After the analysis of the additional health insurance bill presented by the Ministry of Health, the Polish Insurance Association submitted to the Ministry its own proposal of the bill. According to the Association, the Ministry correctly evaluates the needs of the Polish health system. However, the proposed provisions do not fulfill the assumptions and goals presented in the justification of the bill. The bill of the Polish Insurance Association is based on the same assumptions and goals and the basic differences consist in the manner of fulfillment of these assumptions and goals which is based on providing more precise definitions of a private health insurer and the relationships between the National Health Fund (NFZ), insurers and entities providing services.
The additional health insurance act of the Ministry of Health was to be an opportunity to ‘heal’ the Polish health care system. The development of this solution, which is universally applied throughout Europe, would make it possible to have quick access to health services especially for those who cannot afford commercial health services. According to the Polish Insurance Association, the bill of the Ministry, presented in March, does not fulfill this goal. Eminent experts on law, insurance, social politics and health protection are of the same opinion as the Polish Insurance Association. These are prof. Michał Kulesza, a partner of the Domański Zakrzewski Palinka law office, prof. Tadeusz Szumlicz of the Warsaw School of Economics and Marek Wójcik, an expert on health protection of the Association of Polish Districts. They also believe that the provisions of the act proposed by the Ministry have serious legal and system defects.
– We appreciate the fact that the Ministry of Health has taken steps to regulate the additional health insurance market. However ,the act does not provide for comprehensive solutions and without any changes might become unfavorable to Polish patients and hospitals. That is why we have prepared a bill with our own provisions – said Jan Grzegorz Prądzyński, president of the board of the Polish Insurance Association.
The solutions presented by the Ministry of Health and approved by the Polish Insurance Association include, among others: the opportunity to include occupational health care services in private health insurance and the proposition to finance premiums from company social benefit schemes. The above-mentioned provisions were also included in the bill presented by the Polish Insurance Association.
However, the Association does not approve of the ambiguous definition of additional health insurance and the provisions specifying the role of the National Health Fund in the planned system. The Polish Insurance Association, in its bill, proposed a more precise definition which leaves no doubt about the nature of health insurance and the role of payers in the system. The definition of the Polish Insurance Association also makes it more precise that the additional health insurance might be offered both by life insurers and property insurers.
The bill of the Polish Insurance Association specifies that the National Health Fund is a public payer. It also balances the relationships between the Fund, insurers and service providers who work for private and public taxpayers. According to the Association, the provision of the Ministry of Health which gives the Fund power to control and interfere in contracts between insurers and service providers is contradictory to the passive role of the National Health Fund as a payer. The provisions proposed by the Polish Insurance Association clearly specify mutual relationships of all the participants of the system. The activity of insurers is controlled by relevant institutions (Polish Financial Supervision Authority), the Fund takes care of the performance of contracts on services financed from public funds concluded by the Fund. Health institutions which concluded a contract with the National Health Fund are obliged to regularly provide the Fund with information on patients awaiting health care services; and this is emphasized by both the Ministry of Health and the Polish Insurance Association. Such provisions protect the rights of patients who only use services financed from public funds.
In accordance with the opinion of prof. Michał Kulesza, one of the most valued law authorities in Poland, there are no doubts of constitutional nature as to the implementation of additional, private health insurance in Poland. However, there are serious doubts of legal nature as to certain provisions of the bill of the Ministry.
The additional health insurance bill of the Polish Insurance Association has been submitted to the Ministry of Health. – Additional health insurance is a solution which the Polish health system needs very much. However, in order for patients to have quicker and better access to services, the law must be transparent and precise. I hope that the Ministry of Health is willing to hold a discussion with us and will accept the changes in the provisions proposed by the Polish Insurance Association – said Jan Grzegorz Prądzyński.