The system relies heavily on employer contributions, but demographic trends (ageing, emigration) reduce revenues and undermine fiscal stability. Key challenges include: lack of clearly defined entitlements, moral hazard (overuse of services), employer arrears in contributions, and inconsistencies in state budget transfers. Comparisons with the Netherlands and Czechia show the need for more efficient financing models and stronger patient participation. AmCham recommends: stricter control of contribution collection, clear definition of entitlements and costs, increased patient co-payments, introduction of minimum and maximum contribution bases, greater transparency, and in the long term, shifting part of the burden from employers to employees while adjusting income tax to maintain net wages. The goal is to ensure financial stability, improve accessibility and efficiency of healthcare, and strengthen the competitiveness of Croatia’s labor market.