natgillin/translations-raw huggingface dataset:
Bemærkningerne til indledningsafgørelsen fra sundhedsforsikringsforeningen, den anden privatejede konkurrent til SZP/VZP, er stort set på linje med bemærkningerne fra Dôvera, idet det hævdes, at SZP og VZP er virksomheder i henhold til artikel 107, stk. 1, i traktaten.
In response to the opening decision, Dôvera, the complainant, provided additional information about the health insurance system and additional argumentation in particular to substantiate its view that SZP/VZP are undertakings subject to competition law and have benefitted from incompatible State aid.
Sundhedsforsikringsforeningen mener, at fem af de seks foranstaltninger, der er beskrevet i afsnit 3 i denne afgørelse, kan opfattes som statsstøtte og er uforenelige med det indre marked.
Dôvera points out that SZP/VZP compete with private health insurance companies offering the same service while seeking profit, referring to its previous submissions on the economic nature of the activity and to recent case-law of the Court [33].
Med hensyn til den sjette foranstaltning, risikoudligningsordningen, hævder sundhedsforsikringsforeningen, at den muligvis opfylder de betingelser, som er fastsat i Altmark-dommen vedrørende kompensation for offentlig tjeneste, eller kan være forenelig med det indre marked i henhold til artikel 106, stk. 2, i traktaten, idet foreningen kræver en mere tilbundsgående undersøgelse af foranstaltningens eventuelle forskelsbehandling til fordel for risikoudligningsordningens nettomodtager, dvs. SZP/VZP.
In this context, Dôvera claims that the several elements presented by the Slovak Republic listed in the opening decision as pointing to the non-economic nature of VZP/SZP activities do not withstand scrutiny.
SUNDHEDSPOLITISK INSTITUT, INEKO OG ZZP
According to Dôvera, the 2004-2005 reform was meant to create a competitive market, which has been recognised and confirmed by the Slovak judiciary (i.e. the Slovak Constitutional Court) as well as the Slovak authorities themselves.
De bemærkninger til indledningsafgørelsen, som de tre øvrige tredjeparter (sundhedspolitisk institut, INEKO og ZZP) fremsendte, understøtter i høj grad klageren Dôveras og sundhedsforsikringsforeningens holdning om, at aktiviteten er økonomisk, og at foranstaltningerne indebærer statsstøtte, idet de giver SZP/VZP en selektiv fordel, og de tre tredjeparter er overbevist om, at sundhedsforsikringsselskaber handler i et konkurrencepræget miljø (idet de bruger forskellige metoder til at tiltrække kunder), og hævder, at staten har behandlet sine statsejede sundhedsforsikringsselskaber fordelagtigt.
In this context, Dôvera also points to the fact that insurers compete for healthcare providers through selective contracting and negotiations on price and quality of services, and it also mentions marketing campaigns by health insurance companies to retain and attract clients.
BEMÆRKNINGER TIL INDLEDNINGSAFGØRELSEN OG TIL DE YDERLIGERE OPLYSNINGER FRA DEN SLOVAKISKE REPUBLIK
Dôvera also denies the exclusively social nature of the system, referring to the possibility for health insurers to make and distribute profits and the willingness of private investors to invest in operators active in the Slovak compulsory health insurance sector.
Den Slovakiske Republik fremsendte sine bemærkninger til indledningsafgørelsen samt til tredjeparternes bemærkninger.
Referring to its previous submissions to the Commission before the opening decision, Dôvera further submits that all measures identified in that decision should be qualified as unlawful aid since all the other elements of Article 107(1) of the Treaty have been fulfilled.
De slovakiske myndigheder fremsendte forklaringer og supplerende argumenter for at underbygge deres holdning om, at det obligatoriske sygesikringssystem ikke er underlagt konkurrencereglerne, da det ikke indebærer nogen økonomisk aktivitet.
In its view, the Slovak Republic cannot be considered to have acted as a market economy investor when increasing SZP's capital in 2006 and VZP's capital in 2010.
Systemet har et socialt formål.
Dôvera also argues that the Slovak Republic discriminated between SZP/VZP and private insurance companies by a more favourable treatment of SZP in the 2003-2005 debt discharge process as well as by the introduction of two new parameters in the RES in 2009 and 2012.
Obligatorisk optagelse for slovakiske indbyggere.
In this respect, it states that the Commission may have been misinformed by the Slovak authorities about the applicable legal framework for that portfolio transfer.
Alle forsikrede er garanteret de samme minimumsydelser.
