Health insurance will heal the health care system

The participants of the panel concurred that the basic question about health insurance is not “whether to introduce it” but “of what type?” and “when?” — the health care system must be reformed and must become effective. The act on additional health insurance is prepared and will be passed shortly after the parliamentary elections. It is necessary to work out a definition of additional health insurance, to determine the relations between service providers and NFZ (the National Health Fund) and to safeguard patients’ rights — said Jakub Szulc, Deputy Minister of Health.

Representatives of PIU (the Polish Insurance Association) pointed out that there is a large group of Polish citizens who are prepared to pay an additional, voluntary health insurance premium in exchange for a better quality and availability of medical procedures. — Additional insurance must be a part of the system. This would be beneficial not only to patients, but also to service providers and the state. However, in order for this to become a reality, we need appropriate regulations. That is why I am calling for the Ministry of Health to act with courage — said Jan Grzegorz Prądzyński, President of PIU Management Board.

The participants emphasised the fact that a lack of legal regulations is the main reason for the underdevelopment of the Polish health insurance market. Consequently, even though Poles spend over PLN 30 billion yearly on services and medication provided by the private sector, insurance constitutes only ca PLN 160 million out of this amount. — A joint partnership initiative of INFARMA and PIU is a response to the lack of statutory regulations connected with private health insurance and with the recently-passed act on reimbursement of medicinal products. The freezing of spending on pharmaceuticals at the current level and the fixing of official prices and margins resulted in the creation of space for insurance products associated with the reimbursement of medicines — said Paweł Sztwiertnia, CEO of INFARMA.

Paweł Kalbarczyk, Board Advisor at PIU and the debate’s chairman, underscored the fact that currently 95 percent of private spending on health care comes directly from patients’ pockets, which is highly ineffective. — The only solution that makes sense is the institutionalised purchase of services —emphasised Jan Grzegorz Prądzyński.

According to the participants of the panel, the reform should be divided into three stages. The first one would consist in introducing additional insurance and generating competition between service providers. Another task should lie in the elaboration of a detailed basket of guaranteed medical services. — The state is giving rise to a situation where it promises almost everything but is unable to deliver on its promises — said Marcin Matczak, PhD, partner at the Domański Zakrzewski Palinka legal firm.

According to Professor Tadeusz Szumlicz, the development of an Additional Health Insurance market would be aided a great deal by a tax relief for people taking on the additional insurance. — If the state is unable to provide social security, then it should not tax private expenditures — pointed out Professor Szumlicz.
The third and final stage of the health system reform should be the emergence of full competition among payers — public and private ones.

The panel organised by PIU and INFARMA took place on 8 September 2011. Participants of the panel:
• Jakub Szulc, Secretary of State in the Ministry of Health
• Marcin Matczak, PhD, Partner at the Domański Zakrzewski Palinka legal firm
• Professor Tadeusz Szumlicz, PhD, Warsaw School of Economics, Medical University of Łódź
• Krzysztof Łanda, PhD, Chairman of the Watch Health Care Foundation
• Jan Grzegorz Prądzyński, President of PIU’s Board
• Paweł Sztwiertnia, CEO of INFARMA

The debate was chaired by Paweł Kalbarczyk, Board Advisor at PIU.

Additionally, during the panel a study was shown which is the first Polish work to provide a detailed description of the Polish health care system as well as the systems of other European countries. The study contains comprehensive data on additional insurance and spending on medical treatment and pharmaceuticals.

The work is a preview of the report of the Polish Insurance Association and the Employers’ Union of Innovative Pharmaceutical Companies INFARMA, entitled “The role of private health insurance in the health care system. Its impact on the availability of services, innovation and medicines” which was prepared by Sequence HC Partners, a research and consultancy company.

The role of private health insurance in the health care system. Its impact on the availability of services, innovation and medicines — key points and recommendations.

The role of private health insurance in the health care system. Its impact on the availability of services, innovation and medicines — key points and recommendations.