det offentlige sundhedsforsikringsprogram, og de sundhedsydelser, der er omfattet af den obligatoriske sygesikring, leveres, uanset hvor stort et bidrag den forsikrede har indbetalt.
In this context, the question whether a market exists for certain services may depend on the specific way those services are organised and carried out in the Member State concerned [39].
En forsikret har ret til frit at vælge et sundhedsforsikringsselskab, og i henhold til pligten til fri optagelse kan sundhedsforsikringsselskaberne ikke nægte at forsikre en person på grund af personens alder, sundhedstilstand eller sygdomsrisici [54].
The State aid rules only apply where a certain activity is provided in a market environment.
For det andet er den obligatoriske slovakiske sygesikring baseret på bidrag, som er fastsat ved lov, og som står i forhold til den forsikredes indkomst og ikke i forhold til den forsikrede risiko (alder, sundhedstilstand, sygdomsrisici).
The economic nature of the same kind of services can therefore differ from one Member State to another.
Derudover er der ikke nogen direkte forbindelse mellem størrelsen af de bidrag, en person indbetaler til ordningen, og værdien af de ydelser, som personen modtager fra ordningen.
Moreover, due to political choices or economic developments, the classification of a given service can change over time.
Det betyder, at forsikringsselskaberne ikke har mulighed for at påvirke hverken bidragenes størrelse eller den minimumsdækning, som de forsikrede er berettiget til, eftersom alt dette er fastsat ved national lovgivning.
What is not a market activity today may turn into one in the future, and vice versa [40].
For det tredje er det fastsat ved lov, at alle forsikrede skal modtage det samme grundlæggende ydelsesniveau, som er meget højt, eftersom det dækker stort set alle sundhedsprocedurer i Den Slovakiske Republik, hvilket betyder, at praktisk taget alle sundhedsydelser leveres under det obligatoriske sygesikringssystem [55].
In relation to the provision of healthcare, the qualification of healthcare schemes as involving an economic activity depends on their political and economic specificities and on the particular way in which such schemes are set up and structured in the Member State concerned.
Den slovakiske risikoudligningsordning sikrer, at forsikringsrisiciene fordeles, og styrker dermed yderligere solidariteten.
In essence, the case-law of the CJEU distinguishes between schemes based on the principle of solidarity and economic schemes [41].
Derudover er det slovakiske system baseret på princippet om fælles satser, hvilket betyder, at forsikringsselskaberne ikke kan differentiere forsikringspræmierne alt efter forsikringsrisikoen.
The case-law of the CJEU uses a range of criteria to determine whether a social security scheme is solidarity-based and therefore does not involve an economic activity.
Endelig minder Kommissionen ud over alle ovenstående sociale og solidariske træk om, at den slovakiske obligatoriske sygesikring er organiseret og gennemført i henhold til en klar lovgivningsmæssig ramme, idet alle sundhedsforsikringsselskabers status, rettigheder og forpligtelser er fastsat ved lovbestemmelser, som opstiller detaljerede betingelser herfor, og de er underlagt streng statslig kontrol [57].
A number of factors can be relevant in this respect: (i) whether affiliation with the scheme is compulsory [42]; (ii) whether the scheme pursues an exclusively social purpose [43]; (iii) whether the scheme is non-profit [44]; (iv) whether the benefits are independent of the contributions made [45]; (v) whether the amount of benefits paid is not necessarily proportionate to the insured persons' earnings [46]; and (vi) whether the scheme is supervised by the State [47].
Kommissionen erkender, at visse træk i det slovakiske obligatoriske sygesikringssystem kan pege i retning af, at de i systemet udøvede aktiviteter er af økonomisk art: i) tilstedeværelsen af flere forsikringsaktører (offentlige og private) på det slovakiske marked for obligatorisk sygesikring, ii) en vis grad af konkurrence mellem disse sundhedsforsikringsselskaber, som udøver iii) en aktivitet med vinding for øje, og iv) det forhold, at aktiviteten af den slovakiske forfatningsdomstol blev opfattet som værende åben for konkurrence.