Dôvera finally argues that the Slovak authorities have failed to demonstrate that the provision of compulsory health insurance is a service of general interest and thereby questions the very basis of an analysis under the Altmark case-law [34] and the Commission's SGEI package.
Bidragene er ikke afhængige af de individuelle ydelser, da de er fastsat ved lov (ingen priskonkurrence).
UNION HEALTH INSURANCE
Forsikringsselskaberne er risikosolidariske (risikoudligningsordningen og de fælles satser).
The observations on the opening decision submitted by Union Health Insurance, the other privately-owned competitor of SZP/VZP, are broadly in line with the comments provided by Dôvera, arguing that SZP and VZP are undertakings within the meaning of Article 107(1) of the Treaty.
Der findes detaljerede lovgivningsmæssige rammer, som er underlagt statens kontrol.
Union Health Insurance submits that five of the six measures described in Section 3 of this Decision qualify as State aid and are incompatible with the internal market.
Alle sundhedsforsikringsselskabers status, rettigheder og forpligtelser er fastsat ved lov.
As regards the sixth measure, the RES, Union Health Insurance claims that it could potentially fulfil the conditions of the Altmark case-law for public service compensation or may be compatible with the internal market under Article 106(2) of the Treaty, requiring further investigation into its potential discriminatory approach in favour of the net recipient of the RES, i.e. SZP/VZP.
Den Slovakiske Republik afviser, at det slovakiske sundhedssystem som følge af de lovgivningsmæssige ændringer i 2005 skulle være blevet et kommercielt system, og hævder, at systemet aldrig er holdt op med at være et offentligt, ikkeøkonomisk system.
HPI, INEKO AND ZZP
Slovakiet henleder endvidere opmærksomheden på, at det slovakiske sundhedsforsikringssystem er en del af den sociale sikringsordning, og henviser til medlemsstaternes ansvar for organisation og levering af sundhedstjenesteydelser i henhold til artikel 168, stk. 7, i traktaten.
The observations on the opening decision submitted by the other three third parties, i.e. HPI, INEKO and ZZP are mainly supportive of the position of the complainant Dôvera and Union Health Insurance that the activity is of an economic nature and the measures involve State aid by providing SZP/VZP with a selective advantage, showing their conviction that health insurers are operating in a competitive environment (by using different ways to attract clients) and claiming that the State has given preferential treatment to its State-owned health insurance companies.
De slovakiske myndigheder oplyser endvidere, at sundhedsforsikringsreformen ikke erstattede offentlig sundhedsforsikring med privat sundhedsforsikring, og at den ikke banede vej for, at private forsikringsselskaber kunne dække en risiko, der var omfattet af den lovbestemte sociale sikringsordning.
COMMENTS ON THE OPENING DECISION AND ADDITIONAL SUBMISSIONS OF THE SLOVAK REPUBLIC
Ifølge Slovakiet var hovedformålet med reformen af sundhedssektoren at opstille nøjagtige regler for håndteringen af finansielle ressourcer, som blev afsat til sundhedsformål, og omorganiseringen pr. 30. september 2005 af alle eksisterende sygekasser til aktieselskaber med klart definerede regnskabsregler syntes at være en hensigtsmæssig måde at opstille disse regler på.
The Slovak Republic submitted its observations on the opening decision and provided comments on the third-party observations.
De slovakiske myndigheder mener, at alle sundhedsforsikringsselskaber i Slovakiet forvalter offentlige midler, som de får tildelt inden for det offentlige sundhedsforsikringssystem.
In their submissions, the Slovak authorities provided clarifications and additional argumentation to strengthen their position that the system of compulsory health insurance is not subject to competition rules as it does not involve an economic activity.
Ifølge de slovakiske myndigheder kan det forhold, at det obligatoriske sygesikringssystem i Slovakiet giver begrænset plads til kvalitetskonkurrence, ses som et element, der opfordrer sundhedsforsikringsselskaberne til at operere økonomisk i henhold til principperne om forsvarlig forvaltning for at opretholde et velfungerende system, men ikke som et element, der kan påvirke den ikkeøkonomiske karakter af sundhedsforsikringssystemet som helhed.
They allege that Slovak compulsory health insurance cannot be qualified as economic pursuant to settled case-law of the Court of Justice [35] in particular for the following reasons:
Alle sundhedsforsikringsselskaber har derfor til opgave at forvalte offentlige midler opkrævet fra offentligheden i overensstemmelse med gældende lovbestemmelser med henblik på midlernes anvendelse til dækning af sundhedsydelser.
