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Health Care Policy in Poland – part II

The research shows that over a span of a dozen or so years public expenses on health care have been reduced, and the considerable part of health care costs increase falls to private income – a significant influence on such situation, except for contributions increase, have had privatised stomatology and constant increase in drug prices, which are higher in Poland than in most other European countries.

Function of Polish health care system still leaves much to be desired. The number of medical staff falling to 1000 citizens is insignificant (lower than in most European countries such as: Germany, Denmark, France, Sweden). Health service, except for staff shortage, suffers from insufficient supply of devices for clinical diagnosis as well as advanced device for medical treatment. Deficit in health care system finances increases debt of health care institutions, especially hospitals. Medical professionals who gain low remuneration go on strike (wave of strikes in 2007), part of them take a job in other countries of aging Europe, where demand on their work goes up, and as a result of this their pay increases.

The National Development Plan for 2007-2013 does not however provide any assurance of a growth in financial resources on public health care. It is supposed that authorities are willing to transfer part of their competence to non-governmental or voluntary institutions, whereas a plan to gain financial resources on health care would be based on an idea of charity actions like The Great Orchestra of Christmas Charity (Wielka Orkiestra Świątecznej Pomocy). The total amount of money collected during such actions, publicised by the most popular mass media, does not exceed 0,1 percent of National Health Fund’s annual income. Still it sometimes seems that government’s policy should be replaced by a free financial support provided by private subjects, depending on their goodwill. Solving any social problems would be transferred from a public organization to other units. This way even the poorest citizens cannot count on government’s support, but a mercy of those in a good financial situation, who dispose with financial resources (Szumlewicz, 2008).

For a few years it has been socially and politically debated to transform health care institutions into partnerships (without their liquidation). This is an issue currently known in mass media as ‘public health care privatisation’ – the buck passed by candidates for the president election to each other.  

Every independent public health care institution would be transformed into a company running a health care institution. A newly established company would take over all rights and duties of a previous independent public health care institution (SP ZOZ) on the day of transformation. Within that day employees of a transformed SP ZOZ would become, by the law, employees of a company. Employment relations of the previously appointed employees would expire then as well. The first board of the company would be appointed for a year at most.

The Act on Health Care Institutions which states that a company into which a health care institution is transformed, can run an economic activity other than running a health care institution in case that activity does not restrict access to health care services provided in that institution, is questionable. In the days of such a difficult financial situation of many hospitals and their considerable debt, giving them such possibility is for sure a great opportunity for a health care institution. However this may bring a danger of commercialisation in fields different than health care. There can be commercial institutions established on the hospital’s premises in order to gain profit.

The other doubtful issue is the concept of the three groups of benefits: guaranteed and other – including proposals for ‘health benefit basket’ (register of guaranteed and non-guaranteed benefits), which is found in the project of Act on Health Care Benefits Financed from Public Funds of 2004 (Journal of Acts, No. 210, item 2135) and was discussed in 2008. A question arises, is it a fair solution, which may lead to patients’ classification into citizens of 1st and 2nd category, depending on the package of insurance policies they purchased.

Transformation of the health care system is definitely necessary. What is more its function should be efficient to a greater extent than nowadays. This is related above all to the solutions concerning system financing, which as follows concerns the problems of the government’s welfare (or not) function.


Julia Siemińska


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