Certain schemes combine elements of both categories (solidarity-based and economic schemes) [52], so that, in order to determine whether a particular scheme is economic or non-economic in nature, the Commission must verify the presence and weigh the respective importance of each of the different elements listed in the two preceding recitals to the scheme at hand [53].
Ikke desto mindre mener Kommissionen ikke, at disse træk sår tvivl om dens konklusion, som er, at obligatorisk sygesikring i Slovakiet er en ikkeøkonomisk aktivitet.
The ultimate determination whether the provision of compulsory health insurance services in the Slovak Republic is a non-economic or an economic activity will therefore depend on a thorough analysis of the specific way in which that activity is organised and carried out in that Member State and will therefore be specific to the compulsory health insurance system in that Member State.
For det første bemærker Kommissionen, at det forhold, at der er flere (offentlige og private) aktører på markedet for obligatorisk sygesikring, ikke i sig selv er ensbetydende med, at aktørernes aktiviteter er økonomiske, i et system, hvor de sociale funktioner og formål indtager en vigtig plads, hvor solidaritetsprincippet er omdrejningspunktet for systemets drift, og hvor statens kontrol er streng (betragtning 85-87).
It is in the light of these general observations that the Commission will assess whether the contested measures allegedly granted to SZP/VZP constitute State aid as measures granted to an ‘undertaking’ within the meaning of Article 107(1) of the Treaty.
En sådan fortolkning ville tillægge de organisatoriske ordninger, som en medlemsstat har valgt for driften af en del af dens sociale sikringssystem, uforholdsmæssig stor vægt i forhold til det pågældende systems egentlige indhold.
A number of indicators point to the non-economic nature of the Slovak health insurance system, in particular as regards its social features and objectives, which feature predominantly in the operation of that system, and that the system is centrally based on the solidarity principle.
[59]
First, participation in the public health insurance programme is compulsory by law for most of the population in the Slovak Republic and medical services covered under the compulsory health insurance are provided regardless of the contributions paid by the insured person.
I det foreliggende tilfælde er den form for konkurrence, der er mest interessant for forbrugerne — priskonkurrence med hensyn til bidragenes størrelse — udelukket, da de slovakiske sundhedsforsikringsselskaber ikke kan ændre bidragenes størrelse, som er fastsat ved lov.
An insured person is free to choose any health insurance company and, under the open enrolment obligation, the health insurance company chosen cannot refuse that person insurance on the grounds of his age, state of health or disease risks [54].
For det tredje mener Kommissionen ikke, at den obligatoriske sygesikrings ikkeøkonomiske aktivitet påvirkes af, at sundhedsforsikringsselskaberne indgiver sig på kvalitetskonkurrence og konkurrence med hensyn til indkøbseffektivitet ved at købe sundhedsydelser og tilhørende ydelser af høj kvalitet fra udbydere til konkurrencedygtige priser.
As a result, insurance companies have no possibility to influence either the amount of contributions or the minimum level of coverage to which the insured persons are entitled as this is all fixed by national legislation.
På denne måde erhverver forsikringsselskaberne sig gennem en aktivitet, der kan adskilles fra deres kontrakter med de forsikrede under den obligatoriske sygesikring, de forsyninger, der er nødvendige for at varetage deres rolle i det pågældende system.
Third, all the insured are guaranteed by law to receive the same basic level of benefits, which is in fact very high since it covers almost all healthcare procedures provided in the Slovak Republic, meaning that virtually complete healthcare is provided through the compulsory health insurance scheme [55].
For det fjerde ændrer den kendsgerning, at bestemmelserne om obligatorisk sygesikring i Slovakiet giver sundhedsforsikringsselskaberne mulighed for at skabe og udlodde overskud til deres aktionærer, ikke på deres aktiviteters ikkeøkonomiske art, da de udøves i et system, hvor alle ovennævnte træk, som påviser systemets ikkeøkonomiske art, er fremtrædende.
