On 13 December 2016, the Polish Insurance Association organised a scientific and training conference under the title of “Current principles of financing medical procedures, including rehabilitation, within the public healthcare system. Indications for rehabilitation treatment in the private system”. The conference had been prepared with employees of insurance companies dealing with adjustment of claims due to personal injuries in mind, and constituted a compendium of knowledge for them.
The conference was opened by Dorota M. Fal, adviser to the Management Board of PIU, who discussed how the healthcare system operates in Poland, along with issues relating to public healthcare as well as the scope and principles of access to the benefits financed from public sources. The issue of patient queues to healthcare services was also addressed, with particular focus on orthopaedic and rehabilitation procedures as well as contracts between medical facilities and the National Health Fund (NFZ). In her conclusion, Dorota M. Fal indicated that although health is of the highest value for Poles, the public healthcare system is affected by a deepening financial gap, which actually limits patients’ access to guaranteed benefits.
The types of post-accident rehabilitation was discussed by Professor Anna Wilmowska-Pietruszyńska, MD, PhD, the Chairperson of the Polish Society for Medical Certification, who emphasized the importance of medical, social and professional rehabilitation in the return of the injured to health and daily life. The Professor also discussed the way of financing and functioning of the aforesaid rehabilitation in Poland as well as the sources of its financing. Then she outlined the principles of functioning of rehabilitation in other countries on the example of Germany. It was pointed out that support to victims of accidents, examination of their fitness for work and financial support are extremely valuable. Finally, it was emphasized that rehabilitation of the injured was an investment, which undoubtedly brings better effects if it is started as soon as possible – preferably just after the accident.
The floor was also taken by Professor Krystyna Księżopolska-Orłowska, MD, PhD, the national consultant in the field of medical rehabilitation, who discussed the importance of rehabilitation in reducing the disability rating and raised the issue of rehabilitation standards existing in Poland. Professor Księżopolska highlighted the significance of rehabilitation specialists establishing a special plan of treatment and rehabilitation for post-accident patients and the importance of access to treatment and rehabilitation in Poland. The issue of standards applied in long-term rehabilitation was also addressed. The key point of the lecture was the firm statement that the worst possible scenario is a loss of self-dependence by the injured. That’s why rehabilitation should be perceived in compensation categories where one function is replaced by others, using the available capacities of the injured. The aim of the above is to optimise the accident victim’s participation in professional and social life.
During the next part of the meeting, the floor was taken by Joanna Bugajska, MD, PhD, Head of the Department of Ergonomics of the Central Institute for Labour Protection – National Research Institute, who discussed the indications for treatment and rehabilitation of accident victims. On the basis of the project being implemented by the Central Institute for Labour Protection (CIOP) in cooperation with the Social Insurance Institution (ZUS), it was presented what proper post-accident rehabilitation should look like. The advantages of rehabilitation and threats relating to its lack were also presented. Persons participating in the pilot programme of early comprehensive rehabilitation were presented as case studies on the basis of own experience. Lecturers also indicated the importance and possibilities of vocational rehabilitation in Poland and the necessity to treat this issue in a comprehensive manner.
The conference culminated with the lecture of Łukasz Wilma, Attorney, who, from the prospect of resolution of the Supreme Court of 19 May 2016 on the costs of treatment and rehabilitation, presented the procedural approach and the potential rationale of covering the costs of private treatment by insurance companies in the light of judicial decisions. Mr Wilma emphasised that a key term was the principle of full compensation of damage, and a determinant of the scope of compensation is a causal link between the event entailing liability and the consequences. What is important, in the lecturer’s opinion, is that the postulate of natural restitution should be a reference point. Attention was drawn also to the burden of proof, which is distributed between both parties.