TCS Daily

Sick Leave

By Kamila Pajer - August 26, 2004 12:00 AM

The Polish Parliament didn't get a holiday this year. Normally in the summertime, deputies would be relaxing on beautiful beaches in exotic countries. But this year they have to pass a new bill on the public health care system as the previous piece of legislation proved to be unconstitutional.

In January the Polish Constitutional Tribunal decided that the act establishing the National Health Fund (NHF) just a year earlier was full of mistakes. The tribunal found that the regulations on organization, financing and control over the NHF are unconstitutional and therefore ruled that the new act should be rectified by the end of this year.

However, the new project seems to be controversial, too. In mid-August the Senate voted down 203 amendments to the project previously worked over in the Sejm, or lower house of parliament. The Senate re-established privileges for high representatives of government, their families and diplomats in access to the public health care institutions previously taken away by the deputies in the Sejm. They also decided that contraceptives should be refunded, priests should pay health insurance for themselves, and that the amount of money people pay for health insurance will be greater next year than presently.

They did not vote to convert the public system into a private one, even though the latest poll carried out by PENTOR shows that the majority of citizens - about 64 percent of them - support a market-based health care system. The poll also showed that even those who earn little would agree to pay for health care services. PENTOR's survey was commissioned by the National Doctors Trade Union, the association that strongly opposes the new government's project as in their opinion it will not improve the public health care system. The association knows also that many doctors cannot find jobs in Poland.

There are in Poland various interest groups that are unwilling to change anything in the public health care system. There are politicians who want to cash in on the huge amounts of money allocated to health care, following the example of Alexander Nauman - only a year ago the president of the NHF and now a money laundering suspect in an investigation conducted by the Swiss police. There are doctors, influential in society, who are not good professionals and would lose their positions if patients were given more choice. And there are public health care system bureaucrats - huge masses of them in the ministry, the agencies of the NHF around the country and various specialists at universities all remunerated with public money.

That is why the people's voice does not count. Instead, bureaucrats say the only way to ensure that people have access to health care institutions is the public system, as the private one would be too expensive. But would it be really?

As work on new law on public health care system continues in the Parliament, the private health care institutions have announced they are considering introducing cheap health insurance for poorer clients. Research those institutions conducted shows that more than 50 percent of respondents would be willing to pay a bond of about 30 zloty for private services. The bond would allow access to some basic services. The one ensuring access to more services (for example, specialist treatment) would cost about 100 to 200 zloty.

It must be said, however, that on average each month every insured person in Poland already pays some 100 zloty for the public health care - exactly the amount that would allow them to use private services and specialist treatment of high quality. Yet, instead of services that should be competitive with private, they get poor, dirty, badly equipped public hospitals and clinics where doctors and nurses are rude and corrupt, where patients wait for months in queues for examination and surgeries.

Although every person in the country is obliged to pay for health insurance and the amount of money they pay is considered by the private heath care services providers to be enough to ensure even specialist treatment, the Polish health care system is running a deficit. There is no money for medical equipment - not just modern appliances but also the simplest ones. Patients have already grown accustomed to bringing their own food to the hospitals. Lately they do not even get drugs unless their family provides them.

The Polish health care system badly needs a change but none of the parties with a majority in the Parliament understands this. They just want to change as little as possible and go on holidays at last.

Kamila Pajer is a freelance journalist and correspondent from Poland. She is also a contributor and translator for Polish American Foundation for Economic Research and Education.


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