The Slovak risk equalisation scheme (RES) ensures that insurance risks are shared and therefore further strengthens solidarity.
Det, at sundhedsforsikringsselskaberne er berettiget til at skabe og udlodde overskud, er ikke i sig selv nok til at tilsidesætte systemets fremtrædende sociale funktioner og formål, solidaritetsprincippets centrale rolle i systemet og den stramme statsregulering og strenge statslige kontrol, som systemet er underlagt.
In addition, the Slovak system imposes the community rating principle, that is, insurers are not allowed to differentiate premiums according to insurance risk, while risk equalisation partially compensates insurers who have a riskier demographic profile in their portfolio by redistributing money from those insurers paying less than average benefits to those paying higher than average benefits to their insured persons [56].
Med hensyn til statsreguleringen minder Kommissionen om, at muligheden for at skabe, anvende og udlodde overskud er reguleret og begrænset af retlige forpligtelser, som staten har pålagt de slovakiske forsikringsselskaber, og som har til formål at sikre den obligatoriske sygesikrings levedygtighed og kontinuitet med alle dens fremtrædende sociale og solidaritetsrelaterede formål [62].
Finally, in addition to all of the abovementioned social and solidarity characteristics, the Commission recalls that Slovak compulsory health insurance is organised and carried out under a strong regulatory framework: the status, rights and obligations of all health insurance companies are established by laws laying down detailed conditions and they operate subject to tight supervision by the State [57].
Endelig mener Kommissionen ikke, at den kendsgerning, at den slovakiske forfatningsdomstol (i forbindelse med dens undersøgelse af en eventuel krænkelse af den forfatningsbeskyttede ret til at drive egen virksomhed i Slovakiet) opfattede det slovakiske obligatoriske sygesikringssystem som værende »omfattet af konkurrencesfæren« betyder, at systemet omfatter aktiviteter af økonomisk art i henhold til statsstøttereglerne.
The Commission acknowledges certain features of the Slovak compulsory health insurance system could point to the economic nature of the activities involved in that system: (i) the presence of several insurance operators (public and private) in the Slovak compulsory health insurance sector; (ii) some degree of competition between these health insurers; which are (iii) involved in a for-profit activity; and (iv) the fact that the activity was considered to be open to competition by the Slovak Constitutional Court.
Faktisk skulle den slovakiske forfatningsdomstol i den pågældende sag undersøge, hvorvidt det lovgivningsmæssige forbud fra 2007 mod sundhedsforsikringsselskabernes udlodning af overskud var foreneligt med den slovakiske forfatning (krænkelse af ejendomsretten, beskyttelse af ejendom og retten til at drive egen virksomhed) og med artikel 18, 49, 54 og 63 i traktaten.
Nevertheless, the Commission is of the opinion that the presence of those features does not call into question its conclusion that compulsory health insurance in Slovakia is a non-economic activity.
Den slovakiske forfatningsdomstol fastslog, at dette forbud var i strid med den slovakiske forfatning, og at der derfor ikke var nogen grund til at gennemgå de væsentligste elementer af reglerne om EU's indre marked og træffe afgørelse om den eventuelle krænkelse heraf.
First, the Commission notes that the fact that there are several (public and private) operators active in the compulsory health insurance sector does not in itself confer an economic nature to their activities in a system where, as explained in recitals 85 to 87, the social features and objectives of the system are predominant, the solidarity principle is central to the operation of that system and State supervision is tight.
På baggrund heraf og under hensyntagen til denne sags særpræg og tilstedeværelsen og afvejningen af de relevante faktorer kan aktiviteterne i den obligatoriske sygesikring, således som den er organiseret og gennemført i Slovakiet, ikke anses for økonomiske aktiviteter.
Such an interpretation would grant inappropriate weight to the organisational arrangements chosen by a Member State in operating part of its social security system, rather than to the substance of the system in question [59].