The system has a social objective.
indførelse af skat på sundhedsforsikringsselskabers overskud
compulsory enrolment for Slovak residents;
obligatorisk anvendelse af overskud til oprettelse af en reservefond på op til 20 % af den indbetalte selskabskapital (reservefonden må kun anvendes til at dække tab i det pågældende sundhedsforsikringsselskab)
all the insured are guaranteed the same minimum level of benefits;
obligatorisk oprettelse af forsikringsmæssige hensættelser til dækning af planlagte sundhedsydelser for forsikrede på ventelister (hvilket betyder, at sundhedsforsikringsselskaberne ikke kan skabe overskud på bekostning af deres kunder ved at sætte dem på ventelister i stedet for omgående at dække deres sundhedsydelser.
contributions are unrelated to benefits on an individual level, as contributions are fixed by law (no competition on prices);
Dette er afgørende for overholdelsen af almindeligt anerkendte regnskabsstandarder inden for offentlig sundhedsforsikring).
there is risk-solidarity among insurers: RES and community rating.
I denne forbindelse forklarer de slovakiske myndigheder, at da VZP indberettede et overskud, oprettede selskabet en sundhedsydelsesfond til dækning af anvendelsen af sundhedsydelser og finansiering af særligt omkostningskrævende sundhedsydelser, som er omfattet af den offentlige sundhedsforsikring.
There is a detailed regulatory framework, subject to supervision by the State: status, rights and obligations of all health insurance companies are established by law.
I denne forbindelse peger Den Slovakiske Republik endvidere på en yderligere restriktion, som sundhedsforsikringsselskaberne er underlagt, idet de kun kan låne midler i henhold til lov nr. 523/2004 om budgetregler for den offentlige forvaltning med sundhedstilsynsmyndighedens forudgående godkendelse.
The Slovak Republic rebuts the assumption that, as a result of 2005 legislative changes, the Slovak health system changed into a commercial system and claims that the system never lost its public non-economic nature.
De slovakiske myndigheder forklarer ligeledes, at forfatningsdomstolen i 2011 erklærede, at forbuddet mod overskudsudlodning fra 2007 var forfatningsstridigt, da det krænkede ejendomsrettighederne i den slovakiske forfatning, men at den ikke var enig i, at loven om sundhedsforsikringsselskaber indskrænkede de markedsøkonomiske principper.
According to Slovakia, the primary aim of the health sector reform was to set precise rules for dealing with financial resources allocated to health and reorganising, by 30 September 2005, all existing health insurance funds as joint stock companies with clearly defined accounting rules seemed to be an appropriate way of setting those rules.
De påpeger ligeledes, at forfatningsdomstolen i denne henseende bemærkede, at lovgivningen om sundhedsforsikring, som udelukker eller i væsentlig grad begrænser de markedsøkonomiske værktøjers virkning og dermed konkurrencen, er forfatningsmæssigt acceptabel.
The Slovak authorities consider that all health insurers in Slovakia are involved in managing public funds entrusted to them within the public health insurance system.
Ud over deres påstand om, at levering af obligatorisk sygesikring i Slovakiet falder uden for konkurrencereglernes anvendelsesområde, påstår de slovakiske myndigheder, at foranstaltningerne ikke opfylder de øvrige statsstøtteelementer i henhold til artikel 107, stk. 1, i traktaten.
According to the Slovak authorities, the fact that the Slovak compulsory health insurance system allows for a limited degree of competition on quality could be seen as an element that encourages health insurance companies to operate economically in accordance with principles of sound management, in the interests of the proper functioning of the system, but not as an element that could influence the non-economic nature of the health insurance system as a whole.
De hævder i denne forbindelse, at kapitalforøgelserne i 2006 og 2009 ikke var statsstøtte, da de var i overensstemmelse med princippet om den markedsøkonomiske investor.
The Slovak authorities also expla in that the funds accumulated and redistributed within the structure of the Slovak public health insurance system via the health insurance companies are the sum of public health insurance contributions which are mandatory under the law, and are thus part of Slovakia's public finances.
De afviser yderligere, at der fandt uretmæssig forskelsbehandling sted i forbindelse med Veriteľs betaling af gæld, og fastholder, at VZP ikke modtog noget tilskud i 2006, men at der var tale om statens normale betaling af eksisterende uanfægtet gæld.
All health insurance companies are therefore tasked with the management of public funds collected from the public in accordance with relevant legal regulations with a view to their use in the coverage of healthcare.
