1 October 2012

During the panel discussion organised by PIU and Ernst & Young advisory company at the Healthcare System Forum, part of the Economic forum in Krynica-Zdrój, the Ministry of Health confirmed commencement of work on the parliament’s bill on additional health insurance systems. Changes are also planned in the NFZ (the National Health Fund), which is the public payer system. The above will constitute first steps in the process of increasing the effectiveness of healthcare system financing methods. Competition of payers is one proposal that will be taken into account as a means of long-term perspective direction shift.

On September 5, a debate “Competition of Payers as a Way of Improving Healthcare System” was held at the Healthcare Forum as part of the Economic Forum in Krynica-Zdrój. Panel participants discussed the existing healthcare model in Poland, which is based on one public payer, mainly NFZ. Public calls for the change of the above have been an ongoing issue. One of the speakers in the discussion, Jan Krzysztof Bielecki, Chairman of the Economic Advisory Council to the Prime Minister of Poland, underlined that he sees no return to state budget financing of the healthcare system and that it’s essential to continue works aiming at establishing a rational attitude to healthcare system financing taking into account cost analysis and implementation of mechanisms which have already been successfully implemented in other sectors of the economy.

“One of the ways to improve the quality and increase the effectiveness of healthcare proposed by, among many, insurance industry is introduction of the competition of payers. The idea of competition, as opposed to one public payer system, assumes that each person will have the possibility of choosing whether their mandatory healthcare contribution will be paid to the public payer or to one of the private payers. Competing payers will have to attract patients, which will hopefully result in more effective management of financial means and improvement of the service offered. All this, of course, with respect of the rules of social solidarity and equal access to healthcare service” – said Dorota M. Fal, advisor of PIU management board, who led the discussion during the Forum in Krynica.

Experts agreed that competition of payers could be a step in the right direction therefore a discussion concerning this issue is necessary. Ministry of Health declared introduction of changes in the public payer system in the near future. At the same time representatives of the Ministry stated that passing a bill on additional health insurances quickly as well as improving the organisation of insurance market processes is vital as it will give insurance providers a chance to gain experience in financing healthcare in Poland. Jan Grzegorz Prądzyński, President of the Board of the Polish Chamber of Insurance, stressed that insurance providers already posses the knowledge, competences and experience of the international markets necessary for the cause and that they have proved effective in numerous healthcare systems as payers.

“We have already made the first step leading to greater, evolutionary changes of the system by commencing work on the bill on additional health insurances” – said Sławomir Neumann, Secretary of State at the Ministry of Health. However, Johan Hjerqvist, President of Health Consumer Powerhouse, a company analysing healthcare systems throughout Europe, pointed to the fact that works on the reform of financing solutions for Polish healthcare system have been in progress for over 20 years and it is the lack of brave decisions that still ranks Poland at the bottom of European healthcare system evaluation rankings.
Panel participants agreed that challenges awaiting Poland in connection with inevitable demographical changes force quicker implementation of healthcare system reforms. ”Today, the average cost of medical treatment of a patient over 65 years old is almost six times higher than the cost of treatment of people aged 26 to 30, with the number of the former to double in 2060. That is why the only way to achieve success in this field is to start introducing changes today. Otherwise, to cover the current scope of healthcare needs of the future society we will need 0.9% of GDP more as early as in 2020 with long-term prediction showing an increase to 2.6% of GDP in 2060” – concluded Dorota M. Fal
Summing up the panel, its participants expressed hope that the Ministry of Health would soon lead the healthcare sector into a better direction and that works of the government will reflect results of meetings held here in Krynica.

The second panel which took place on 6 September was devoted to different ways of financing healthcare. The system requires changes with choosing the effective financing model being one of the crucial elements of the reform. Participants of the panel entitled “Financing of healthcare – interministerial challenges” organised by PIU and Ernst&Young agreed that the current public payer system is unable to provide healthcare service within the scope and standard required by all patients. Jakub Szulc, MP and former Deputy Minister of Health, claimed that the system in its current shape will not “provide everyone with everything on 100% level.” For this reason, among others, Polish citizens currently spend over PLN 30 billion on healthcare services, medicine and parapharmaceuticals each year. The problem is that this money is spent in a dramatically ineffective way as only 300 million of this amount is dedicated to health insurance. Sławomir Neumann, Deputy Health Minister, once again announced implementation of the bill on additional health insurances. He admitted that without appropriate legal regulations insurance companies will remain overly cautious about entering this new market. Dorota M. Fal, health insurance advisor of PIU management board, said that private insurances are very flexible and therefore can improve the standard of healthcare service and facilitate access to it while remaining fully compatible in their shape and scope with the requirements of the public system.
At the same time experts underlined the fact that all proposed solutions will rule no-one out of the system as they are all based on the rule of social solidarity. Panel participants also talked about the role of other Ministries in the process of developing effective health protection system and the so-called alternative costs related to the healthcare system, i.e. the cost of sick leaves and disability pensions.