Prospects for the development of health insurance – the different scenarios

Last year the Poles spent more than 25 billion PLN for health care from their own pocket. According to forecasts made by the Polish Insurance Association by the beginning of 2012 level of these expenses will have increased to 40 billion PLN. Meanwhile, the revenue from health insurance policies is only 120-150 million PLN, representing only 0.5 – 0.6 percent of private expenses on health services. What is the future of health insurance in Poland? Will it develop for the benefit of patients? PIU representatives outlined three possible scenarios for the development of health policy in Poland until 2012.

Scenario I – Status Quo

In this scenario, there won’t be any fundamental changes on the Polish market concerning medical services in the next three years. Subscription companies still continue to benefit from tax advantages (ie, sell most of their services as occupational medicine, even though the reality is different), and insurers can count only on organic growth at a rate close to the present. In this scenario, in 2012 on the Polish market there will be 120-150 thousand hospital products – mainly insurance. They give you access to limited public system benefits and increased surgical and accommodation standard and certain procedures, which are already of commercial interest (eg, childbirth).
Subscription companies will continue to focus on outpatient services. Hospital products will be included only in the most expensive offers, available for a limited group of customers. They will also lead the distribution of hospital insurance or insurance companies related by capital.

Prospects for consumers:

• increase of the queues to specialists in the subscription companies
• lack of universal hospital insurance =  expensive hospital services (available in the ffs system and by insurance)
• State budget losses resulted from continuing tax preference for companies
• lack of proper supervision of subscription insurance companies continuing their business without a license

Scenario II – equalization of the laws of subscription companies and insurers

This scenario is based on the assumption that the legislature will  determine exactly what is health insurance. In this case, insurance companies, in collaboration with medical companies would be responsible for the offer and the range of available benefits within the insurance policies, selling policies an a professional risk, wheres medical companies for the provision of medical services, and therefore the implementation of the service. In such scenario, in Poland, a rapid development of health insurance is noticed, both ambulatory and hospital. This will happen primarily through the so-called ‘polisowanie’ of the subscription and extension of the offer to existing customers to hospital insurance.

Prospects for consumers:

• shorter queues for specialists and medical services (outpatient and hospital)
• more popular products, hospital offers opportunities for lower price, and thus greater availability
• all activities in health insurance (legal and on the border of law) is under a united supervision
• development of private health insurance hospital increases the pool of resources available in the entire health care system and discharges queues in the public system

Scenario III – legislative changes promoting voluntary hospital insurance

According to recent announcements of the Ministry of Health, the customers who opted for voluntary hospital policy, in return, receive tax allowance. At the same time subscription companies continue to benefit from their allowances. It has a positive effect on the rate of development of health insurance in Poland, which has gained a bigger interest than subscription insurance. By 2012 the market will have had at least half a million such policies, which means the premium of 0.6 – 1 billion PLN. The vast majority of the money (though not all at once) supplies the health care system – that is, mainly hospitals.

Prospects for consumers:

• the growing prevalence of hospital insurance = lower price
• a clearly defined co-operation of medical and insurance companies in the field of hospital products, but still uneven competition in the market for outpatient services
• for clients of insurance companies the same or shorter queues due to transition to insurance contracts
• all hospital services offered by insurance companies are under appropriate supervision

Basic features favoring the subscription companies today:

• signing most contracts as occupational health services, although this is not true
• lack of supervision of insurance services operating without a license
• no need to meet the same capital requirements and financial security services, which must met by the insurance companies

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