De slovakiske myndigheder fremlægger yderligere oplysninger om overførslerne af kundeporteføljer fra DZP til VZP og fra EZP til SZP og påstår, at heller ikke disse overførsler gav SZP/VZP nogen selektiv fordel i henhold til artikel 107, stk. 1, i traktaten.
To further support their claim, the Slovak authorities also recall the fact that even after the ban on profit distribution was abolished in 2011, the amending Act No 250/2011 allowed health insurance companies to make a profit only under precisely defined conditions, i.e.:
Endelig fremlægger de yderligere oplysninger om risikoudligningsordningen og forklarer navnlig, hvordan bidragene blev omfordelt (på måneds- og årsbasis) i perioden 2006-2012, og de hævder, at denne foranstaltning heller ikke kan anses for statsstøtte, da den udligner de risici, der er forbundet med systemet som følge af de fælles bidragssatser for alle grupper af forsikrede trods deres varierende risikoprofil.
the introduction of a tax on the profits of health insurance companies;
I de slovakiske myndigheders bemærkninger til indledningsafgørelsen forsvarede de først og fremmest den holdning, at SZP/VZP ikke er virksomheder, da de ikke udøver nogen økonomisk aktivitet, og at foranstaltningerne er i overensstemmelse med princippet om den markedsøkonomiske investor og ikke giver SZP/VZP nogen fordel og altså ikke kan anses for statsstøtte.
the mandatory use of profits to create a reserve fund of up to 20 % of the paid-up registered capital of the insurance company (the reserve fund may be used only to cover losses of that insurance company);
De fandt det derfor ikke nødvendigt at fremsætte argumenter om de påståede støtteforanstaltningers forenelighed.
the mandatory creation of technical provisions to cover the planned healthcare of insured persons on waiting lists (consequently, health insurance companies cannot make a profit at the expense of their clients by placing them on waiting lists instead of promptly covering their healthcare; this is essential for compliance with generally accepted accounting standards in public health insurance).
VURDERING AF FORANSTALTNINGERNE
In this respect, the Slovak authorities explained that, when VZP reported a surplus, it created a healthcare fund to cover the use of healthcare and to finance particularly costly healthcare covered by public health insurance.
Det bestemmes i traktatens artikel 107, stk. 1, at statsstøtte eller støtte, som ydes ved hjælp af statsmidler under enhver tænkelig form, og som fordrejer eller truer med at fordreje konkurrencevilkårene ved at begunstige visse virksomheder eller visse produktioner, er uforenelig med det indre marked, i det omfang den påvirker samhandelen mellem medlemsstaterne.
In addition, in the years in which they reported a surplus, part of the profits of VZP was also allocated to the statutory reserve fund which was subsequently used to reduce accumulated losses.
I henhold til den bestemmelse finder statsstøttereglerne kun anvendelse, når modtageren af støtten er en virksomhed.
Therefore, according to the Slovak authorities, no profit made by a State-owned health insurance company was ever disbursed to shareholders.
I EU-Domstolens retspraksis defineres begrebet »virksomhed« i forbindelse med traktatens artikel 107, stk. 1, som enhver enhed, der udøver en økonomisk aktivitet, uanset dens juridiske status og dens finansieringsmåde [37].
In this context, the Slovak Republic also point to a further restriction on health insurance companies in that they can only borrow funds in accordance with the Act 523/2004 on public administration budgetary rules, subject to prior approval from the HSA.
Klassificeringen af en bestemt enhed som en virksomhed afhænger derfor helt af, om dens aktiviteter er økonomiske eller ikkeøkonomiske.
To further support their claim that the activity of compulsory health insurance does not fall under competition rules, the authorities also draw attention to a 2009 investigation by the Slovak Antimonopoly Office which revealed that the activities by health insurance companies are performed within a system characterised by a high degree of solidarity where healthcare is provided free of charge and the essential elements of such activities are regulated by the State and that, therefore, the activities carried out by health insurance companies in the provision of public health insurance cannot be regarded as an economic activity by undertakings which restricts competition.
Som nævnt i indledningsafgørelsen afhænger spørgsmålet om, hvorvidt foranstaltningerne til fordel for SZP/VZP anses for statsstøtte, derfor i første omgang af, hvorvidt og i hvilket omfang SZP/VZP handler som virksomheder, når de opererer inden for det obligatoriske sygesikringssystem i Slovakiet, og derfor kan opfattes som udøvende en økonomisk aktivitet i henhold til retspraksis.
Hence, according to the Antimonopoly Office, the Slovak Competition Act does not apply to the activities of health insurance companies carried out in the provision of public health insurance [36].