KONKLUSION
In the case at hand, the type of competition which is most interesting for consumers — price competition with regard to the level of contributions — is ruled out since Slovak health insurers cannot modify the level of contributions of the insured which are fixed by law.
I lyset af ovenstående betragtninger konkluderer Kommissionen, at de anfægtede foranstaltninger ikke udgør statsstøtte i henhold til artikel 107, stk. 1, i traktaten —
Moreover, the scope for quality competition is rather limited since the Slovak compulsory health insurance system foresees a very wide range of statutory benefits which are equal for all insured persons, thus leaving little scope for insurers to compete for clients on the basis of offering additional (gratuitous) entitlements.
VEDTAGET DENNE AFGØRELSE:
Health insurers therefore have no possibility of influence over those statutory benefits and are therefore not in competition with one another or as regards the grant of the obligatory statutory benefits in respect of healthcare which constitutes their main function.
Artikel 1
Third, the Commission considers the non-economic nature of the activity of compulsory health insurance not to be affected by the fact that health insurance companies engage in quality competition and procurement efficiency competition by buying healthcare and related services of good quality from providers at competitive prices.
Følgende foranstaltninger, som Den Slovakiske Republik har iværksat til fordel for Spoločná zdravotná poisťovňa, a. s.
In this way, the insurance companies, through an activity severable from their contracts with the insured persons within the compulsory health insurance procure the inputs necessary to fulfil their role within that system.
(SZP) og/eller Všeobecná zdravotná poisťovňa, a. s.
It follows from the case-law of the CJEU that if the system of compulsory health insurance is due to its inherent features of a non-economic nature, then the activity of procuring inputs necessary to run this system is likewise of a non-economic nature [61].
(VZP), udgør ikke statsstøtte i henhold til artikel 107, stk. 1, i traktaten:
Fourth, the fact that the regulation of compulsory health insurance in Slovakia allows health insurers to make profits and to distribute some profits to their shareholders does not change the non-economic nature of their activities since they are performed in a system which has a strong presence of all the abovementioned features indicating the non-economic nature.
kapitalforøgelsen i SZP på 450 mio. SKK foretaget mellem den 28. november 2005 og den 18. januar 2006
The mere fact that health insurers are allowed to make profits and to distribute some profits cannot in itself overturn the predominance of the system's social features and objectives, the central role of the solidarity principle in it and the tight degree of State regulation and supervision under which it operates.
Veritel 'a. s.' betaling af SZP's gæld fra 2003 til 2006
With regard to that State regulation, the Commission recalls that the possibility to make, use and distribute profits is framed and limited by legal obligations imposed by the State on the Slovak insurance companies designed to ensure the viability and continuity of compulsory health insurance with all its predominant social and solidarity objectives [62].
tilskuddet til SZP fra sundhedsministeriet i 2006
The freedom to make, use and distribute profits is therefore significantly more restricted in the sector of Slovak compulsory health insurance than in normal commercial sectors and subjected to the attainment of social and solidarity objectives.
kapitalforøgelsen i VZP på 65,1 mio. EUR den 1. januar 2010
As a result, due to the limited nature of competition that was introduced into the Slovak compulsory health insurance system (i.e. only limited quality competition and no price competition at all) as well as the restrictions on the way profits can be made and used, the elements of competition and profit-orientation which are present in the Slovak system of compulsory health insurance do not call into question the predominant social, solidarity and regulatory features indicating the non-economic nature of the activities performed by health insurance companies in that system.
risikoudligningsordningen, som blev oprettet ved del 3 i lov nr. 580/2004, og
Rather, the elements of competition and profit-orientation present in the Slovak system of compulsory health insurance should be considered to pursue the prime objective of encouraging the insurance companies to operate in accordance with the principles of sound management in the interest of a proper functioning of that social security system, thereby contributing to ensure that the social and solidarity objectives of that system are attained [63].
overførslen af kundeporteføljer fra afviklede sundhedsforsikringsselskaber, særlig fra selskabet Družstevná zdravotná poisťovňa til VZP og fra selskabet Európská zdravotná poisťovňa til SZP.
