20 December 2010

The public, as well as the non-public hospitals have nowadays the right to cooperate with private insurers apart from the agreement with the National Health Fund. Commercial agreements of this kind would help to reduce the queues and would provide the system of health care with additional money. The problem is that not all of the health care institutions and their owners know that they are entitled to such cooperation.

According to the data of the National Health Fund, today 650 thousand people are waiting to be admitted to hospitals and to undergo operations. At the same time, only 70 percent of the rooms which are available to the patients are used. Why, despite free rooms, are the queues longer year by year? – It needs to be clearly stated that the long waiting does not result from too low number of doctors or the lack of rooms for the patients. In Poland, we do not talk about the queues for procedures; these are the queues for public money – says Paweł Kalbarczyk, the chairman of the Health and Accident Insurance Committee of the Polish Insurance Association.

This “queue for money” results from the current form of the health care system in which all the Polish hospitals must cooperate with one system payer – the National Health Fund. Every operation performed over the limit set by the Fund means that a given hospital is indebted. Consequently, the health care institutions, despite the fact that they could perform many more operations, must stick to the limits set by the agreement with the National Health Fund. – The only solution to this problem is the private hospital insurance. The hospitals would use its potential by providing commercial services whose costs cannot be covered by the National Health Fund. Such cooperation means not only providing the health care system with additional money, but also the fulfilment of the public service, that is providing high standard of services to all those who need it – says Paweł Kalbarczyk. 

It results from the analyses carried out by the reputable law office – Domański Zakrzewski Palinka – that every health care institution has a right to render commercial services in cooperation with insurers; regardless of the fact whether it is a public institution or a non-public one.
Non-public institutions are run by independent entrepreneurs or self-government companies and they have a right to freely determine the entities with which they want to cooperate and the conditions of this cooperation. There is a slightly different situation in case of public institutions which are established by self-governments. – The justification for public institutions to conclude the same agreements as the non-public ones is, among others, the political task of self-governments concerning the recognition and determination of health needs found within the governed area of the self-government which are not fulfilled due to the lack of possibilities to be financed by the National Health Fund. The concluding of agreements with insurers is nothing else but the fulfilment of such needs – explains Dr Marcin Matczak, a partner in the Domański Zakrzewski Palinka law office. Furthermore, the legislator, in the regulations on the health care institutions, directly allowed for the public institutions to conclude agreements with private insurers.

The representatives of the Polish Insurance Association stress that a great part of self-governments and public institutions is not aware of the right to conclude agreements with commercial partners. Making them aware of this possibility is a benefit for all the entities operating on the health care market. It results from the estimates of the Association that the widespread hospital insurance means – for the health care system – additional PLN 300,000,000 within the first five years. It is several dozen thousand more operations per year and quicker reduction of queues; and there is no need to raise the compulsory health insurance fees. The private hospital policies will help to reduce the range of the greatest absurdity which is functioning in the current system – limits on the planned operations and the growing queues for these operations.

It is not enough to raise the awareness to propagate the insurance. Poland is probably the only country in the EU where there is no notion of private health insurance in the regulations of law. Furthermore, the regulations do not provide any tax reliefs or exemptions connected with the concluding of an agreement of private health insurance. Such reliefs have already been implemented in two thirds of the countries which are the members of the EU. – Without a clear definition, in the regulations of law, of private health insurance, without determining the roles of particular entities in such a system and without incentives which allow for the development of private insurance, we can expect, in Poland, only longer queues for operations and still lower standard of the rendered services – claims Paweł Kalbarczyk.

The press information
The presentation of Paweł Kalbarczyk
The presentation of Dr Marcin Matczak