Ifølge Domstolen er en økonomisk aktivitet en aktivitet, der består i at udbyde varer og/eller tjenesteydelser på et givet marked [38].
The Slovak authorities also explain that in 2011, the Constitutional Court declared the ban on profit distribution as from 2007 unconstitutional because it violated Slovak constitutional rights of ownership, but that it did not share the view that the Health Insurance Companies Act restricted the principles of a market economy.
I denne forbindelse kan spørgsmålet om, hvorvidt der findes et marked for visse tjenesteydelser, afhænge af den måde, hvorpå disse tjenesteydelser organiseres og udføres i den pågældende medlemsstat [39].
They also point to the fact that the Constitutional Court further observed, in this regard, that legislation on health insurance excluding or significantly restricting the impact of market-economy tools and hence restricting competition is constitutionally acceptable.
Statsstøttereglerne finder udelukkende anvendelse, når en bestemt aktivitet udøves i et markedsmiljø.
In addition to their claim that the activity of compulsory health insurance in Slovakia falls outside the scope of competition rules, the Slovak authorities claim that the measures do not fulfil the other State aid elements under Article 107(1) of the Treaty.
En og samme tjenesteydelses økonomiske karakter kan derfor variere fra medlemsstat til medlemsstat.
In this context, they claim that the 2006 and 2009 capital injections were not aid as they respected the market economy investor principle.
Derudover kan en bestemt tjenesteydelse som følge af politiske valg eller den økonomiske udvikling klassificeres forskelligt over tid.
They further deny that there was unjustified discriminatory treatment in the debt-discharging process by Veriteľ and maintain that no subsidy was granted to VZP in 2006, but rather that this operation involved a normal payment of existing undisputed liabilities by the State.
Det, der ikke er en markedsaktivitet i dag, kan blive en markedsaktivitet på et senere tidspunkt, og omvendt [40].
The Slovak authorities provide further details on the transfers of portfolios from DZP to VZP and of EZP to SZP and claim that also those transfers did not provide SZP/VZP with a selective advantage under Article 107(1) of the Treaty.
I forbindelse med levering af sundhedsydelser afhænger spørgsmålet om, hvorvidt sundhedssystemerne skal karakteriseres som omfattende en økonomisk aktivitet, af deres politiske og økonomiske karakter og af, hvordan de er tilrettelagt og struktureret i den pågældende medlemsstat.
Finally, they also provide further information on the RES, clarifying in particular how the contributions were redistributed (monthly and annually) in the years 2006 to 2012, and argue that this measure does not qualify as State aid either, as it equalises the risks included in the system due to the existence of uniform contribution rates for all groups of insured persons with varying degrees of risk.
I EU-Domstolens retspraksis sondres der overordnet set mellem ordninger, der er baseret på princippet om solidaritet, og ordninger af økonomisk karakter [41].
The Slovak authorities devoted their comments to the opening decision on defending their position that SZP/VZP, due to the absence of economic activity, are not undertakings and that the measures are compliant with the market economy investor principle and do not provide SZP/VZP with an advantage and, hence, do not involve aid.
EU-Domstolen bruger en række kriterier til at fastslå, om en social sikringsordning er baseret på solidaritet og således ikke omfatter en økonomisk aktivitet.
Therefore, they did not consider it necessary to present any arguments about the compatibility of the alleged aid measures.
En række faktorer kan være relevante i den henseende: i) er tilslutning til ordningen obligatorisk [42], ii) forfølger ordningen et rent socialt formål [43], iii) drives ordningen med vinding for øje [44], iv) er ydelserne uafhængige af de beløb, der er betalt i bidrag [45], v) er størrelsen af de udbetalte ydelser ikke nødvendigvis proportional med forsikredes indkomst [46], og vi) er ordningen undergivet statskontrol [47].
ASSESSMENT OF THE MEASURES
I modsætning til solidaritetsbaserede ordninger er ordninger af økonomisk karakter normalt karakteriseret ved: i) frivillig tilslutning [48], ii) kapitaliseringsprincippet (ydelserne afhænger af de betalte bidrag og ordningens økonomiske resultater) [49], iii) ordningen drives med vinding for øje [50], og iv) ydelser, som supplerer ydelserne i henhold til grundordningen [51].
Article 107, paragraph 1 of the TFEU provides that ‘[…] any aid granted by a Member State or through State resources in any form whatsoever which distorts or threatens to distort competition by favouring certain undertakings or the production of certain goods shall, in so far as it affects trade between Member States, be incompatible with the internal market.’