Finally, the Commission considers that the fact that the Slovak Constitutional Court (when assessing a possible violation of the right under the Slovak Constitution to conduct a business) considered the Slovak compulsory health insurance system to be ‘included in the realm of competition’ does not mean that this system involves activities of an economic nature within the meaning of the State aid rules.
Artikel 2
In fact, in that case the Slovak Constitutional Court was asked to review whether the 2007 legislative ban on profit distribution by health insurance companies was compatible with the Slovak Constitution (violation of the right of ownership, protection of property and right to conduct a business) and compatible with Articles 18, 49, 54 and 63 of the Treaty.
Denne afgørelse er rettet til Den Slovakiske Republik.
The Slovak Constitutional Court decided that this ban violated the Slovak Constitution, and that therefore there was no reason to discuss the substantive elements of the EU internal market rules or to rule on their violation.
Udfærdiget i Bruxelles, den 15. oktober 2014.
Against this background, taking account of the particularities of the current case and the presence and weighting of the relevant indicators, the activity of compulsory health insurance as organised and carried out in Slovakia cannot be considered as an economic activity.
På Kommissionens vegne
In light of the above, the Commission concludes that SZP/VZP, as the recipients of the contested measures, cannot be considered to constitute undertakings within the meaning of Article 107(1) of the Treaty and thus that those measures do not give rise to State aid within the meaning of that provision.
Næstformand
Therefore, there is no need to examine the other conditions for the existence of State aid within the meaning of Article 107(1) TFEU nor to assess the compatibility of the contested measures.
EUT C 278 af 26.9.2013, s. 28.
CONCLUSION
Se fodnote 1.
In light of the above considerations, the Commission concludes that the contested measures do not constitute State aid within the meaning of Article 107(1) of the Treaty,
Se også 2004-rapporten, Hlavačka S, Wágner R, Riesberg A., »Health care systems in transition: Slovakia« (vol. 6, nr. 10 2004), s. 36 ff., udgivet af European Observatory on Health Systems and Policies (findes på http://www.euro.who.int/__data/assets/pdf_file/0007/95938/E85396.pdf), særlig s. 99.
HAS ADOPTED THIS DECISION:
I henhold til § 3 i lov nr. 580/2004 skal en fysisk person, der har permanent ophold i Den Slovakiske Republik, være forsikret under det offentlige sundhedsforsikringssystem.
Article 1
Loven indeholder en række undtagelser, men kun for personer, der har en sundhedsforsikring i et andet land.
The following measures granted by the Slovak Republic to Spoločná zdravotná poisťovňa, a. s.
I § 3 fastsættes det ligeledes, hvilke personer der skal være forsikret under det offentlige sundhedsforsikringssystem, også selv om de ikke har permanent ophold i Den Slovakiske Republik.
(SZP) and/or Všeobecná zdravotná poisťovňa, a. s.
I denne afgørelse bruges termen »slovakisk indbygger« om alle personer, der skal være forsikret under det offentlige sundhedsforsikringssystem.
(VZP) do not constitute aid within the meaning of Article 107(1) of the Treaty:
Se også 2011-rapporten, Szalay T, Pažitný P, Szalayová A, Frisová S, Morvay K, Petrovič M og van Ginneken E., »Slovakia: Health system review.
the capital increase in SZP of SKK 450 million made between 28 November 2005 and 18 January 2006;
Health Systems in Transition« (vol. 13, nr. 2 2011), udgivet af European Observatory on Health Systems and Policies (findes på http://www.euro.who.int/__data/assets/pdf_file/0004/140593/e94972.pdf), s. 78.
the discharge of SZP's debts through Veritel' a. s.. from 2003 to 2006;